Limb Weakness and Severe Respiratory Symptoms Reported With the D68 Enterovirus Infection

enterovirusThose who lived in the first half of the 20th century (1900-1950) have clear memories of the polio epidemic.  We have not had a new case of polio acquired in the USA since 1979. The CDC HEALTH ADVISORY September 30th (you can read here… ) reports on nine children with focal limb weakness and MRI abnormalities in the grey mater of their spinal cords.

All children had fevers and cold and cough symptoms in the 2 weeks before they developed limb weakness (weak arms or legs). Of the eight nasal viral cultures, six were positive for enterovirus/rhinovirus and of these six, so far 4 were Enterovirus D68 (EV-D68) with the other two pending.

The US is currently experiencing an outbreak of EV-D68, with 500 cases the past two months in 42 States. Read more here…


States with Lab-confirmed EV‑D68 Infections
States with Enterovirus






From mid-August to October 1, 2014, a total of 500 people in 42 states and the District of Columbia have been confirmed to have respiratory illness caused by EV-D68. Learn more about states with confirmed cases here…

Enterovirus D68 was recently associated with increased respiratory symptoms and has been causing fever, runny nose, cough, and body aches, but also triggering severe asthma with difficulty breathing.  While we have had no confirmed cases in Oregon, we had a patient in my office with known asthma hospitalized yesterday (October 1) who fit this pattern.

Infection spreads from saliva, nasal secretions, sputum, and droplets from sneezing or cough. Enterovirus infections (there are over 100 different kinds of enteroviruses) are usually in the summer and fall.  The younger you are, the less likely you are to have immunity against enteroviruses.  Those with asthma are particularly at risk of more severe symptoms.  If your child seems to be working hard to breathe, struggling for air, or coughing way more than usual, please have them evaluated.

As of October 1st, 2014, while 4 people who have died were found to be positive for EV-D68, it is unclear whether or not it was the actual cause of death.

Treatment is supportive. Nasal/throat swabs can be sent to the CDC for EV-D58 testing in those children sick enough to need hospitalization, or those showing limb paralysis symptoms.


Prevention is the key.  WHAT CAN YOU DO TO AVOID INFECTION?

  1.  Good hand washing, especially after using bathrooms, changing diapers, touching contaminated surfaces.
  2.  Avoid touching your nose, mouth, or eyes with unwashed hands.
  3.  Don’t share food that has touched another person’s hands or lips, or share drinks or eating utensils.
  4.  Disinfect toys, door knobs and frequently touched surfaces.


Dr. Paul





  • Dr. Thomas, thank you for the post. I am a little confused by the introduction of the post with Polio and how this tracks to the EV-D68. I tried to read the health advisory which I assume explains it — but could not untangle the content. My apologies if I am missing something, but really want to understand.

  • Polio is a virus that caused limb paralysis – hence the comparison. Only there for perspective. The blog was meant to be about the EV-D68 and mention of polio was for context only – sorry if that created confusion.

  • AA H

    Thank you for this blog Dr. Thomas. Please keep the info coming!

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