Enterovirus D-68 (EV-D68) Fact Sheet for General Public

What is Enterovirus D-68 (EV-D68)?
EV-D68 belongs to a group of viruses called enteroviruses. Enteroviruses are similar to the common cold virus and can spread from person to person through coughing and sneezing, close contact with an infected person, or touching a contaminated surface. There are more than 100 types of enteroviruses. Most circulate and peak in the summer and autumn.

EV-D68 causes mild to severe respiratory illness, sometimes even requiring ventilator support. It has also been associated with cases and clusters of polio-like neurological symptoms including acute flaccid paralysis (AFP) (i.e. when you are unable to move due to sudden onset of muscle weakness and paralysis), and meningo-encephalitis (i.e. brain and spinal cord infection).

What is the incubation period for EV-D68 infection?
The incubation period is three to five days (although it can be as long as 10 days). The incubation period is the time between catching an infection and symptoms appearing.

What are the symptoms of EV-D68 infection?
Most people with EV-D68 infection will likely have no symptoms. However, some will have mild to severe respiratory illness.

Mild symptoms may include:

• Body and muscle aches,
• Fever,
• Coughing,
• Runny nose,
• Sneezing
• Mouth blisters, and
• Skin rash.

Severe symptoms may include:

• Wheezing, and
• Difficulty breathing.

In rare cases, some people may develop:

• Heart infection (i.e. endocarditis),
• Brain and spinal cord infection (i.e. meningo-encephalitis), and
• Inability to move due to muscle weakness and paralysis (i.e. acute flaccid paralysis).

How do you get EV-D68 infection?
EV-D68 can spread when an infected person coughs or sneezes. Touching surfaces or objects contaminated with the virus may also result in infection if the virus then gets into your body by touching the mouth, nose or eyes.

Is a person with EV-D68 infection infectious?
Yes, EV-D68 is very infectious.

Who gets EV-D68 infection?
Anyone can get sick with EV-D68 infection. In Ireland, the risk of getting sick usually occurs in the summer and autumn. Anyone who comes in close contact with infected people or with surfaces contaminated with the virus may get sick with EV-D68.

Who is at risk of EV-D68 infection?
Infants, children and teenagers are at most risk for infection. This might be because they do not yet have immunity (i.e. protection) from previous exposures to these viruses. People with asthma or who have weakened immune systems (immunocompromised) due to treatment or disease are at greater risk for severe disease. Adults can get infected, but they are more likely to have no symptoms or mild symptoms.

How is EV-D68 infection diagnosed?
EV-D68 can only be diagnosed by doing specific laboratory tests on specimens from a person’s nose and throat, or blood.

How is EV-D68 infection treated?
There is no specific treatment for EV-D68 infection, so the illness has to run its course. Talk to a medical doctor or general practitioner (GP) about your symptoms and the best way to control them. Most people with mild symptoms recover completely; however some people with severe symptoms need to be hospitalised.

How can EV-D68 infection be prevented?
There is no specific treatment against non-polio enterovirus infections, including EV-D68. However, as with many viral infections, there are simple steps you can take that can reduce the chances of getting EV-D68:

• Clean hands frequently with soap and water or an alcohol-based hand rub, including after touching commonly used objects and surfaces, before touching your face, before preparing food and before eating, when around someone who is sick. Also clean your hands with soap and water or an alcohol-based hand rub before and after changing the nappies of sick children;
• Avoid touching your face as much as possible;
• Stay at least one metre (three feet) away from people who are ill (i.e. avoid close contact such as kissing, hugging, and sharing cups or eating utensils with people who are sick, and when you are sick); and
• Frequently clean surfaces and objects that are commonly touched.

To avoid spreading viral infections:

• Stay home from work, school and other activities if you are ill;
• Covering your nose and mouth with a tissue (if you have no tissue use your sleeve) when you cough and sneeze (catch it), disposing of the tissue as soon as possible (bin it) and cleaning your hands as soon as you can (kill it) are important measures in helping prevent the spread of viruses to others. See the poster on HPSC website and
• Clean your hands frequently with soap and water or an alcohol-based hand rub.

Is EV-D68 a notifiable disease?
EV-D68 is not a notifiable disease. 

Is there a vaccine available for EV-D68?
Currently there is no vaccine available against EV-D68.

Last reviewed: 10 February 2017