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What You Need to Know About Enterovirus D68 | Learn Symptoms & Signs of Respiratory Virus Enterovirus D68 | Education Resource Center | Staples®

Going Viral: What Teachers Need to Know About Enterovirus D68

If the dire headlines don’t spook you, the name just might: Enterovirus D68 (EV-D68). As if the flu isn’t bad enough, this year schoolteachers need to be on the ready for this virus too. We asked two experts — a pediatrician and an emergency physician — what you need to know and do to prevent an outbreak in your classroom.

“This family of viruses is a very common cause of childhood illness in the summer and early fall,” says Michael Steiner, division chief of General Pediatrics and Adolescent Medicine at the

North Carolina Children’s Hospital and the University of North Carolina School of Medicine. “The strain that’s circulating in the Midwest [right now] is causing a somewhat unique set of symptoms that are more severe than usual infections by this virus. In particular, it seems to cause more respiratory symptoms than most enteroviral infections.”

According to a Centers for Disease Control advisory, “The virus can be found in respiratory secretions such as saliva, nasal mucus or sputum [mucus that’s coughed up from the lower airways]. The virus likely spreads from person to person when an infected person coughs, sneezes or touches contaminated surfaces.” So it’s no surprise it’s spreading through schools.

Enterovirus D68 Symptoms

As with any respiratory infection, the most important symptom to look for is difficulty breathing.

Obvious indicators are wheezing or turning blue. Ben Hippen, an emergency physician in San Francisco, CA, says another symptom to watch for is rapid breathing. “Any child breathing once per second or faster should be seen by a doctor immediately,” he warns. Another sign: the skin of the chest is pulled in with each breath, “indicating that the child is needing to use extra chest muscles to assist with breathing.”

Other symptoms include urinating less than usual or hardly at all; profuse vomiting or diarrhea; dry, chapped lips; dehydration; or skin that appears pale or unusual. “Dehydration can be serious and should be assessed by a doctor,” Hippen explains. “By the time a child has moderate to severe dehydration, it may not be possible to fully rehydrate with oral fluids at home or school.”

Finally, pay attention to behavior. “If the child is coughing so long and hard that it’s difficult for him to talk, or seems ‘out of it,’” Steiner says, seek medical assistance immediately.


Most EV-D68 infections are mild, requiring only treatment of the symptoms, according to the CDC advisory. But the stakes are higher for children who already have respiratory issues, like asthma. Parents should make sure all prescriptions are filled and taken as directed, and should notify teachers and school nurses of the child’s condition. “If your child develops coughing or wheezing, begin using your albuterol, and if that doesn't help, then call your doctor immediately,” Steiner says.

How to Prevent EV-D68

Germs are everywhere in schools, so frequent hand washing is smart even when there’s not a viral outbreak. Steiner and Hippen agree it’s a key component in staving off the spread of EV-D68. Children and adults should wash hands after sneezing, coughing or wiping their eyes and noses — and after touching surfaces that have been exposed to the germs.

Other tips include:

  • Make sure children dispose of used tissues and napkins properly
  • Use disinfectant wipes or other products to clean surfaces in the classroom and at home
  • Avoiding sharing cups, utensils and toys with people who are sick

A little vigilance can help us spot sick children and avoid further transmission. What may be harder, actually, is managing feelings and fears.

“With news about things like Ebola now, it’s important to remember that even with this virus, the majority of infections are very mild and even the children who develop severe disease seem to be fully recovering when given appropriate support in a hospital,” Steiner says. “This is just a more rare strain in a very common family of viruses that infect millions of children every year.”

Note: Don’t disregard professional medical advice, or delay seeking it, because of what you read here. This information is not intended as a substitute for professional consultation, diagnosis or treatment; it is provided “as is” without any representations or warranties, express or implied. Always consult a healthcare provider if you have specific questions about any medical matter, and seek professional attention immediately if you think you or someone in your care may be suffering from a healthcare condition.

Margot Carmichael Lester began her career working for a major health insurance plan. She now covers business and healthcare topics for a variety of media outlets. Her company, The Word Factory , works with organizations like the Vasculitis Foundation and UNC Healthcare, and pharma companies, to share stories of basic science, wellness and more. Find her on Google+.

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