2014 enterovirus D68 outbreak

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2014 Enterovirus D68 Outbreak

The 2014 Enterovirus D68 outbreak was a significant public health event characterized by widespread infections caused by Enterovirus D68 (EV-D68), a non-polio enterovirus. First identified in California in 1962, EV-D68 is known for causing respiratory illness ranging from mild symptoms to severe conditions such as acute flaccid myelitis (AFM), particularly in children. The 2014 outbreak marked a notable increase in reported cases, drawing attention to the virus's potential for severe respiratory disease and neurological complications.

Background[edit | edit source]

Enterovirus D68 belongs to the family of Picornaviridae, which includes other enteroviruses and rhinoviruses responsible for a variety of diseases. EV-D68 primarily targets the respiratory system, and its transmission occurs through respiratory secretions, such as saliva, nasal mucus, or sputum. Before the 2014 outbreak, EV-D68 infections were relatively rare, with sporadic cases reported worldwide.

The Outbreak[edit | edit source]

The 2014 outbreak of EV-D68 began in August, with the Centers for Disease Control and Prevention (CDC) reporting an unusual increase in hospitalizations for severe respiratory illness among children in Missouri and Illinois. Subsequently, similar reports emerged from other states, indicating a widespread outbreak. By the end of 2014, the CDC had confirmed hundreds of cases across the United States, with several instances of severe respiratory illness and AFM associated with the virus.

Symptoms and Diagnosis[edit | edit source]

The symptoms of EV-D68 infection range from mild, flu-like respiratory symptoms to severe respiratory distress requiring hospitalization. Common symptoms include coughing, wheezing, and difficulty breathing. In severe cases, patients may develop AFM, a serious condition that affects the nervous system, leading to muscle weakness and paralysis.

Diagnosis of EV-D68 involves laboratory tests, including polymerase chain reaction (PCR) and virus isolation from respiratory specimens. Due to the similarity in symptoms with other respiratory infections, specific testing is necessary to confirm EV-D68.

Response and Management[edit | edit source]

In response to the outbreak, health authorities, including the CDC, issued guidelines for healthcare providers on the management of suspected cases and the prevention of virus spread. Recommendations included the importance of hand hygiene, avoiding close contact with sick individuals, and the use of personal protective equipment (PPE) by healthcare workers.

There is no specific treatment for EV-D68 infections, and care is supportive, focusing on relieving symptoms and supporting breathing in severe cases. The development of vaccines and antiviral drugs against EV-D68 is an area of ongoing research.

Impact[edit | edit source]

The 2014 EV-D68 outbreak highlighted the need for vigilance regarding enteroviruses and their potential for severe disease. It also underscored the importance of rapid detection, reporting, and response to emerging infectious diseases. The outbreak led to increased research into EV-D68, its pathogenesis, and potential interventions to prevent future outbreaks.

See Also[edit | edit source]


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Contributors: Prab R. Tumpati, MD