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What Are the Symptoms of Enterovirus D68? Prevention Tips

The symptoms of Enterovirus D68 may vary in severity but could include sneezing, sore throat, diarrhea, Dyspnea, and wheezing.

The symptoms of Enterovirus D68 may vary in severity, from mild to severe, with some infected individuals experiencing none at all. The symptoms are generally worse in children than in adults, although they may be more severe in people with low immunity or asthma as well.

Enterovirus D68 symptoms are generally sudden in onset (acute onset), and may include:

  • Mild symptoms
    • Sneezing
    • Rhinorrhea (runny nose)
    • Cough
    • Fever (although many people may not have fever)
    • Sore throat
    • Headache
    • Body ache or fatigue
    • Myalgia (muscle aches)
    • Diarrhea
  • Severe symptoms
    • Dyspnea (difficulty breathing)
    • Wheezing

Severe or worsening symptoms require immediate medical attention, such as the following:

  • Dysphagia (difficulty or pain while swallowing)
  • Difficulty speaking or slurring of speech
  • Weakness in the arms or legs
  • Difficulty walking
  • Facial weakness or drooping
  • Difficulty moving the eye
  • Ptosis (drooping eyelids)
  • Diplopia (double vision)

What is Enterovirus D68?

Enterovirus D68, also called EV68 or EV-D68, is a type of virus affecting the respiratory system (the airways and lungs), which was first identified in 1962 in California. EV-D68 belongs to the nonpoliovirus category of the enterovirus group that contains hundreds of other viruses (such as poliovirus).

Most of the enteroviral infections are mild, but Enterovirus D68 can cause serious disease, especially in people with underlying breathing conditions, such as asthma. Although Enterovirus D68 mainly causes respiratory symptoms, it can cause neurological manifestations (such as acute flaccid myelitis) as well, including muscle weakness or paralysis, facial drooping, ptosis, diplopia, and dysphagia.

Most patients with severe illness, who require hospitalization, are children. Although the infection can occur any time of the year, it is more common in summer and fall in the United States.

How is Enterovirus D68 diagnosed?

For the diagnosis of Enterovirus D68 infection, the doctor will do the following:

  • Take detailed medical history about the symptoms and any underlying health conditions, such as allergies or asthma.
  • Perform a thorough medical examination including chest examination.
  • Order certain tests or imaging studies, such as:
    • The test for Enterovirus D68 requires specimen collection from the nose and throat.
    • A blood sample could be taken.
    • A specific type of test called real-time reverse transcription-polymerase chain reaction (rRTPCR) is done to diagnose Enterovirus D68 infection. The test is available in some doctors’ offices and several hospitals. The test reports may come after a few days.
    • The doctor may suggest chest X-rays.
    • In case of neurological symptoms, a magnetic resonance imaging scan and cerebrospinal fluid examination could be done.

How can you protect yourself from Enterovirus D68 infection?

Presently, there is no vaccine against Enterovirus D68 infection. The virus mainly spreads through coughing, sneezing, or touching an infected surface.

To prevent the infection and its spread, the following tips are recommended:

  • Practice proper and frequent handwashing using soap and water for 20 seconds.
  • Cover the mouth and nose with a tissue or the elbow while sneezing or coughing.
  • Avoid touching the nose or mouth without washing hands.
  • Disinfect frequently touched objects and surfaces, such as doorknobs and toys, particularly if someone has respiratory symptoms at home.
  • Avoid sharing eating utensils or cups, kissing, or hugging when a person is sick or with someone who is sick.
  • Avoid public places including school or work when a person is sick.


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Medically Reviewed on 10/28/2021


Image Source: VioletaStoimenova / Getty Images

You H-J. Enterovirus D68 Workup. Medscape.

Centers for Disease Control and Prevention. Enterovirus D68.

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