﻿ Severe Respiratory Illness Associated with Enterovirus D68 — Missouri and Illinois, 2014
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Claire M. Midgley, PhD1,2, Mary Anne Jackson, MD3, Rangaraj Selvarangan, PhD4, George Turabelidze, MD5, Emily Obringer, MD6, Daniel Johnson, MD6, B. Louise Giles, MD6, Ajanta Patel, MD6, Fredrick Echols, MD7, M. Steven Oberste, PhD2, W. Allan Nix2, John T. Watson, MD2, Susan I. Gerber, MD2 (Author affiliations at end of text)





Since the original isolation of EV-D68 in California in 1962 (2), EV-D68 has been reported rarely in the United States; the National Enterovirus Surveillance System received 79 EV-D68 reports during 2009–2013. Small clusters of EV-D68 associated with respiratory illness were reported in the United States during 2009–2010 (3).

There are no available vaccines or specific treatments for EV-D68, and clinical care is supportive. Health care providers should consider EV-D68 as a possible cause of acute, unexplained severe respiratory illness; suspected clusters or outbreaks should be reported to local or state health departments. CDC's Picornavirus Laboratory (e-mail: wnix@cdc.gov) is available for assistance with diagnostic testing.

1Epidemic Intelligence Service, 2Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC; 3Infectious Disease Department, 4Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, Missouri; 5Missouri Department of Health and Senior Services; 6University of Chicago Medicine; 7Illinois Department of Public Health. (Corresponding author: Claire M. Midgley, cmidgley@cdc.gov)


  1. Oberste MS, Maher K, Schnurr D, et al. Enterovirus 68 is associated with respiratory illness and shares biological features with both the enteroviruses and the rhinoviruses. J Gen Virol 2004;85:2577–84.
  2. Schieble JH, Fox VL, Lennette EH. A probable new human picornavirus associated with respiratory disease. Am J Epidemiol 1967;85:297–310.
  3. CDC. Clusters of acute respiratory illness associated with human enterovirus 68—Asia, Europe, and United States, 2008–2010. MMWR 2011;60:1301–4.

* Enterovirus and rhinovirus species names recently were revised to remove host names and to append the type number to the species designation; hence, human enterovirus 68 (HEV-68, also previously called EV68) is now EV-D68.





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