The respiratory illness season is off to an eventful start

Recent reports describe an outbreak of Enterovirus 68, which in mid-August caused some cases of severe respiratory illness in Missouri and Illinois [1], and which may be the cause of a spike in respiratory illness across the Midwest region of the United States. As of September 5th, the Children's Hospital Colorado had treated over 900 cases of severe respiratory illness in three weeks [2]. This NPR blog provides a good overview of the disease [3]. The Centers for Disease Control and Prevention also have published an informative fact sheet [4]. Little surveillance information is available, since the disease is "not a reportable disease in the United States" (see [4]). Most cases affect children under 5, especially if they have pre-existing respiratory conditions such as asthma.  As there are no specific treatments or vaccination, prevention and early response are the best safeguards. 

Keeping an eye on the Enterovirus outbreak could be particularly important with the coming influenza season; recent research suggests that, at least with the H1N1 pandemic influenza strain, co-infection with other respiratory illness can predispose a patient toward substantially more severe disease [5]. 


[1] Claire M. Midgley, Mary Anne Jackson, Rangaraj Selvarangan, George Turabelidze, Emily Obringer, Daniel Johnson, B. Louise Giles, Ajanta Patel, Fredrick Echols, M. Steven Oberste, W. Allan Nix, John T. Watson, Susan I. Gerber. (2014) Severe Respiratory Illness Associated with Enterovirus D68 — Missouri and Illinois, 2014. Morbidity and Mortality Weekly Report, 63(Early Release): 1-2.

[2] Electra Draper. (5 Sept. 2014) Colorado children's hospitals see spike in severe respiratory illness. The Denver Post,

[3] Nancy Shute. (8 Sept. 2014) CDC warns of fast-spreading enterovirus afflicting children. NPR,


[5] Frank P. Esper, Timothy Spahlinger, Lan Zhou. (2011) Rate and influence of respiratory virus co-infection on pandemic (H1N1) influenza disease. Journal of Infection, 63 (4): 260–266. doi: 10.1016/j.jinf.2011.04.004