The human enterovirus D68 is a rare virus closely related to the rhinovirus which causes the common cold. However, there have been recent outbreaks throughout the midwest and the areas are rapidly expanding.
Mild symptom onset of rhinorrhea and cough rapidly progress to hypoxia and respiratory distress.
Key features are the rapid progression, presence of wheezing even without a history of reactive airway disease, and typically an absence of consolidation on chest XR.
Children under 5 years and those with asthma are at the greatest risk for respiratory failure.
There are a limited number of labs in the US which test specifically for EV-D68. At UMMC, the Luminex respiratory virus panel can be ordered using the kit form which includes a flocked swab and viral transport media. Unfortunately, the panel does not differentiate between the closely related enterovirus and rhinovirus.
There is no definitive cure, rather only supportive care and low-threshold for admission/observation for high risk patients.
Severe Respiratory Illness Associated With Enterovirus D68--Missouri and Illinois, 2014. CDC MMWR. Vol 63. September 2014.