SACRAMENTO – As of October 1, the California Department of Public Health (CDPH) has confirmed enterovirus D68 (EV-D68) infection in 14 patients in 2014. The patients are residents of San Diego (5), Alameda (2), Los Angeles (1), Riverside (1), San Francisco (1), Santa Cruz (1), Solano (1), and Ventura (1) counties, and Long Beach City (1) it was announced today by Dr. Ron Chapman, CDPH director and state health officer.

Thirteen of these patients have had respiratory illness and one has had acute flaccid paralysis. There are other specimens from throughout the state being tested at CDPH laboratories and more cases are anticipated in the coming weeks. CDPH continues to work with local health departments to collect and test specimens from patients with severe respiratory illness and acute flaccid paralysis without other known cause.

“We are not surprised to find EV-D68 causing some illnesses in California given the apparent widespread nature of this virus in other parts of the country,” said Dr. Chapman.

On a separate investigation, CDPH has identified 35 patients as of October 1 with acute flaccid paralysis and spinal cord involvement since 2012. Of these patients, three have had infection with EV-D68, two in 2012 and one in 2014. Because EV-D68 was found in respiratory specimens from these patients, it is not known whether EV-D68 was a cause of paralysis or a coincidental finding.

EV-D68 causes respiratory illness and the virus likely spreads from person to person when an infected person coughs, sneezes, or touches contaminated surfaces. Symptoms of EV-D68 include fever (although fever may not be present), runny nose, sneezing, cough, and body and muscle aches. Some children have more serious illness with breathing difficulty and wheezing, particularly children with a history of asthma. EV-D68 can rarely cause neurologic illness.

Parents should seek medical attention immediately for children who are having any breathing difficulty (wheezing, difficulty speaking or eating, belly pulling in with breaths, blueness around the lips), particularly if the child suffers from asthma. There is no specific treatment for persons with EV-D68, nor is there a vaccine to prevent it. However, everyone six months of age and older should receive influenza vaccine every year to protect themselves against that important cause of respiratory disease.

Health care providers should consider EV-D68 as a possible cause of acute, unexplained severe respiratory illness, even if the patient does not have fever, and consider laboratory testing of respiratory specimens for enteroviruses when the cause of respiratory illness in severely ill patients is unclear. In addition, health care providers should contact their local health departments to report cases of acute flaccid paralysis with spinal cord involvement and test these patients for possible enterovirus infection.

The best way to prevent transmission of enteroviruses is to:
• Wash hands often with soap and water for 20 seconds, especially after changing diapers.
• Avoid touching eyes, nose and mouth with unwashed hands.
• Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick.
• Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.

Additional information about EV-D68 can be found on the Centers for Disease Control and Prevention’s Enterovirus D68 page.

www.cdph.ca.gov