Rapid Risk Assessment: Enterovirus 68 detections in the USA and Canada

Risk assessment

European Centre for Disease Prevention and Control. Enterovirus 68 detections in the USA and Canada – 26 September 2014. Stockholm: ECDC; 2014.

​​The EU/EEA countries have a moderate risk of transmission of the Enterovirus D-68 (EV-D68), although no increase of acute respiratory infections or hospital admissions has been reported so far this year, according to a new risk assessment published today by ECDC. The report also indicates that the likelihood for cases to be detected in EU/EEA is low because most countries do not routinely screen for EV-D68, and the disease is not notifiable.

Executive summary

ECDC is closely monitoring the recent upsurge of EV-D68 cases in the United States of America (USA) and Canada. From mid-August to 24 September 2014, 220 people in the USA had respiratory illness caused by EV-D68. In Canada the number of severe respiratory illness cases has also increased in the same period.

In recent years there have been sporadic cases of EV-D68 in several EU/EEA countries but the circulation of this strain in the population is low and no epidemic clusters of severe disease have been reported. Additionally, there is no evidence that the viruses identified in Europe are related to the viruses identified in the USA and Canada.

In general, enteroviruses circulate and peak in the summer and fall months so it is not unusual to see increased illnesses caused by EV-D68 this time of year. ECDC recommends EU/EEA countries to remain vigilant for possible increase and unexpected infections causing respiratory illness, especially among children travelling from North America.

Enteroviruses such as EV-D68 are related to the common cold virus and spread when an infected person coughs, sneezes, or touches contaminated surfaces. There is no specific treatment for people with respiratory illness caused by EV-D68, and in severe cases the treatment is supportive. Based on the age profiles of the earlier outbreaks, children under 10 years of age are at risk for severe EV-D68 infection, especially if they have an underlying illness in the respiratory tract such as asthma.