Rare Strain of Enterovirus Confirmed in Middlesex County Children

NEW BRUNSWICK, NJ—The Center for Disease Control and Prevention announced on October 7 that it had confirmed cases of enterovirus-D68 in a second Middlesex County child, raising the total number of confirmed cases in New Jersey to fourteen.

Confirmed cases of enterovirus-D68 have been reported in Camden, Mercer, Burlington, Sussex, Passaic, Essex, Morris, and Middlesex Counties so far.  All of the cases reported involve children ages 14 and under.

A 4-year-old child from Hamilton Township who died last week was confirmed to have been infected by enterovirus-D68 by the Center for Disease Control and Prevention.

According to the Center of Disease Control and Prevention (CDC), enteroviruses are a very common type of virus with more than 100 types and over 10 million reported cases each year, but enterovirus-D68 is an uncommon strain that has been rarely reported in the United States until recently.

"Enterovirus D68 is treated the same as other respiratory illnesses that are seen in children this time of year," NJ Health Commissioner Mary O'Dowd said.

There is no vaccine or specific antiviral medication to treat the illness, according to a NJ Department of Health press statement.

"Parents and caregivers should be aware that children with weakened immune systems or underlying medical conditions, such as asthma, may experience severe complications and require hospitalization with supportive therapy," Commissioner O'Dowd said.

Enteroviruses are transmitted through close contact with an infected person, or by touching objects or surfaces that are contaminated with the virus and then touching the mouth, nose, or eyes.

Enterovirus-D68 has been reported to cause mild to severe respiratory illness, along with fever, muscle aches, runny nose, sneezing, and coughing.

From mid-August to October 7, the CDC and state public health laboratories have confirmed 628 cases of enterovirus-D68 in 44 different states and the District of Columbia.

According to the CDC, enterovirus-D68 has been confirmed in four people who have died nationwide, but state and local health departments are still investigating the role of the virus played in the deaths.

Testing for enterovirus-D68 is complex and slow, and can only be done by the CDC and a handful of state public health laboratories.

The Center for Disease Control and Prevention stated that, as the backlog of specimens are processed, the amount of confirmed cases will likely increase, but this will not necessarily reflect changes in real time, or indicate that the situation is getting worse.

The virus is not well-studied, so how it is transmitted is unclear, but it is thought to be spread through respiratory excretions such as mucus and saliva, which are expelled from the body by coughing and sneezing.

According to the New Jersey Department of Health, infants, children, and teenagers are more susceptible to contacting enterovirus-D68 than adults because they have not yet developed immunity to enteroviruses from past exposure.

The CDC recommends following these steps to help prevent the spread of the virus:

  • Wash hands often with soap and water for 20 seconds, especially after changing diapers.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Avoid kissing, hugging, and sharing cups or eating utensils with someone who is sick.
  • Disinfect frequently touched surfaces, such as toys or doorknobs, especially if someone is sick.

The Middlesex County Department of Public Safety is also taking steps to prevent the spread of enterovirus-D68 in Middlesex County.

Officials met September 29 at the Middlesex County Superintendent’s Office to discuss ways that residents can help protect their families from the virus.

Middlesex County officials sent out a letter which contained important information about enterovirus-D68 and is distributing it at all Middlesex County schools.

“Middlesex County has been working with the State, local health departments, hospitals, medical providers and schools to provide information about this virus in numerous formats including email and website updates and other health alerts,” said Freeholder Director Ronald G. Rios.

“By staying informed and taking preventative measures, we can all do our part to controlling Enterovirus-D68.”

Editor's Note: Jacquelyn Gray contributed to this report.