NEW findings from a 6-year surveillance study across seven major US academic medical centers reveal that Enterovirus D68 (EV-D68) is capable of causing severe respiratory illness in children regardless of underlying health conditions. The study highlights that a significant proportion of children hospitalized with EV-D68 were previously healthy, challenging prior assumptions about who is most at risk from the virus.
Conducted through the New Vaccine Surveillance Network between 2017 and 2022, the cross-sectional study identified 976 children with laboratory-confirmed EV-D68 infections. Of these, 856 cases had no evidence of other viral infections. Notably, 536 children with EV-D68 were hospitalized and half of them had no prior medical conditions. Additionally, over one-third had a history of asthma or reactive airway disease.
Among the hospitalized children, those with nonasthma-related underlying conditions were significantly more likely to require intensive interventions. Specifically, they had more than double the odds of needing supplemental oxygen and over three times the odds of admission to intensive care compared with children without such conditions.
These results are particularly relevant to clinicians and healthcare professionals amid growing concerns about respiratory illness trends. Most EV-D68 infections occurred in the 2018 and 2022 seasons, which may indicate cyclical spikes in virus circulation. The median age of infected children was around four years, and both emergency department visits and hospitalizations occurred across a wide pediatric age range.
Importantly, the study found no association between asthma alone or age and severe outcomes like oxygen use or ICU admission. This underscores the need for heightened awareness and targeted surveillance, especially for children with less commonly discussed comorbidities.
The findings suggest a critical opportunity to improve early detection and management of EV-D68 in pediatric care settings. Clinicians should be alert to the potential severity of this virus, even in children who are otherwise healthy or have only minor medical histories.
Reference:
Clopper BR et al. Enterovirus D68–Associated Respiratory Illness in Children. JAMA Netw Open. 2025;8(5):e259131.
