Parents all over the country and here in the metro are concerned now that the Minnesota Department of Health has confirmed cases of enterovirus 68 or EV-D68. It is a rarely seen virus believed to be sending children to the hospital with serious respiratory infection symptoms.  

Certainly respiratory infections are common this time of year. The news about EV-D68 has helped stir up a helpful conversation about respiratory illness and how to know when a simple cough or cold has progressed to the point of needing emergency medical attention.

Respiratory infections can be particularly dangerous for children, older adults, and people with immune system disorders. According to the World Health Organization (WHO), acute respiratory infections kill an estimated 2.6 million children annually every year worldwide.

What is an upper respiratory infection?

Upper respiratory infections are one of the most frequent causes of doctor visits with varying symptoms ranging from runny nose, sore throat and cough, to breathing difficulty, and lethargy. In the United States, upper respiratory infections are the most common illness leading to missing school or work. These infections are the most common in the fall and winter months from September to March. That’s the time when kids are in close quarters during the school year and also when the low humidity of winter creates the perfect environment for upper respiratory infections to thrive and spread.

The symptoms of upper respiratory infection usually last between 3-14 days; if symptoms last longer than 14 days, an alternative diagnosis can be considered such as, sinusitis, allergy, pneumonia or bronchitis.

How do I know if it’s serious or EV-D68?

The virus will begin with symptoms of a common cold, sneezing, a runny nose and a cough. Some patients will then get a severe cough, have difficulty breathing and/or develop a rash. EV-D68 is sometimes also accompanied by a fever or wheezing.

In the beginning it may be difficult, even impossible, to tell the difference between a regular cold and this type of virus. But there are symptoms you should be on the lookout for if your child becomes sick including:

• A sudden high fever (0-3 months 100.4 or higher and 3 months and older 102.9 or higher)

•    A rash

• Difficulty breathing including nasal flaring, grunting in infants and chest retractions or the chest appears to sink in just below the neck and/or under the breastbone with each breath--one way of trying to bring more air into the lungs. Be particularly careful if your child has a history of asthma or breathing problems as this will make them even more susceptible for severe symptoms.


As with less severe upper respiratory infections, there is no specific treatment. Plenty of rest, fluids and over-the-counter medications will help ease symptoms in standard cases. Hospitalized patients will likely receive assistance breathing and what’s called “supportive therapy” to help their immune systems fight off the infection.


As doctors, we cannot emphasize enough the importance of washing your hands, not just in public places, but at home too! Always sneeze into a tissue or the arm of your shirt and teach your children how to do this. Try your hardest not to touch your face, especially your eyes and mouth, to prevent introducing germs into your system.

If you smoke, stop. Also make sure you get your vitamins, especially vitamin C which can boost your immune system.

— Kurt Belk is an ER physician and medical director of The Urgency Room in Vadnais Heights.

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