Enterovirus US Death Toll Surpasses Ebola

The debilitating respiratory virus impacting hundreds of children throughout the United States claimed its second victim late last week.

On October 10, 2014, 21-month-old Madeline Reid died due to complications related to enterovirus D-68 (EV-D68) and a stomach virus, which caused congestive heart failure and damaged most of her organs, according to a Go Fund Me Web page set up by her mother to raise money for funeral expenses.

The Michigan child suffered severe brain damage following 2 massive strokes while on life support.

"It is never easy to lose a child, and our entire health care team at the Children's Hospital of Michigan is deeply saddened by this family's loss and mourns with them during this very difficult time," said Rudolph Valentini, MD, chief medical officer at Children's Hospital of Michigan in a Detroit News report. "Madeline was transferred to the Children's Hospital of Michigan for advanced services, with presumed community-acquired enterovirus infection. The US Centers for Disease Control and Prevention (CDC) confirmed EV-D68 after her arrival here, and she subsequently succumbed to her illness.”

The Michigan toddler’s death came on the heels of a New Jersey child becoming the first recorded fatality directly connected to EV-D68.

Eli Waller, 4, showed no symptoms of the virus when he went to bed on September 24, 2014, but he was found dead by his mother the following morning.

Four other children who recently died have tested positive for EV-D68, though health care officials noted it is not yet clear what role, if any, the virus played in their deaths. A 10-year-old child from Rhode Island who died on September 22, 2014, was the first death to be recorded with a confirmed presence of EV-D68.

The Rhode Island Department of Health reported that the child died from Staphylococcus aureus sepsis associated with EV-D68, noting that the death was clearly due to sepsis, while the role EV-D68 played remains unclear.

“State and local officials have the authority to determine the cause of death, including the role that EV-D68 may have played,” the CDC said in a statement. “They also have the authority to determine the appropriate information to release, and the time to release it. CDC will defer to states to provide this information.”

As of October 10, 2014, the CDC has confirmed 691 cases of EV-D68 in 46 states. That number is expected to continue to grow as a backlog of specimens are still awaiting testing by CDC or state public health laboratories.

About half of the specimens tested by CDC labs have come up positive for EV-D68, while about one-third have tested positive for an enterovirus or rhinovirus other than EV-D68.

Symptoms for EV-D68 include fever, runny nose, difficulty breathing, muscle aches, hypoxemia, and possible wheezing. Approximately two-thirds of confirmed EV-D68 patients had a previous medical history of asthma.

Enteroviruses typically infect 10 to 15 million people annually in the late summer and early fall seasons, but the EV-D68 strain has led to more serious complications than the typical flu-like symptoms associated with the illness.