States with Lab-confirmed Enterovirus D68

From mid-August to October 10, 2014, CDC or state public health laboratories have confirmed a total of 691 people from 46 states and the District of Columbia with respiratory illness caused by EV-D68. The 46 states are Alabama, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. This indicates that at least one case has been detected in each state listed but does not indicate how widespread infections are in each state.

CDC is prioritizing testing of specimens from children with severe respiratory illness. Of the specimens tested by CDC lab, about half have tested positive for EV-D68. About one third have tested positive for an enterovirus or rhinovirus other than EV-D68.

In the upcoming weeks, states will have more confirmed cases of EV-D68 infection.

• The primary reason for increases in cases is that several states are investigating clusters of people with severe respiratory illness, and specimens are still being tested for EV-D68. It can take a while to test specimens and obtain lab results. That’s because the testing is complex and slower, and can only be done by CDC and a small number of state public health laboratories. As the backlog of specimens is processed, the number of states and confirmed cases will likely increase. These increases will not necessarily reflect changes in real time, or mean that the situation is getting worse.
• Some of the increase will be from new EV-D68 infections since people are more likely to get infected with enteroviruses in the summer and fall. We are currently in the middle of the enterovirus season.

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