Complications

Complication
Timeframe
Likelihood
short term
high

Patients with a history of asthma or wheezing, especially children, are at increased risk of developing lower respiratory symptoms and severe wheezing when infected with enterovirus D68. Persons with asthma should be encouraged to adhere to their asthma action plan and to seek medical attention for breathing difficulties. Some patients suddenly become worse, and may require treatment in hospital or breathing support in an intensive care unit. Fortunately, most patients also respond relatively quickly to standard asthma therapies.

Acute asthma exacerbation in children

long term
low

Mounting evidence suggests a causal relationship between enterovirus D68 infection and acute flaccid myelitis (AFM).[5][6][7][8][9]​​​[10][11][12]​​​ The cardinal symptom of AFM is acute, flaccid weakness of one or more limbs.[41] Patients may also experience fever (prodromal or at weakness onset), prodromal respiratory illness, gait difficulty, back, neck or limb pain, acute cranial nerve dysfunction, difficulty holding up the head, decreased appetite, difficulty swallowing, and bladder or bowel changes, especially constipation.​[43][51]

AFM is a clinical emergency. Patients require immediate medical attention, and ideally, subspecialty consultation from a neurologist and an infectious disease specialist. Patients should be monitored closely for respiratory failure and supported with intensive care admission and mechanical ventilation if necessary. Prospective clinical trials of AFM treatments are lacking and there are no approved drugs for treatment or prevention.​[50]

Recovery may be prolonged and is often incomplete.

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