Enterovirus D68

Patients with worsening or progressive respiratory symptoms should seek prompt medical attention. Patients hospitalized with enterovirus D68, especially children, often have a history of asthma or chronic lung disease. During outbreaks, some reports indicate that more than 50% of hospitalized patients require admission to intensive care units.[18]Midgley CM, Watson JT, Nix WA, et al. Severe respiratory illness associated with a nationwide outbreak of enterovirus D68 in the USA (2014): a descriptive epidemiological investigation. Lancet Respir Med. 2015 Nov;3(11):879-87. http://www.ncbi.nlm.nih.gov/pubmed/26482320?tool=bestpractice.com Sudden respiratory deterioration is not uncommon, and children with severe disease may benefit from proactive admission to hospitals that are able to provide specialized care for critically ill children, even before the need for higher-level care develops. 

Long-term follow-up is essential in children with acute flaccid myelitis, as paralysis may be prolonged and recovery is often incomplete.