Surveillance information for Enterovirus D68

Advisory Alert

September 15, 2015

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For all reporting, inquiries or comments, please contact:
Sudbury & District Health Unit at 705.522.9200, ext. 301; after hours 705.688.4366.

September 15, 2015

This Advisory Alert provides public health surveillance information for Enterovirus D68 (EV-D68) for the 2015-2016 respiratory season.


In early fall 2014, there was an increase of EV-D68 infections in North America with some patients presenting with severe respiratory symptoms. Rare cases of acute flaccid paralysis (AFP) were also reported that were likely related to EV-D68 infection. In Ontario, the total number of respiratory specimens tested for EV-D68 at Public Health Ontario (PHO) in 2014 was 1,121, and of these, 100 (8.9%) tested positive for the virus. Of cases where AFP was documented, two were confirmed positive for EV-D68, both in children less than 15 years of age. EV-D68 was last detected in late October 2014. Testing was ceased on December 1, 2014 and recommenced on August 3, 2015 in preparation for the 2015/2016 respiratory season.


As you are aware, EV-D68 is not a reportable disease in Ontario. In 2014, to ensure that any potential cases of AFP associated with EV-D68 were captured, the Ministry of Health and Long-Term Care temporarily removed the upper age limit of 15 years on the case definition for AFP. The age limit for reporting of AFP was subsequently returned to less than 15 years of age in April 2015.

Laboratory Testing

Laboratory testing for EV-D68 should be considered during the late summer and early fall season for patients with severe respiratory illness, especially children, among whom symptomatic enterovirus infections, including EV-D68, are more common. Testing can also be considered if clusters of severe respiratory illness are identified. Testing patients with mild illness, or outside of the late summer/early fall season, is of limited clinical utility.

Health care providers ordering enterovirus/EV-D68 testing are required to complete a Clinical Summary Form and a General Test Requisition Form when submitting samples for EV-D68 testing. These can be found on the Public Health Ontario website.

In addition, PHO has updated their EV-D68 webpage with general information on the virus and how to contact the laboratories when submitting specimens for EV-D68 testing.

Should you require further information please contact the Sudbury & District Health Unit at 705.522.9200, ext. 301.



This item was last modified on September 9, 2016