Enterovirus-68: Why is it a public health risk?
How can wastewater-based epidemiology
identify outbreaks?
By Layla Katiraee, GT Molecular
Enterovirus D68 (EV-D68) is a respiratory virus that has gained increasing attention
from public health experts due to its potential to cause severe illness, especially in
at-risk children. As outbreaks of EV-D68 continue to emerge, wastewater-based
epidemiology (WBE) is proving to be a powerful tool for early detection and public
health response.
What Is Enterovirus D68?
EV-D68 is a non-polio enterovirus that often leads to very mild symptoms such as
runny nose, sneezing, and mild coughing. Children, particularly those with asthma
or other respiratory conditions, are at higher risk for complications.
In 2014, EV-D68 gained national attention due to its association with accute flacid
myelitis (AFM). This neurological condition is rare and leads to weakness in limbs,
as well as the loss of muscle tone and reflexes. Most AFM cases occur in children,
and there is no vaccine available against EV-D68.
Wastewater surveillance as a public health tool in
the fight against EV-D68
EV-D68 outbreaks tend to follow a biennial pattern, with spikes observed in 2014,
2016, 2018, and again in 2022 and 2024. These outbreaks have coincided with
increases in AFM cases, prompting the CDC to initiate active surveillance
programs. As such, 2026 may be another year with a spike in EV-D68 cases.
Key Advantages of WBE for EV-D68:
Early Detection: Viral RNA from EV-D68 can be detected in wastewater
before clinical cases are reported, allowing for proactive public health
responses.
Community-Level Monitoring: WBE captures data from symptomatic and
asymptomatic individuals, offering a more comprehensive view of virus
circulation.
Cost-Effective Surveillance: Compared to individual testing, wastewater
sampling is scalable and efficient.
In California, researchers tracked EV-D68 RNA in wastewater solids over 26
months. They found that viral concentrations spiked between July and December
2022, aligning with confirmed clinical cases and AFM diagnoses. Similar studies in
Israel and Colorado have demonstrated strong correlations between wastewater
data and clinical surveillance, reinforcing the value of multimodal monitoring.
[wwwnc.cdc.gov] [mdpi.com], [wwwnc.cdc.gov]
Looking Ahead: Strengthening Public Health
Preparedness
As EV-D68 continues to circulate and evolve, integrating wastewater surveillance
into routine public health monitoring can enhance outbreak preparedness. These
data can offer health authorities a better understanding of transmission dynamics
and emerging strains and ultimately allow them to allocate resources effectively.
At GT Molecular, we are committed to advancing molecular tools that support
wastewater surveillance and pathogen detection. Our technologies empower
communities to stay ahead of outbreaks and protect vulnerable populations