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Volume 32, Number 7—July 2026

Dispatch

Household Transmission of Enterovirus D68, Washington and Oregon, United States, 2022–2024

Pavitra RoychoudhuryComments to Author , Erica Wetzler, Anna Elias-Warren, Katherine L. Hoffman, Alex Harteloo, Hyeong Geon Kim, Kevin Kong, Hong Xie, Jolene Gov, Margaret G. Mills, Collrane Frivold, Madison Hollcroft, Mark Drummond, Tara Hatchie, Erica Clark, Brenna Ehmen, Peter D. Han, Luis Gamboa, Sally Grindstaff, Jeremy Stone, Alexander L. Greninger, Lea M. Starita, Christina Lockwood, Janet A. Englund, Marco Carone, Ana A. Weil, Sacha L. Reich, Richard A. Mularski, Mark A. Schmidt, Jennifer L. Kuntz, Allison L. Naleway, and Helen Y. Chu
Author affiliation: Fred Hutchinson Cancer Center, Seattle (P. Roychoudhury); University of Washington, Seattle, Washington, USA (P. Roychoudhury, E. Wetzler, A. Elias-Warren, K.L. Hoffman, A. Harteloo, H.G. Kim, K. Kong, H. Xie, J. Gov, M.G. Mills, C. Frivold, M. Hollcroft, M. Drummond, T. Hatchie, E. Clark, B. Ehmen, P.D. Han, L. Gamboa, S. Grindstaff, J. Stone, A.L. Greninger, L.M. Starita, C. Lockwood, J.A. Englund, M. Carone, A.A. Weil, H.Y. Chu); Brotman Baty Institute for Precision Medicine, Seattle (L. Gamboa); Seattle Children’s Research Institute, Seattle (J.A. Englund); Kaiser Permanente Center for Health Research, Portland, Oregon, USA (S.L. Reich, R.A. Mularski, M.A. Schmidt, J.L. Kuntz, A.L. Naleway)

Main Article

Table 1

Characteristics of index cases in study of household transmission of enterovirus D68, Washington and Oregon, United States, 2022–2024*

Characteristics Potential secondary transmission† Unlikely secondary transmission‡ Total
No. index cases
7
28
35
Median age, y (range)
11 (3–34)
8.5 (1–48)
9 (1–48)
Age range
6 mo–1 y 0 2 (7.1) 2 (5.7)
2–4 y 1 (14.3) 8 (28.0) 9 (25.7)
5–12 y 3 (42.9) 8 (28.6) 11 (31.4)
13–50 y
3 (42.9)
10 (35.7)
13 (37.1)
Sex
F 3 (42.9) 17 (60.7) 20 (57.1)
M
4 (57.1)
11 (39.3)
15 (42.9)
Race or ethnicity
Asian 0 (0.0) 1 (3.6) 1 (2.9)
White 3 (42.9) 22 (78.6) 25 (71.4)
Multiracial 3 (42.9) 4 (14.3) 7 (20.0)
Other 1 (14.3) 1 (3.6) 2 (5.8)
Hispanic
0 (0.0)
3 (10.7)
3 (8.6)
Child attending school or daycare
5 (71.4)
18 (64.3)
23 (65.7)
Any smoking
0
0
0
Any underlying conditions§
1 (14.3)
8 (28.6)
9 (25.7)
Masking in public at baseline
Any 7 (100) 23 (82.1) 30 (85.7)
Never
0
5 (17.9)
5 (14.4)
Relative cycle threshold
Median (range) 18.8 (13.6–21.8) 16.0 (9.6–22.5) 17.3 (9.6–22.5)
Overall median >17.3
2 (28.6)
17 (60.7)
19 (54.3)
Viral co-detections¶
Any 7 (100) 26 (92.9) 33 (94.3)
SARS-CoV-2 0 1 (3.6) 1 (2.9)
Adenovirus 1 (14.3) 0 (0) 1 (2.9)
RSV 0 1 (3.6) 1 (2.9)
HPIV
1 (14.3)
0
1 (2.9)
ARI symptoms#
>2 ARI symptoms 7 (100) 19 (67.9) 26 (74.3)
Cough, rhinorrhea, or both
7 (100)
28 (100)
35 (100)
Any care seeking during illness**
0
3 (10.7)
3 (8.6)
Any behavior change to reduce transmission in the air††
3 (42.9)
11 (39.3)
14 (40.0)
Any behavior change to reduce transmission on surfaces‡‡ 3 (42.9) 10 (35.7) 13 (37.1)

*Values are no. (%) except as indicated. ARI, acute respiratory illness; EV, enterovirus; HPIV, human parainfluenza virus; RSV, respiratory syncytial virus. †Occurring when EV-D68 is detected in a secondary household member 1–14 days after index case. ‡Unlikely secondary transmission defined as occurring when only 1 EV-D68 case is detected in the household or when >2 EV-D68 cases are in a household but secondary case detected >14 days after index case. §Underlying conditions include asthma, chronic obstructive pulmonary disease (including chronic bronchitis and emphysema), sleep apnea, heart disease, congenital heart disease, heart failure, Down syndrome, hypertension (high blood pressure), diabetes (high blood sugar), liver condition, weak or failing kidneys, cancer or malignancy, arthritis, stroke, deep vein thrombosis or pulmonary embolism, sickle cell disease or thalassemia, weakened immune system, depression, anxiety, thyroid issues, or other health diagnosis. ¶Rhinovirus target was detected in 32 (91.4%) samples but is not shown because of cross-reactivity between that target and EV-D68 and several other enterovirus species (assay ID Vi99990016_po, Thermo Fisher [https://www.thermofisher.com]). #Symptoms reported <7 days of the individual EV-D68 illness episode’s first positive specimen collection, including fever​, cough​, sore throat​, shortness of breath​, myalgia​, rhinorrhea, or a combination of symptoms. All persons included reported >1 symptom. **Self-reported care seeking defined as seeking healthcare from a healthcare provider during illness. ††Includes masking, sleeping separately, covering cough or sneeze before or during illness episode. ‡‡Includes handwashing, cleaning, disinfecting.

Main Article

Page created: May 28, 2026
Page updated: June 23, 2026
Page reviewed: June 23, 2026
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