What are enterovirus and parechovirus, and how can I protect my child from them?

Answer From Elizabeth Ristagno, M.D.

Enterovirus and parechovirus are the name for two groups of viruses. Both types of viruses are common worldwide. They spread from person to person. These viruses can infect anyone but often start spreading between children.

These viruses can cause a range of sickness from no symptoms to serious illness.

Specific strains of these viruses are linked to serious illness in infants and young children. Two examples are enterovirus D68 and parechovirus A3.

A health care provider may order lab tests to find out which virus is causing illness in cases of severe sickness.

The best way to protect your child from these viruses is to focus on avoiding the virus. You can do this by:

  • Cleaning and disinfecting things you touch often.
  • Keeping distance between yourself and those who are sick.
  • Washing your hands often and teach your young children this skill.

Enterovirus D68

Enterovirus D68 spreads when a person who is sick with the virus sneezes or coughs, or touches a surface without washing their hands. Adults can get infected with enteroviruses. But enterovirus D68 most commonly affects children.

Many people, especially adults, who get enterovirus D68 have no symptoms or very mild ones. Symptoms may include:

  • Runny nose.
  • Sneezing.
  • Cough.
  • Body and muscle aches.

Severe symptoms may include:

  • Wheezing.
  • Problems breathing.

Children with asthma who get enterovirus D68 may be more likely to have serious breathing problems.

In rare cases getting enterovirus D68, or in some parts of the world, a related virus called enterovirus 71, is linked to problems with how muscles work. After an infection, some muscles quickly become weak or stop working.

This paralysis after an infection is called acute flaccid myelitis. Muscles that are most often affected are in the arms and legs, or in the face or throat.

Contact a health care provider if your child has had a cold within about 10 days and then develops:

  • Fever.
  • Headache.
  • Back pain or pain in an arm or leg.
  • Sudden weakness in the face or neck muscles, or drooping face muscles or eyelid on one side.
  • A new problem with walking.
  • Problems using a hand or arm.
  • Problems swallowing, talking or breathing.

Parechovirus A3

Parechovirus A3 spreads between people in the same way as enterovirus D68. Most people have had an infection with a strain of parechovirus by around age 5.

People may not have any symptoms of infection. Or they may have typical cold symptoms such as fever, headache, sore throat or tiredness.

Infection with the parechovirus A3 strain can cause a more serious illness. Severe symptoms most often occur in infants 12 months old or younger and may include:

  • High fever in children age 6 months or younger.
  • Widespread rash.
  • Intensely red hands and feet.
  • Trouble breathing.
  • Symptoms of sepsis, which can include a combination of very fast breathing, very fast heart rate, fewer wet diapers, not being able to wake your child up or a child who seems confused.
  • Seizures.
  • Swelling of the tissue around the brain and spinal cord, called meningitis.


There is no specific treatment for enterovirus D68, acute flaccid myelitis or severe illness from parechovirus A3. But health care providers can support your child's health with medicine. Or they might recommend your child be monitored in the hospital.

Call your provider or get emergency care right away if:

  • Your child is having trouble breathing.
  • You notice muscle problems.
  • Your child younger than age 3 months has a temperature over 100.4 F (38 C); your child ages 3 to 6 months has a fever higher than 102 F (38.9 C); or an older child has a temperature higher than 104 F (40 C).
  • Your child's symptoms don't improve after a few days or get worse.


There is no vaccine against enterovirus D68 or parechovirus A3. But you can protect your child from getting an infection from these viruses and prevent the spread of infection by:

  • Washing hands often with soap and water.
  • Not touching your eyes, mouth and nose.
  • Avoiding close contact with people who are sick.
  • Covering coughs and sneezes with a tissue or shirt sleeve.
  • Cleaning and disinfecting frequently touched surfaces, such as doorknobs, stair rails and toys.
  • Staying home from school, work or child care if you are sick.

If your child has asthma, make sure the asthma action plan is up to date. And make sure other caregivers and teachers know how to help your child.

It's also important that your child takes prescribed medicines as directed. And get a flu vaccine for you and your child when it's available too.

If your child develops wheezing or difficulty breathing that doesn't improve with prescribed medicines, get medical help right away. Get medical help right away if your child has limb weakness or other muscle problems, especially within two weeks after being sick.


Elizabeth Ristagno, M.D.

March 02, 2023 See more Expert Answers