Enterovirus D-68 is responsible for the death of a 4-year-old boy in New Jersey, a state medical examiner determined this weekend. It is the first case in which the virus has been cited as a direct cause of death.
Hamilton Township health officer Jeff Plunkett said the Mercer County medical examiner's office found that Eli Waller's Sept. 25 death was the result of the virus, which has severely sickened more than 500 people nationwide, almost all of them children.
"I think Eli's case is the exception," Plunkett told ABC News. "He had no signs of any illness that night, and his passing was sudden and shocking."
Enterovirus infections are often mild, so they usually go undetected. The virus has been associated, rarely, with severe breathing troubles and, even more rarely, with neurological symptoms, including polio-like muscle weakness. Most reported cases of severe illness from enterovirus D-68 have involved respiratory distress, and children with asthma have been particularly susceptible.
Some children are especially vulnerable to infection because of preexisting conditions, although the medical examiner said that was not the case in Eli's death.
The U.S. Centers for Disease Control and Prevention said last week that four people infected with the virus had died, not including Eli. It is unclear what role the virus played in those deaths. In at least one of the four cases, the patient had a concurrent bacterial infection.
California has 14 confirmed cases of enterovirus D-68, two of which are in Los Angeles County, public health officials said Friday. All the cases affected children ages 1 to 15.
Enterovirus is not new: Epidemiologists have been familiar with it for more than 50 years.
This year, the virus has gotten more attention because it has been linked to hundreds of severe illnesses. Hospitals in Kansas City, Mo., and Chicago have received a flood of children with trouble breathing.
The Associated Press and Times staff writers Eryn Brown and Garrett Therolf contributed to this report.