Enterovirus D68 (EV-D68)

Enterovirus D68 (EV-D68) is a non-enveloped, positive-sense single-stranded RNA virus belonging to the Picornaviridae family and the Enterovirus D species. Originally isolated in 1962, it has emerged as a significant global health threat, primarily causing severe respiratory illness and a polio-like neurological condition known as acute flaccid myelitis (AFM) in children. The viral genome encodes a single polyprotein that is processed by viral proteases (2A and 3C) into structural proteins (VP1-VP4) and non-structural proteins (2A-3D) essential for replication. Therapeutic development focuses on several key targets within the virus, including the VP1 capsid protein for entry inhibition, the 3C and 2A proteases for polyprotein cleavage, and the 3D RNA-dependent RNA polymerase for genome replication. Small molecules like pleconaril and pocapavir target the viral capsid to prevent uncoating, while repurposed drugs like telaprevir have shown activity against the 2A protease. Despite the clinical urgency and the biennial nature of outbreaks, there are currently no FDA-approved vaccines or specific antiviral therapies for EV-D68, with treatment largely limited to supportive care.

Other names

EV68EV-D68Human enterovirus 68Human rhinovirus 87Fermon virus

Capsid binding, 2A protease inhibition, 3C protease inhibition, 2C protein inhibition, RNA-dependent RNA polymerase inhibition, IRES-mediated translation inhibition