When 10-year-old Emily Otrando had a difficult time breathing one night, her parents brought her to the hospital just to check to make sure everything was OK. When she arrived, the doctors described that her condition deteriorated within 24 hours until she died from complications of an unusual respiratory virus that has been spreading to children throughout the U.S. This is the fourth death traced to people who have tested positive for enterovirus D68, a fast-spreading virus that seems like a fever, cough, runny nose, and asthma at first, which could make parents believe it’s nothing to worry about.

“We are all heartbroken to hear about the death of one of Rhode Island’s children,” Dr. Michael Fine, director of the Rhode Island Department of Health, said in a statement. He explained that the child, who also had a staph infection but was otherwise healthy, experienced shortness of breath "and really by the time she got to the hospital, everything fell apart very quickly within 24 hours. Many of us will have EV-D68. Most of us will have very mild symptoms and all, but very few will recover quickly and completely. The vast majority of children exposed to EV-D68 recover completely.”

Since Wednesday, the Centers for Disease Control and Prevention has confirmed 500 people in 42 states with a respiratory illness caused by enterovirus D68. The most recent cases have been seen in children 6 months to 16 years old. The enterovirus has also been linked to several cases seen in Colorado, Boston, and Michigan, where 10 children were hospitalized with limb weakness, cranial nerve dysfunction, and abnormalities in their spinal gray matter. Each year, between 10 to 15 million enterovirus infections occur, and many children need extra care and monitoring as it can be a tough virus to beat.

Enterovirus Season: July Through October

Just when kids are going back to school and prepping their immune system to build strong defenses for the countless exposures they have with their classroom peers. Many health professionals are recommending washing hands five times a day, especially after playing with other students or using public restrooms or restaurants.

The enterovirus germs can live on surfaces for up to a day, depending on the temperature and humidity, and most children catch it from touching a contaminated surface, object, or infected child and then rubbing their nose or eyes. Infants, children, and teenagers are at the highest risk for contracting the virus that’s spread through breathing, saliva, nasal mucus. Many start wheezing, coughing, and having trouble breathing even though they have no history of asthma.