Enterovirus D68 in the United States of America

Supply-chain Risk Briefing

1. Summary

In September 2014, the WHO was notified of severe respiratory illness cases related to Enterovirus D68 (EV-D68) in the United States. This is a respiratory virus that primarily affects children, representing a high-grade disease outbreak situation that could trigger surging demand for medical supplies and strain pharmaceutical supply chains.

2. Supply-chain impact

• Medical supply strain: Concerns over supply shortages affecting related manufacturers and distribution networks due to surging demand for respiratory treatment medical devices, oxygen supply equipment, and personal protective equipment (masks, gloves)
• Pharmaceutical supply chain burden: Pressure on active pharmaceutical ingredient (API) manufacturers and finished pharmaceutical production lines due to increased demand for respiratory treatment medications including antipyretics, bronchodilators, and anti-inflammatory drugs
• Logistics network impact: Potential indirect effects on regional medical logistics systems due to patient isolation and infection prevention measures causing medical staff shortages and hospital operational disruptions
• International trade caution: Potential constraints on North American regional trade flows if inter-country health quarantine measures are strengthened due to disease outbreak originating from the United States

3. Watch points

• Scale of infection spread: Need to monitor whether additional states within the United States are affected and track patient number trends to forecast medical supply demand
• International spread potential: If infection cases occur in neighboring countries (Canada, Mexico), assessment of impact on the entire North American supply chain network will be required