A child in Rhode Island has died from a rare disease combination that stems in part from an enterovirus that has spread across the United States over the past few months, and it may be the first such U.S. death associated with the virus this year.

The child, who has not yet been identified, passed away last week after he was infected by a lethal combination of Staphylococcus aureus sepsis and a strain of the flu-like enterovirus known as EV-D68. Staph infections manifest in different ways but can impair respiratory function, though the combination of a staph infection and enterovirus is rare, according to a statement from the Rhode Island Department of Health.

Michael Fine, the department’s director, said in a different statement that members of his staff were “heartbroken” by the child’s death, but cautioned that “the vast majority of children exposed to EV-D68 recover completely.”

The disease began to make headlines in September after hundreds of children across the midwest sought treatment in hospitals. The children, many of whom were infected with this strain of enterovirus, were experiencing severe respiratory distress. The Centers for Disease Control and Prevention has documented 472 confirmed cases of EV-D68 in 41 states and the District of Columbia this year, 471 of whom have been children. Those children often have asthma or a history of respiratory issues, making them more susceptible to the enterovirus, and many other children hospitalized with similar symptoms and tested by the CDC turned out to be suffering from a milder enterovirus.

EV-D68 is itself a rare breed. Enteroviruses infect 10 to 15 million Americans per year, and symptoms generally progress no further than the runny noses and fevers that one might associate with a common cold. Though the respiratory illness has a greater impact on the young, according to the Rhode Island Department of Health, it’s unknown why the disease has put so many children in hospitals over the past few months.

Regardless of cause, the disease is likely to fade from the spotlight as summer turns to fall, according to the CDC. The number of enterovirus infections generally peaks around August or September each year.

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