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With reports of infections from California and Minnesota trickling in on Thursday, the Enterovirus D 68 has affected children across 21 states.

According to LA Times, California State health officials reported four cases of infection among children, three in San Diego County and one from Ventura County. The numbers are expected to rise in the coming days as more test results are awaited. Infections with Enteroviruses are said to be common at this time of year but the present infections are caused by a rare strain of the virus not seen since 1962. Children, particularly those with upper respiratory problems like asthma, are among the worst affected.

The Washington Post said 153 cases have been reported so far by the Center for Disease Control. Besides California, Minnesota and New Jersey reported infections this week. Positive cases are also expected from Michigan, Utah, Ohio and Georgia, the Post reported.

While there was some concern during the early phases of the outbreak which forced health officials to deter children from visiting hospitals, caregivers across the country are now tackling infections with ease.

Dr Richard Besser told ABC News that opening up airways is helping children get out of emergency rooms.

"It's the same medicine that's used for children who have asthma. But when I was in the emergency room this week in St. Louis, they were giving it to children who didn't have asthma, and you could just see them turn around. Their airways would open up. Some of them could leave the emergency room. Some had to stay, but the medicine helps a lot," he said.

The current outbreak of Enterovirus has mostly affected children. No adult infections have been reported though mild symptoms are possible in adults. Most children coming into emergency rooms have presented with flu symptoms but some have also complained of wheezing and breathing difficulty.