TRENTON, N.J. (AP) -- A virus that has been causing severe respiratory illness across the country is responsible for the death of a 4-year-old boy, a state medical examiner determined.

Hamilton Township health officer Jeff Plunkett said the Mercer County medical examiner's office found the death of Eli Waller was the result of enterovirus 68. The virus has sickened more than 500 people in 43 states and Washington, D.C. - almost all of them children.

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The U.S. Centers for Disease Control and Prevention said earlier this week that four people infected with the virus had died, but it's unclear what role the virus played in the deaths.

Some children are especially vulnerable to infection because of pre-existing conditions, though the medical examiner said that was not the case in the New Jersey boy's death. Most of the severe cases nationwide have involved children because they generally have not been exposed to enteroviruses as often as adults have and are less likely to have developed immunity to them, officials say.

Township officials said the boy's parents have asked for privacy.

"When you're given the news that a virus was the cause of death to your child, of course they were saddened, even more so because they won't get the answers or closure they need," Mayor Kelly Yaede said. "The mother said, `We will never find out where he contracted this.'"

The enterovirus germ is not new; most people who catch the virus experience only a runny nose and low-grade fever. It was first identified in 1962 and has caused clusters of illness before.

This year, the virus has gotten more attention because it has been linked to hundreds of severe illnesses. Beginning last month, hospitals in Kansas City, Missouri, and Chicago have received a flood of children with trouble breathing.

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