A New Jersey preschooler killed last month by a respiratory virus that is spreading across the U.S. showed symptoms only of pinkeye before he died in his sleep, health officials said. 
 
 Four-year-old Eli Waller, of Hamilton Township, was kept home from school by his mother on Wednesday, Sept. 23, because he was developing a little bit of pinkeye, said Jeff Plunkett, the health officer for the township. He was otherwise fine and had been in school on Sept. 21 and 22. 
 
 Waller, a triplet with two sisters, never woke up. 
 
 “Between the time his mom put him to bed Wednesday night and when she went to wake him up on Thursday morning, he passed,” Plunkett said in a telephone interview yesterday. “He had no other symptoms whatsoever.” 
 
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 The Mercer County medical examiner’s office on Oct. 4 listed Waller’s cause of death as Enterovirus D68, or EV-D68, a virus that reemerged in the U.S. in August and has spread to at least 43 states. It can be particularly hard-hitting, and has put hundreds of children in the hospital with breathing difficulties and caused paralysis in dozens more. 
 
 The virus has been documented in the deaths of four people so far in the U.S., based on testing by the U.S. Centers for Disease Control and Prevention. It’s not entirely clear what role the virus played in those deaths. A 10-year-old girl from Rhode Island who died in late September was the first reported fatality linked to the disease. 
 
 Photographer: Scott Ketterer/The Trentonian via AP Images A blue and gold ribbon wrap around a tree in front of Yardville Elementary School in Hamilton Township, New Jersey, on Oct. 4, 2014, in memory of a preschooler who died on Sept. 25 of enterovirus 68. Close A blue and gold ribbon wrap around a tree in front of Yardville Elementary School in... Read More Close Open Photographer: Scott Ketterer/The Trentonian via AP Images A blue and gold ribbon wrap around a tree in front of Yardville Elementary School in Hamilton Township, New Jersey, on Oct. 4, 2014, in memory of a preschooler who died on Sept. 25 of enterovirus 68. 
 
 The U.S. is in the middle of the enterovirus season, though it is expected to ease later in the fall, the CDC said Oct. 3. The relatively rare D68 strain appears to be the dominant type of enterovirus circulating this year and may be contributing to the increase in severe respiratory illness, the agency said. 
 
 There are no special methods to treat or prevent EV-D68, Plunkett said. People should follow typical hand hygiene practices, such as covering their coughs, washing hands with warm water for at least 20 seconds several times a day, and staying home when feeling unwell. 
 
 To contact the reporter on this story: Michelle Fay Cortez in Minneapolis at mcortez@bloomberg.net 
 
 To contact the editors responsible for this story: Reg Gale at rgale5@bloomberg.net Drew Armstrong, Bruce Rule ||||| Eli Waller, the 4-year-old New Jersey boy whose death is the first blamed on the respiratory disease enterovirus 68 was "a beautiful mix of eagerness and hesitancy, need and striving, caution and surprise, all of which were grounded in a pure, unconditional love," his father said today. 
 
 Eli, of Hamilton, N.J., was the youngest of three triplets, born "smaller and lighter than his sisters," but he was never one to let that stand in his way, his father Andy Waller said in a letter released this evening. 
 
 "Eli was not the type to give up, and even though things never really came easily to him, he would just plug away, day after day, practicing sounds, or movements, or skills, until he would eventually get them," his father said. 
 
 "He did this entirely in an effort to make his Mom and Dad proud, and we can unequivocally say that we were, and will continue to be, so very proud of our little Eli," he said. 
 
 He compared his son to "a shy little puppy who wants only to make people proud and happy, maybe tripping a bit over his own paws, but truly full of unconditional love." 
 
 Andy Waller said the family was establishing The First Day of School Foundation, to provide support for students involved in Special Education. 
 
 "Like so many kids his age, Eli was both nervous and excited about starting school, and it is our sincere hope that this Foundation can work to help kids in a way that will make Eli proud of us all, in the same way that we were all so proud of him," he said. 
 
 Courtesy of the Waller family PHOTO: Eli Waller, the 4-year-old New Jersey boy who was the first child confirmed to have died of the Enterovirus-68, seen in a family photo. 
 
 Hamilton Township, N.J., Health officer Jeff Plunkett said Saturday that after the Centers for Disease Control and Prevention confirmed Friday that Eli was infected with the enterovirus 68 when he died last week, the Mercer county medical examiner deterimined the preschooler's death was directly related to the disease. 
 
 Brain and lymph node swelling in the child was then determined to be a result of the virus. 
 
 While the virus has appeared to be particularly dangerous for asthmatic children or children with underlying health issues, Plunkett said Eli had no known health issues. 
 
 At least four other patients who tested positive for the enterovirus 68 have died, and CDC and local medical officials are investigating whether the virus played a role in their deaths. 
 
 Another child in Rhode Island died last week from a combination of bacterial and viral infections. The Rhode Island Department of Health said the 10-year-old girl died of Staphylococcus aureus sepis "associated with" enterovirus 68. 
 
 The respiratory disease is suspected of sickening children in at least 43 states, according to the CDC. The virus often starts out similar to a common cold with patients usually complaining of coughing or a runny nose. In rare cases the respiratory problems can become severe, particularly for asthmatic patients. 
 
 In Colorado, CDC and local health officials are investigating whether limb weakness and paralysis reported in nine children was associated with the enterovirus 68. 
 
 The Associated Press contributed to this story. 
 
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– A 4-year-old New Jersey boy who died after contracting enterovirus-68 had no symptoms other than pinkeye when his mom put him to sleep on the night of Sept. 24; by the time she went in the next morning to wake him up, he had died, Bloomberg reports. Eli Waller stayed home from school on the 24th because of the pinkeye, but had attended school earlier in the week. And unlike other children hard-hit by the virus, Eli was not asthmatic. He was "a beautiful mix of eagerness and hesitancy, need and striving, caution and surprise, all of which were grounded in a pure, unconditional love," his father tells ABC News. Born last in a birthing of triplets, Eli came out "smaller and lighter" than his two sisters but didn't let that hold him back, his dad says: "Eli was not the type to give up, and even though things never really came easily to him, he would just plug away, day after day." Enterovirus-68 has struck at least 43 states, hospitalizing hundreds of children, paralyzing others, and apparently playing a role in at least four US deaths. On the brighter side, the enterovirus season should subside later this fall—but with the rare 68 strain dominating, experts say it's smart to follow basic hygiene practices like covering coughs, staying home when unwell, and washing hands in warm water. (Meanwhile, the CDC is trying to confirm links between EV-68 and cases of paralysis.)