At least four people have died after contracting a severe respiratory illness that has spread to more than 40 states, public health officials announced. The deaths were the first linked to the nationwide outbreak of enterovirus 68, which sent many sick children to hospitals around the country, with some now critically ill. Tests showed the patiients who died had been carrying enterovirus 68, but it is not clear to what extent the virus contributed to their deaths, the Centers for Disease Control and Prevention said. The CDC confirmed 472 cases of the infection as of Wednesday, but experts say the true number of cases is likely many times that number.