Expert Explains Enterovirus D68

A respiratory virus that has sent hundreds of children to hospitals in Missouri is causing alarm across the Midwest and beyond. So far, 10 states have contacted the Centers for Disease Control and Prevention (CDC) for help investigating clusters of the virus that's being blamed for the illness. Although health officials say they're still figuring out what's going on, the bug that appears to be causing most of the concern is Enterovirus D68 (EV-D68). Many of its symptoms are very common and could be confusing parents with sick children.

Saul Hymes, MD, assistant professor in the Department of Pediatrics at Stony Brook Children’s Hospital who specializes in pediatric infectious disease, talks about what parents across the US need to know about this virus.

“Enteroviruses as a whole are a common family of summer viruses that usually cause fever, diarrhea, and sometimes rash,” says Hymes. “But severe respiratory symptoms are not typical.”

The virus can start as just a cold. Signs include coughing, difficulty breathing and in some cases a rash. Sometimes they can be accompanied by fever or wheezing.

“This particular strain, EV-D68, is a rare one and while it has caused outbreaks in the past, it is not as common as viruses like coxsackie (an enterovirus) or others common in children,” says Hymes. “In the past, when this virus has caused outbreaks, interestingly enough, EV-D68 has caused respiratory symptoms.”

There are more than 100 types of enteroviruses causing about 10 to 15 million infections in the United States each year, according to the CDC. They are carried in the intestinal tract and often spread to other parts of the body.

“It is very unusual to see such severe respiratory illnesses in the summer,” says Hymes. “The patient volume in those affected areas are the numbers we see in RSV or flu season, which is late fall and winter. And it is unusual to see respiratory symptoms in a summer virus that is landing patients in the hospital.”

It was reported that this virus has sent more than 30 children a day to a Kansas City, Mo. hospital, where about 15 percent of the youngsters were placed in intensive care.

“Treatment, as this is a virus, is symptomatic,” says Hymes. “We treat the fever, treat the respiratory symptoms, hydrate, and make the patient feel comfortable.”

Like other enteroviruses, the respiratory illness appears to spread through close contact with infected people. That makes children more susceptible. To prevent the spread, Hymes says, “The only thing you can do is take simple precautions.”

• Wash your hands with soap and water for 20 seconds -- particularly after going to the bathroom and changing diapers.
• Clean and disinfect surfaces that are regularly touched by different people, such as toys and doorknobs.
• Avoid shaking hands, kissing, hugging and sharing cups or eating utensils with people who are sick.
• Stay home if you feel unwell.

Currently, there is no vaccine for EV-D68.

“We have not yet seen this virus in any numbers here in Stony Brook Children’s or on the East Coast,” says Hymes. “But the outbreak may travel and epidemiologists and clinicians are monitoring the situation.”

Source: Stony Brook University

See also: http://www.infectioncontroltoday.com/news/2014/09/respiratory-illnesses-due-to-enterovirus-d68-being-investigated-in-missouri.aspx