Enterovirus D68 and What To Do

September 17th, 2014 by Barbara Lounsury, M.D.

The recent outbreak in the Midwest of severe respiratory illnesses in children due to Enterovirus D68 hasn’t hit California yet but school and other activities are now in full swing so we can expect the disease to spread, possibly to San Diego.

What is Enterovirus D68? D68 is a rare virus that is very similar to the far more prevalent virus that causes most common colds.  In fact, infections from Enterovirus D68 start out looking just like the common cold but they can and sometimes do progress to far more serious problems, including wheezing and difficulty breathing.  Because children haven’t yet built up much immunity to enterovirus, their infections tend to be more severe than those of adults.

Anyone can get an enterovirus-caused infection.  The “common cold” is so common that there are 10-15 million infections each year in the U.S.  Currently, there are fewer than 100 infections that are known to be caused by Enterovirus D68, although public health experts believe there hundreds more.  All of these have occurred in Colorado, Illinois, Iowa, Kansas, Kentucky, and Missouri.  However, because several young children and some adults have required hospitalization for respiratory care, D68 has rung an alarm bell.

Diagnosis and treatment.  Currently, only state health departments and the Federal government’s Centers for Disease Control (CDC) test for the D68 variant of enterovirus.  Moreover, the test is not likely to be done unless the individual requires hospitalization.  This shouldn’t create concern for families, however, because most cases of infection are mild, involving some combination of fever, runny nose, sneezing, cough, and achy muscles.  They last five to seven days and treatment with over-the-counter medications for fever and pain is likely to provide some relief.  In addition, there are no antiviral medications available, so knowing that D68 is the culprit wouldn’t be helpful for treatment.

What should parents do?  If your child gets a cold, be watchful but don’t panic.  Most respiratory illnesses will still be the common cold.  Look for wheezing or difficulty breathing.  If these symptoms occur, check with your doctor or take your child in to be checked.  Children with asthma may be at higher risk for serious illness, so you need to be especially vigilant.

What about prevention?  Preventing illness from Enterovirus D68 is no different from prevention of colds and flus more generally.  In summary:

1. wash your hands often using soap and water for 20 seconds. Alcohol gels do not work as well as simple hand washing.

2. avoid touching your eyes, nose, and mouth with unwashed hands;

3. avoid kissing, hugging, and sharing cups or eating utensils with people who are sick; and

4. disinfect frequently-touched surfaces, such as toys and doorknobs, especially if someone is sick.

CDC has a nice infographic to serve as a reminder.  Go to the following website (http://www.cdc.gov/non-polio-enterovirus/about/EV68-infographic.html), print out the infographic, and post it where its most likely to be seen and followed.

For those who have asthma, there are some additional items:

1. regularly take asthma medications so asthma is under good control;

2. reduce other asthma triggers such as smoke or other allergens; and

3. take advantage of the influenza vaccine to avoid another respiratory illness which can trigger asthma symptoms.

 

Further information is available at: www.cdc.gov/non-polio-enterovirus/about/EV-D68.html