Colds and other illnesses begin spreading rapidly once children return to school. But at the start of this new school year, health officials are warning parents and schools to watch for a rarely seen virus, EV-D68, which has the potential to land some children in the hospital.
The Center for Disease Control said “from mid-August to September 19, 2014, a total of 160 people in 22 states have been confirmed to have respiratory illness caused by EV-D68.” This latest total includes Washington State – and more specifically, King County.
The outbreaks are resulting in significant numbers of children requiring emergency department visits and hospitalizations, primarily for difficulties with breathing and severe asthma.
Distinguishing Enteroviruses and EV-D68
According to the Washington State Department of Health, enteroviruses are very common, with over 100 varieties and 10-15 million Americans being infected by them each year. Enterovirus D-68 is not as common and has been rarely reported in the U.S. in the past 40 years. Most enteroviruses appear in late summer and early fall.
The Department of Health says most people infected with an enterovirus only present with mild, cold-like symptoms. Enterovirus D-68, though, can cause serious respiratory symptoms – especially in children prone to asthma or other conditions that make breathing difficult. For some of those children, D-68 can result in hospitalization, as seen in the midwest U.S. over the past month.
First Suspected EV-D68 Cases in Washington
Thursday, September 11, 2014, it was reported by The Seattle Times that a cluster of patients with a severe respiratory illnesses were being treated at Seattle Children’s.
King County Public Health said these patients “tested positive for a possible enterovirus infection,” and that the Centers for Disease Control (CDC) was performing additional testing to determine if it is the D-68 strain that has been seen in other U.S. states.
First Confirmed D-68 Cases
Friday, September 19th, the CDC confirmed the presence of enterovirus D68 (EV-D68) in Washington state, including King County. The CDC testing confirmed that a King County child hospitalized at Seattle Children’s Hospital has respiratory illness associated with EV-D68.
“Confirmation of this case indicates that EV-D68 is likely circulating in our community and regionally, and we could see additional
cases over the coming weeks,” said Dr. Jeff Duchin, Chief of Communicable Disease and Epidemiology at Public Health – Seattle & King County. “However, we can’t predict at this time how severe or how long an EV-D68 outbreak might be locally. Outside of Seattle Children’s Hospital, our monitoring does not show an increase in patients hospitalized for asthma in King County.”
The results of the testing also show that EV-D68 is not alone in causing serious respiratory illness. The tests indicated that a variety of common cold viruses that cause uncomplicated infections in most children can cause severe disease in asthmatics and those with underlying lung diseases. Influenza was not detected during testing.
“It’s important for families to make sure asthma symptoms are under control, and to see a health care provider if a person with asthma develops a respiratory illness that worsens asthma symptoms,” Duchin said.
People who do not have severe illness do not need to seek medical evaluation or testing for EV-D68, which is not widely available outside of hospitals.
Symptoms of Enterovirus D-68
EV-D68 presents like a common cold. It has been reported to cause mild to severe respiratory illness (runny nose, cough, difficulty breathing) with and without fever. A minority of people may have more serious infections, particularly children with pre-existing asthma.
EV-D68 virus can be found in a person’s respiratory secretions. The virus likely spreads from person to person when an infected person coughs, sneezes, or a person touches contaminated surfaces.
Infants, children, and teenagers are most likely to get infected with enteroviruses and become sick. Anyone who has difficulty breathing or who appears seriously ill should be evaluated promptly by a healthcare provider.
Because EV-D68 has previously been uncommon in the US, health officials are still learning about the illness and risk factors for infection.
Prevention of EV-D68 Infection
There is no vaccine or specific treatment for enterovirus infections. To decrease the risk of infection:
- Wash hands often with soap and water for 20 seconds (alcohol hand gel is not as good as hand washing for enteroviruses)
- Avoid touching eyes, nose and mouth with unwashed hands
- Avoid contact with ill people
- Do not attend daycare, school or work while ill
- Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick
- Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick
- Children and adults with asthma should be sure to have their asthma symptoms under control and see a health care provider if they develop a respiratory infection and their asthma worsens
King County Public Health says adults and children with non-severe enterovirus infections do not need to see a health care provider and do not need to be tested.