D-68 Entero Respiratory Virus Confirmed in Washington, Can Hit Kids with Asthma Hard

It’s common to see 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 says from mid-August to September 12, 2014, a total of 97 people in six states were confirmed to have respiratory illnesses caused by EV-D68. [Most often, testing is not performed unless patients require hospitalization for symptoms.]

By September 19th, the CDC reported 160 people in 22 states had confirmed cases of a respiratory illness caused by EV-D68.

The EV-D68 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.

Suspected EV-D68 in Washington

Last 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 – and that it might be D-68.

King County Public Health says these patients “tested positive for a possible enterovirus infection,” and that the Centers forconfirmed D68 Disease Control (CDC) is performing additional testing to determine if it is the D-68 strain that has been seen in other U.S. states.

At this time there are no confirmed cases of EV-D68 in King County or Washington state.

“Although we can’t currently say that these cases are definitely due to EV-D68, it would not be surprising if the virus is confirmed on further testing,” said Dr. Jeff Duchin, Chief of Communicable Disease and Epidemiology at Public Health – Seattle & King County.

King County Public Health says if EV-D68 does appear locally, “large numbers of children could develop respiratory infections in a short time period, as the virus spreads similarly to the common cold. With most enterovirus infections, the vast majority of children have a mild illness that does not require medical attention. However, parents of children with asthma should be aware that their children appear to be more susceptible to serious illness.”

“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 D68

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. 

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