Health and Safety Alert- Respiratory Virus Enterovirus D68/EV-D68

ENTEROVIRUS D68/EV-D68

Hundreds of children across the United States have been hospitalized with a serious respiratory illness. Scientists say they believe the bug to blame is Enterovirus D68, also known as EV-D68. Enteroviruses are common, especially in September, but this particular type is not. There have been fewer than 100 cases recorded since it was identified in the 1960s, according to the Centers for Disease Control and Prevention. This respiratory virus is unusually high number of hospitalizations reported could be “just the tip of the iceberg in terms of severe cases,” said Mark Pallansch, a virologist and director of the Centers for Disease Control and Prevention’s Division of Viral Diseases. Ten states have contacted the CDC for assistance in investigating clusters of enterovirus: Colorado, North Carolina, Georgia, Ohio, Iowa, Illinois, Missouri, Kansas, Oklahoma and Kentucky. Four — Colorado, Illinois, Missouri and Iowa — have confirmed cases of Enterovirus D68, also known as EV-D68. The CDC confirmed that samples it tested from children who had been hospitalized in Illinois and in Kansas City, Missouri, did show signs of the EV-D68 virus, meaning there is a possible regional outbreak.

Enteroviruses, which bring on symptoms like a very intense cold, aren’t unusual.”It’s important to remember that these infections are very common,” said Dr. Anne Schuchat. Schuchat is the assistant surgeon general for the U.S. Public Health Service and the director of the National Center for Immunization and Respiratory Diseases. When you have a bad summer cold, often what you have is an enterovirus. The CDC estimates there are 10 to 15 million viral infections each year in the United States. The season often hits its peak in September.

This particular type of enterovirus — EV-D68 — is uncommon but not new. It was identified in the 1960s, and there have been fewer than 100 reported cases since that time. But it’s possible that the relatively low number of reports might be because EV-D68 is hard to identify. EV-D68 was seen last year in the United States and this year in various parts of the world. Over the years, clusters have been reported in Georgia, Pennsylvania, Arizona and various countries including the Philippines, Japan and the Netherlands.

The reason health officials are concerned this year is that there have been so many hospitalizations. That’s the scary part — the unpredictability.

What are the symptoms?

Most people who are infected with non-polio enteroviruses do not get sick, or they only have mild illness. Symptoms of mild illness may include:

•fever

•runny nose, sneezing, cough

•skin rash

•mouth blisters

•body and muscle aches

Some non-polio enterovirus infections can cause

•viral conjunctivitis,

•hand, foot, and mouth disease,

•viral meningitis (infection of the covering of the spinal cord and/or brain).

Less commonly, a person may develop:

•myocarditis (infection of the heart)

•pericarditis (infection of the sac around the heart)

•encephalitis (infection of the brain)

•paralysis

People who develop myocarditis may have heart failure and require long term care. Some people who develop encephalitis or paralysis may not fully recover.

Newborns infected with non-polio enterovirus may develop sepsis (infection of the blood and other organs). But this is very rare.

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. Respiratory problems appear to the hallmark of EV-D68, according to the Missouri Department of Health and Senior Services. “Most enteroviruses cause either a little bit of a cold or a diarrheal illness — a few cause meningitis,” said Schaffner. “This one is the, if you will, odd cousin. It causes prominent respiratory symptoms. Why it does that, we’re really not sure.”

What parents should know about EV-D68

The virus has sent more than 30 children a day to a Kansas City, Missouri, hospital, where about 15% of the youngsters were placed in intensive care, officials said. In Kansas City, about 475 children were recently treated at Children’s Mercy Hospital, and at least 60 of them received intensive hospitalization, spokesman Jake Jacobson said. Vaccines for EV-D68 aren’t currently available, and there is no specific treatment for infections, the Missouri agency said.

“Many infections will be mild and self-limited, requiring only symptomatic treatment,” it said. “Some people with several respiratory illness caused by EV-D68 may need to be hospitalized and receive intensive supportive therapy.” Some cases of the virus might contribute to death, but none of the Missouri cases resulted in death, and no data are available for overall morbidity and mortality from the virus in the United States, the agency said.

Symptoms include coughing, difficulty breathing and rash. Sometimes they can be accompanied by fever or wheezing. The majority of the children who have been hospitalized with the virus, at least on the samples the CDC tested, did have asthma to start with. The virus made their symptoms worse.

Risk of infection and means of transmission

Non-polio enteroviruses can be found in an infected person’s

· eyes, nose, and mouth secretions (such as saliva, nasal mucus, or sputum), or

· blister fluid.

You can get exposed to the virus by—

· having close contact, such as touching or shaking hands, with an infected person,

· touching objects or surfaces that have the virus on them,

· changing diapers of an infected person, or

· drinking water that has the virus in it.

If you then touch your eyes, nose, or mouth before washing your hands, you can get infected with the virus and become sick.

Pregnant women who are infected with non-polio enterovirus shortly before delivery can pass the virus to their babies.

What can be done to prevent it?

Like other enteroviruses, the respiratory illness appears to spread through close contact with infected people. That makes children more susceptible.There’s not a great deal you can do, health officials say, beyond taking commonsense steps to reduce the risk.

· 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. And stay home if you feel unwell.

There’s no vaccine for EV-D68.

 


 

Today’s post comes to us courtesy of Ken Oswald, Safety and Security for Plateau

keno@plateautel.com

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