October 20, 2014 – The vast majority of children who contract Enterovirus D68 will have mild, common cold symptoms, however, some children with underlying conditions such as asthma or other respiratory conditions tend to have airways that are more reactive and therefore can suffer serious outcomes.
The CDC states that all but one of the confirmed Enterovirus cases this year have been children, although 25% of all Enterovirus 68 cases before 2005 were adults. Most adults who have contracted the virus will not have serious symptoms.
- Runny nose
- Skin rash
- Body and muscle aches
- High Fever
- Difficulty breathing
Some types of Enterovirus are more serious and can cause hand, foot and mouth disease, viral meningitis, encephalitis (inflammation of the brain), an infection in the heart and paralysis.
If your child’s symptoms are getting worse…
If your child is experiencing difficulty in breathing or if you feel you are unable to control the symptoms, or if symptoms are getting worse, the CDC recommends you call your child’s doctor immediately. If your child develops severe illness, he or she may need to be hospitalized.
If your child suffers from asthma, the CDC recommends:
- Discuss and update your child's asthma action plan with your doctor.
- Make sure your child takes the prescribed asthma medications as directed, especially long-term control medication(s).
- Make sure your child knows to keep asthma reliever medication with him or her or has access to it at all times.
- Get your child a flu vaccine, since flu and other respiratory infections can trigger an asthma attack. See Vaccination: Who Should Do It, Who Should Not and Who Should Take Precautions
- If your child develops new or worsening asthma symptoms, follow the asthma action plan. If symptoms do not go away, call your child's doctor right away.
- Make sure caregivers, teachers and relatives are aware of your child's condition and that they know how to help if your child experiences any symptoms related to asthma.
- Call your child's doctor if he or she is having trouble breathing, if you feel you are unable to control symptoms, or if symptoms are getting worse.
How Does Enterovirus D-68 Spread?
Enterovirus is spread through virus-laden droplets in the air. When someone coughs or sneezes in your vicinity, you can easily contract the virus. The virus can also be transmitted through contaminated hands.
The eyes, the nose and mouth are portals of entry for this virus and every other virus and cold. To avoid the spread of germs and fend of Enterovirus it is highly recommended that you teach your children the following:
- Wash your hands frequently with soap and water for 20 seconds
- DO NOT cough into your hands - cough into your elbows
- Avoid touching your eyes, nose and mouth with unwashed hands
- Avoid close contact with people who are sick, i.e. kissing, hugging, and sharing cups, glasses or eating utensils
- Cover sneezes with a tissue or shirtsleeve - not your hands.
Clean and disinfect surfaces in your home frequently, i.e. counter tops, tables, desks, washroom sink and toilet, kitchen area, doorknobs, toys, etc. especially if someone is sick.
If your child is sick, “do the right thing” and keep him/her out of school.
What is Enterovirus 68?
Enterovirus D68 (EV-D68) is the name used to describe a group of more than 100 of the most common viruses that affect humans and mammals. Most people will contract Enterovirus by way of the common cold.
The first Enterovirus cases were identified in California in 1962 with four children who had bronchitis and pneumonia.
The Center for Disease Control and Prevention stated that there were only 26 confirmed reports of Enterovirus from 1962 to 2005.
Since 1962, Enterovirus has been speculated to evolve into different sub types and therefore became more prevalent around the world.
Outbreaks have occurred in Asia and Europe, but it's still one of the rarest types of Enterovirus.
It is unclear whether Enterovirus D68 represents a new viral threat.
“Genome sequencing is underway at the National Microbiology Lab in Winnipeg and the U.S. Center for Disease Control to determine if the virus is mutating,” said Dr. Danuta Skowronski, Epidemiology Lead for Influenza and Emerging Respiratory Pathogens at the BC Centre for Disease Control (BCCDC).
Treatment for Enterovirus
- Unlike influenza, there is no specific vaccine or anti-viral treatment for Enterovirus, so prevention and early recognition are key measures.
- While most cases of Enterovirus are not serious, intensive treatment and supportive care, including oxygen is provided in hospitals.
- From 2008 to 2010, the length of hospital stays for patients suffering from Enterovirus ranged from 1.5 to 5 days.
- Enterovirus D68 commonly spreads in the summer and autumn seasons.
- Enterovirus D68 is a rare but known virus that can cause severe breathing problems in children, especially those with asthma.
- People of any age with underlying health conditions like asthma are at risk of complications from the illness.
- A Vancouver, British Columbia man in his twenties with a history of severe asthma died after contracting Enterovirus D-68 this year. The B.C. Centre for Disease Control stated that this is the first laboratory confirmed death linked to the severe respiratory illness in Canada.
- Canadian Laws do not require the reporting of Enterovirus so it is possible that the virus has contributed or been associated with other deaths in the country.
- Enterovirus D68 is part of the Picornaviridae family, which also includes the Poliovirus, other Enteroviruses and Rhinoviruses. The CDC estimates that 10 to 15 million infections occur in the United States each year.
- As of Oct. 16, the CDC reported 825 people with laboratory-confirmed Enterovirus D68 in the U.S. Seven patients died.
Children Suffering from Polio-like Symptoms
Polio-like symptoms including limb paralysis and weakness ‘seem to be linked’ to the virus in Canada and across the United States as well. A boy who contracted Enterovirus D68 suffered from paralysis and was hospitalized but doctors do not know if his paralysis was directly linked to D68. Investigations are underway - and as paralytical findings increase so does the possibility of relation to Enterovirus.
The CDC states that health officials are looking for the cause of a neurologic illness that has affected ten children hospitalized between August 19th and September 28th in Colorado suffering from muscle weakness primarily in their shoulders, triceps, biceps and hips – as well as neck and facial muscles. Doctors do not know if the neurological damage will be permanent.
Most of the children experienced a respiratory illness before being admitted to the hospital although only two had a history of asthma.
MRI tests spotted abnormalities in the children's spinal gray matter. Tests of the children's cerebrospinal fluid came back negative for Enterovirus and West Nile virus but a test of their nasal passages found Enterovirus in six out of eight patients. A cluster of children with similar paralytic symptoms was identified in California last year. Samples from two of the children tested positive for Enterovirus D68.
Health officials do not believe the cases were caused by polio because at least eight of the 10 children are up-to-date on their polio vaccinations.
"We don't know, at this point, if there is any association between the Enterovirus EV-D68 that's circulating and the paralytic conditions some of the children in Colorado are experiencing,” said Tom Skinner, a CDC spokesman.
"It could be something else. That doesn't prove cause and effect, but it's circumstantial evidence," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases adding that, “the cause still remains a puzzle."
More concerning to health officials is Enterovirus 71 usually associated with severe neurological issues including aseptic meningitis, polio-like paralysis and encephalitis.
According to a CDC report, several outbreaks of paralysis caused by Enterovirus 71 were seen in Europe in the 1960s and 1970s. Between 1983 and 2005, 270 cases of Enterovirus 71 were reported in the U.S., but none caused an outbreak.