San Diego health officials are preparing for the possible arrival of a respiratory virus known as enterovirus 68 that has sickened hundreds of children in a dozen states across the Midwest and Southeast.
Enterovirus 68 is a rare strain of a very common family of 200 enteroviruses that usually hit from summer to fall. It causes cold-like symptoms, including a runny nose, sneezing and coughing, that typically last three to seven days.
Most children recover with no problem, but it can cause severe respiratory distress for kids with asthma and heart problems.
“All it takes is a slightly different characteristic of the virus to be able to bind to the respiratory track cells,” said John Bradley, director of the division of infectious diseases at Rady Children’s Hospital.
“When the lungs get irritated, the muscles clamp down because they don’t like to be irritated,” Bradley explained. “And then you end up getting wheezing, and the normal medicines that these asthmatics are on doesn’t open up the airways.”
Bradley said no cases have been confirmed in San Diego, but they have tested 10 to 15 children who are hospitalized with respiratory-related illnesses.
“We’re getting samples from respiratory secretions on all the kids who are being admitted with any kind of viral pneumonia, and there may be a few more than we normally see,” Bradley said. “But when you read the description of what’s happening in the Midwest — we aren’t there.”
Bradley said they are working closely with San Diego County Department of Health, and they've alerted San Diego’s pediatricians to be on the look-out for the virus.
“The heads-up is, if you start seeing a lot of these asthmatics with a cold, we want you to test them, and the county wants all these pediatricians to test,” Bradley said.
Bradley said parents of children with asthma should seek immediate medical attention if their child is having difficulty breathing.
"There’s a chance that they may need to come into the hospital to get IV medicines and extra oxygen, and as happened rarely in the Midwest, actually need a ventilator to help you breathe while your body’s getting over the infection,” Bradley said.
No deaths have been reported in the outbreak.
Enterovirus 68 Fact Sheet
Q: What are the symptoms of EV-D68 infection?
A: EV-D68 can cause mild to severe respiratory illness.
Mild symptoms may include fever, runny nose, sneezing, cough, and body and muscle aches.
Most of the children who got very ill with EV-D68 infection in Missouri and Illinois had difficulty breathing, and some had wheezing. Many of these children had asthma or a history of wheezing.
Q: How does the virus spread?
A: Since EV-D68 causes respiratory illness, the virus can be found in an infected person’s respiratory secretions, such as saliva, nasal mucus, or sputum. EV-D68 likely spreads from person to person when an infected person coughs, sneezes, or touches contaminated surfaces.
Q: Who is at risk?
A: In general, infants, children, and teenagers are most likely to get infected with enteroviruses and become ill. That's because they do not yet have immunity (protection) from previous exposures to these viruses. We believe this is also true for EV-D68.
Among the EV-D68 cases in Missouri and Illinois, children with asthma seemed to have a higher risk for severe respiratory illness.
Q: How is it diagnosed?
A: Many hospitals and doctor’s offices can test for enteroviruses. However, most cannot do testing to determine the specific type of enterovirus, like EV-D68. State health departments and CDC can do this sort of testing.
Respiratory illnesses can be caused by many different viruses and have similar symptoms. Not all respiratory illnesses occurring now are due to EV-D68. Anyone with respiratory illness should contact their doctor if they are having difficulty breathing, or if their symptoms are getting worse.
Q: What are the treatments?
A: There is no specific treatment for people with respiratory illness caused by EV-D68.
For mild respiratory illness, you can help relieve symptoms by taking over-the-counter medications for pain and fever. Aspirin should not be given to children.
Some people with severe respiratory illness may need to be hospitalized .
There are no antiviral medications currently available for people who become infected with EV-D68.
Q: How can I protect myself?
A: You can help protect yourself from respiratory illnesses by following these steps:
Wash hands often with soap and water for 20 seconds, especially after changing diapers.
Avoid touching eyes, nose and mouth with unwashed hands.
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.
Also, see an graphic that shows these prevention steps.
Since people with asthma are higher risk for respiratory illnesses, they should regularly take medicines and maintain control of their illness during this time. They should also take advantage of influenza vaccine since people with asthma have a difficult time with respiratory illnesses.
Q: Is there a vaccine?
A: No. There are no vaccines for preventing EV-D68 infections.
Source: CDC
