Examining Enterovirus D68

Update:  As of Sept 18, 16 states had confirmed cases of enterovirus 68.

When I think of enteroviruses, I think of annoying viruses that give my kids a summer cold and a little rash (usually when we are on vacation).  And of course I think of polio – one of the infamous, eradicated diseases caused by an enterovirus.  But I rarely think of enteroviruses sending scores of children to emergency rooms and intensive care units.

This summer/fall has changed my thinking.

Enterovirus outbreak.  The US is dealing with an outbreak of an enterovirus called enterovirus D68.  Enterovirus 68 is not new.  It was first identified in 1962 and has led to sporadic outbreaks of colds throughout the years.  Until this year, it was considered rare.  Currently, the virus is spreading to the northeast from the midwest and has been reported in 12 different states.

The virus is in saliva and mucus, so it spreads easily from person to person.

Ordinarily, enterovirus infections would pass through the country without anyone being concerned, except this one can cause severe respiratory infections making it difficult for kids to breathe.  This has led to a sharp increase in emergency room visits and hospitalization of children.

Symptoms.  People with enterovirus 68 have colds.  They have achy throats, a runny nose and a cough.  Some have skin rashes, belly aches and diarrhea.  Nothing that would ordinarily alarm you.

However, a small percentage of children develop difficulty breathing, pneumonia and even respiratory failure.  And in a very rare instance, the virus was associated (not proven to cause) with a paralysis in two children in California.

Who is at risk.  For most of you, enterovirus 68 will just cause another one of those annoying back-to-school colds that plague families at the beginning of the school year (3 of mine had colds the second week of school).  So don’t let the media hype scare you into living in your bomb shelter for the next 6 months.

But children under 5, and especially children with asthma (young and old) are having a tough time with this virus.  So parents of these children should be on higher alert.

How to keep your kids safe.  The most effective means of avoiding this and any virus, is simple:  Wash your hands often and well!  Your skin is an awesome barrier to viruses – wash them off regularly.

Other simple things you can teach your kids to do:

• Avoid touching their faces – the eyes, nose and mouth are perfect inlets for viruses
• Love your friends from afar – stay out of their faces, don’t hug and kiss so much, don’t share utensils, straws, etc…
• Stop touching everything in public
• Cover coughs or sneezes with the crook of the arm
• Wash hands after coughing or sneezing
• Use tissues and throw them away for goodness sakes!

As a parent, you should:

• Clean frequently touched surfaces regularly – doorknobs, toys, electronic devices
• Model good hygienic practices for your kids
• Keep yourself informed – ask your doctor or school nurse if there are cases in the area
• Know when a cold is a cold and when it is more than a cold (see below)

When to see the doctor.  It is important to know when it is the right time to seek medical help.  I can’t stress this enough – most kids will just have a cold and be done with it.  Let’s not flood our medical care providers and emergency rooms with children who will bounce back on their own in a day or two.  And you really do want to avoid emergency rooms if you don’t need them.  There is no better place to catch something than sitting in a room with sick people.

That being said, there will be cases that need treatment.

• If your child has asthma or is under 5, be extra vigilant.
• If they have a cold and have trouble breathing, are wheezing, can’t talk, or are blue around the lips then you need help.
• When a younger child is having trouble breathing, you can see the the belly pulling in and going concave when they take a breath.  This is a clear sign that help is needed.

Hopefully none of you will need this advice.

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