In the last several days, multiple parents have asked me about Enterovirus D68 infection which has received of press coverage. In the last week a few cases have been reported here in Connecticut, including one here at Yale New Haven.
First, some background: enteroviruses are a common group of viruses which can cause cold and stomach symptoms. In all likelihood, your child has had enterovirus infections in the past and you have not even known in. This particular strain of the virus is unique in that it has not previously been commonly seen in the US. In the Midwest, there have been clusters of children with severe respiratory illness. [Note that many children with mild symptoms may go undiagnosed so this virus may be more common than the data suggests]. Children with asthma seem to be particularly vulnerable, and those without asthma may present with asthma like symptoms of cough, shortness of breath, and difficulty breathing. Unlike bacterial infection, antibiotics will not help with these infections but they will run their course with supportive care. Interestingly, many of these children do not seem to have fevers at the time of presentation, which is different from other viral syndromes like influenza. At Yale New Haven we are able to test for the virus.
All parents should be on the the look-out for symptoms of cough, runny nose, and difficulty breathing. Hand washing is critical for preventing the spread of this disorder. In my practice I take care of children who are vulnerable to respiratory illness. It is especially critical for the parents of these children to make sure that their children are taking their breathing medications and doing their treatment regimens so that they are in the best possible shape if they have a viral illness, with EV-D68 or any other virus. Specifically:
- Children with asthma who are on controller medications should have started their prescribed controllers with a spacer if they have slacked off over the summer (we did with my four year old). Also make sure there you have an adequate supply of albuterol.
- Children with cystic fibrosis should be doing airway clearance treatments and taking aerosolized treatments regularly as prescribed.
- Children with neuromuscular disorders such as Duchenne muscular dystrophy, spinal muscular atrophy, and other disorders should be using cough assist regularly, or at least their parents should verify that all treatment equipment (oximeters, cough assist devices, VESTs) are in good working order.
I’m a parent and a physician and always get concerned when I hear about a new virus in the news. I think that with preparation your child will be in good shape and will do well if they are exposed to EV-D68. If you are worried about your child, please call your physician and bring him or her to be seen.
Centers for Disease Control Information Page for enterovirus D68
Enterovirus D68: What Parents Need to Know via Web MD
12 states confirm Enterovirus D68 cases via CNN
What You Need to Know About Enterovirus d68 via Boston.com
EV-D68 in KC via KC Kids Doc