Fast Facts: Fast-spreading enterovirus affects children across U.S., what parents should know

September 10, 2014

Carolyn Cannon, M.D., Ph.D., associate professor at the Texas A&M Health Science Center College of Medicine

A respiratory virus that has sent hundreds of children to hospitals across 12 states is likely to become a nationwide issue, experts say. While the disease hasn’t been officially identified, it’s suspected to be a rare respiratory virus called enterovirus 68. We sat down with pediatric pulmonologist Carolyn Cannon, MD, PhD, associate professor at the Texas A&M Health Science Center College of Medicine, to find out more about this respiratory virus, its symptoms and what parents can do to protect their children.

Q: What is enterovirus 68?  

A: EV-68 (or EV-D68) is a member of a family of viruses called enteroviruses that has over 100 other members. While enterorviruses are common, with 10 to 15 million infections in the United States each season that peaks in September, they usually cause mild illness. The unusual aspect of the current outbreak is the high number of hospitalizations.

Q: What are common symptoms of EV-D68? 

A: The symptoms of an EV-D68 infection mirror those of other respiratory viruses that cause runny nose, cough and wheeze. This particular respiratory virus seems to induce wheezing more often than others.

Q: Who is most susceptible?

A: While anyone can become ill with EV-D68, young children seem to be more susceptible to severe respiratory illness. Moreover, children with asthma or a history of breathing problems are at greater risk for severe symptoms.

Q: How is EV-D68 spread?

A: Because EV-D68 has been so infrequently identified previously, it has not been well studied and the mode of transmission is not well understood. The virus can be found in respiratory secretions and causes respiratory illness, so the virus is most likely spread through inhalation of droplets containing the virus generated when an infected person sneezes or coughs. The droplets can also contaminate surfaces and the virus may be spread through touching these surfaces and then touching your eyes, nose or mouth.

Q: How dangerous is the infection?

A: Similar to other viruses that cause respiratory illnesses, many, if not most people will experience a mild or moderate “cold.” Other individuals, particularly children with a history of respiratory ailments, such as asthma, may develop a severe respiratory illness requiring hospitalization for supportive care, possibly including intensive care.

Q: Is there a vaccination against EV-D68?

A: No vaccination currently exists nor are there any anti-viral medications available to help treat infections with EV-D68.

Q: If there are no vaccinations or anti-viral meds, how are cases treated?

A: Cases are treated with supportive measures that include medications to treat symptoms, such as fever; fluids, perhaps delivered by vein, to treat dehydration; nasal suction and other airway clearance techniques to help keep the passages clear to breath; oxygen to supplement the oxygen in the air, if blood oxygenation is low; and in very severe cases, mechanical support for breathing either through a mask or through a tube slipped into the trachea (windpipe). Ultimately, the virus will be cleared by the person’s immune system.

Q: What should parents do to protect their children?

A: Parents can encourage vigorous hand washing after touching any potentially contaminated surfaces. They can also disinfect surfaces that are frequently touched, such as toys or doorknobs. Parents can discourage children from touching their eyes, nose or mouth with unwashed hands. Avoiding crowds may help reduce the likelihood of encountering an infected individual. If parents notice someone who is coughing or sneezing, they can keep their child at least three feet away from the ill person to decrease the possibility of inhaling infected droplets. If someone in the household is ill, children should be discouraged from kissing, hugging or sharing toys, cups or eating utensils with the ill person. To reiterate, hand washing really helps decrease the spread of respiratory viruses and is a good health habit to learn young.

Q: When should you get medical help?

A: Many individuals infected with EV-D68 can be cared for at home without medical intervention. If an infected individual develops difficulty breathing, however, medical help should be sought. Watch for excessive coughing or wheezing, increased respiratory rate and increased work of breathing demonstrated by dipping in around the clavicle (collar bone) or below the ribs. These signs may indicate difficulty breathing and should prompt a call for medical help.

Carolyn Cannon, MD, PhD, associate professor at the Texas A&M College of Medicine, is a pediatric pulmonologist and eminent scientific leader known for developing novel treatments for the most challenging childhood respiratory diseases. Her current research looks at ways to deliver therapeutics to fight lung infections in children living with cystic fibrosis. 

— Holly Shive

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