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The Virus That Is Making Lots of Kids Sick

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You may have heard about a fast-spreading virus that is sending children to emergency rooms around the country. It’s called enterovirus D68 or EV-D68 and was first discovered in 1962 in California.

Until now, the virus has been typically contained to small clusters around the U.S. But that is changing rapidly. Currently, most of the cases have been diagnosed in the Midwest and parts of the South. Because the virus is spreading quickly from area to area, it has gained the attention of the Centers for Disease Control and Prevention (CDC).

This is the first time it’s caused such widespread misery, and it seems to be particularly hard on the lungs.

What are the symptoms of EV-D68? Most viral infections start out with a fever, cough and runny nose, but D68 doesn’t seem to follow that classic pattern, says Mary Anne Jackson, MD She's the division director of infectious disease at Children’s Mercy Hospital in Kansas City, MO, the hospital where the first cases were identified.

“Only 25% to 30% of our kids have fever, so the vast majority don’t,” Jackson says. Instead, kids with D68 infections have cough and trouble breathing, sometimes with wheezing.

They act like they have asthma, even if they don’t have a history of it, she says. “They’re just not moving air.”

Who is at the greatest risk? Recent cases have been in children ages 6 months to 16 years, with most hovering around ages 4 and 5, the CDC says.

Usually the enterovirus strikes between July through October, so we are still in the virus season.

Many kids will experience milder symptoms, but children with a history of breathing problems can be hit particularly hard.

Two-thirds of those hospitalized at Children’s Mercy had a history of asthma or wheezing, Jackson says.

“We made sure that primary care providers are in touch with their patients with asthma, so those have an active asthma plan and know what to do if they get into trouble,” she says.

What treatments are available for EV-D68? Antibiotics don’t work because it is a virus and not bacteria. There is no vaccine available at this time or antiviral medication for treatment. It is treated with supportive care.

“The main thing is giving supplemental oxygen to the children who need it,” says Andi Shane, MD. medical director of hospital epidemiology and associate director of pediatric infectious disease at Children’s Healthcare of Atlanta. 

Children may also get medications, such as albuterol, which help relax and open the air passages of the lungs.

Those with the most critical cases have needed ventilators to help them breathe.

Most children who get EV-D68 will have a milder course of disease that tender loving care; rest and plenty of fluids will work as treatment.

However, it’s time to head to the doctor’s office or emergency room “if there’s any rapid breathing, and that means breathing more than once per second consistently over the span of an hour. Or if there’s any labored breathing,” says Roya Samuels, MD. She's a pediatrician at Steven & Alexandra Cohen Children’s Medical Center in New Hyde Park, N.Y.

Labored breathing, says Samuels, means kids are using smaller muscles around the chest wall to help move air in and out of their lungs.

“If you see the skin pulling in between the ribs or above the collarbone, or if there’s any wheezing, those are clear signs that a child needs to be evaluated,” she says.

You catch it basically like to catch any other virus. The enterovirus is pretty hardy and can live on surfaces for hours and as long as a day, depending on temperature and humidity.

The virus can be found in saliva, nasal mucus, or sputum, according to the CDC.

Touching a contaminated surface and then rubbing your nose or eyes is the usual way someone catches it. You can also get it from close person-to-person contact.

Protect yourself with good hand-washing habits. Tell kids to cover their mouth with a tissue when they cough. If no tissue is handy, teach them to cough into the crook of their elbow or upper sleeve instead of their hand.

The good news is that common disinfectants and detergents will kill enteroviruses. Cleaning surfaces that are frequently touched by everyone in the household is important to help keep the virus from spreading. For children, be sure to include toys, cups and doorknobs. While sick children are gaining most of the media attention, adults can also catch EV-D68. 

The virus may be spreading farther than currently known because it is not always tested for when a child enters the hospital or clinic for help.

Again, many children will only experience milder symptoms and will not need to be hospitalized, but if your child exhibits symptoms that include trouble breathing; take them to a doctor immediately.

Source: Brenda Goodman, MA and Hansa D. Bhargava, MD, http://www.webmd.com/cold-and-flu/news/20140909/enterovirus-d68-parents

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