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Enterovirus D68

 

This is about the severe respiratory illness Enterovirus 68.  The most common sense article I have found on the internet is this one.

http://www.boston.com/lifestyle/health/mdmama/2014/09/what_you_need_to_know_about_enterovirus_d68.html

http://www.huffingtonpost.com/claire-mccarthy-md/dont-panic-about-enterovirus-d68_b_5953488.html

 Enteroviruses are a group of viruses that include the polioviruses (viruses that cause polio) along with other types of viruses called coxsackieviruses and echoviruses. Rhinoviruses (viruses that cause the common cold) are the most common viruses infecting humans. The second most common viruses infecting humans are the non-polio enteroviruses (all the members of this virus group excluding the polio-causing viruses).

 While the polioviruses have been eliminated in the Western Hemisphere, there are 62 different non-polio enteroviruses that are known to cause disease in humans. Anyone can be infected by non-polio enteroviruses, which are believed to cause 10-15 million illnesses per year in the U.S. alone. Infants, children, and adolescents are more likely than adults to develop an illness from enteroviral infection since they are less likely to have immunity to these viruses from previous exposures.

 Enteroviruses are associated with various clinical symptoms, including mild respiratory illness, febrile rash illness, and neurologic illness, such as aseptic meningitis and encephalitis. Enteroviruses can also cause flu-like symptoms, rash, or in rare cases, inflammation of the heart or brain. Serious complications are more common in infants, those with major health problems, and those with weakened immune systems. The condition known as hand foot and mouth disease is also caused by some of the non-polio enteroviruses.

 EV-D68, however, primarily causes respiratory illness, although the full spectrum of disease remains unclear because it is identified at only a few limited number of laboratories in the United States.  So EV-D68 is not frequently identified.

 Enterovirus infections, including EV-D68, are not reportable.  Since the original isolation of EV-D68 in California in 1962, it has been reported rarely in the United States.  There were reports received during 2009–2013 with clusters of respiratory illness during 2009–2010.

 Most people infected with an enterovirus will not become ill and will have no symptoms of the infection. Others will develop a respiratory illness similar to the common cold. Because infections with non-polio enteroviruses are most common during the summer and fall and are diagnosed as a "summer cold".   

 I have mentioned that many cases of severe diseases are mild and never get diagnosed or reported.  See my articles on West Nile and Ebola.  In 1920 we had polio.  Did you know 90% of polio infections cause no symptoms at all.  Paralysis occured in only one in 1000 cases in children and adults one in 75 cases.  So there are many cases of Enterovirus 68 that are not diagnosed.  Then when some cases are diagnosed, the doctors hear about it and start running tests for it. 

 This current strain has caused children in at least 11 states to experience sudden difficulty in breathing.  From Aug. 18 to Wednesday afternoon, Children's Hospital Colorado had treated more than 1,750 children for severe respiratory illness in its emergency locations.  Of these, 156 were admitted to the hospital.  72% of the severe cases had asthma. 

 There have always been cases of respiratory disease outbreaks.  Remember last year the news went crazy about the Middle East Respiratory Syndrome MERS http://www.cdc.gov/coronavirus/mers/ until Ebola came along.  There was a case of MERS this year in May here in America. And before that there was SARS – Severe acute respiratory syndrome http://www.cdc.gov/sars/. They were coronaviruses.  We normally average yearly 100 children deaths from flu in America but we had 282 in 2009 with the new strain H1N1.  There were 1700 cases of West Nile in Texas in 2012 but last year there were 180.   There is a large increase in many illnesses because of a new strain that no one has immunity to or there are a lot of people that are not immune to the disease in the community.  That is why we have outbreaks of Measles when many kids do not get vaccinated. 

 There are a large number of cases this year of EV68 because there are a lot of children who have not yet had this illness and those with health issues are hit hardest.  That is why we recommend flu vaccines for children but especially for those with asthma and other debilitating diseases.  That is why more children are getting this Enterovirus disease since older teens and adults are immune to it from years ago.

 Watch for a cold and cough that causes the child to have severe difficulty breathing. There is no cure except giving oxygen and supportive care.

 It is spread in the same ways as the winter flu and for precautions against it, use similar techniques … like hand washing. Most illness are contagious right before symptoms start so using good precautions every day is wise.

 It is a bad chest cold and pray our kids do not get it or at least have a mild case.  It is heart breaking when a child is ill and horrible when they die.  We can’t prevent all illness and death.  All we can do is use the normal illness precautions and pray.

 Enterovirus 68

http://www.cdc.gov/non-polio-enterovirus/about/EV-D68.html

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e0908a1.htm