This has been a jolting start to the fall season. Enterovirus D68 and Ebola have placed fear and anxiety in the hearts of many parents. It is true that in the United States we are currently experiencing a nationwide outbreak of Enterovirus D68. That being said, there is a lot of misinformation out there. We want to help ease anxiety and help clarify some of the basics of Enterovirus D68.
What is enterovirus D68?
Enteroviruses are a family of viruses that cause varying symptoms. Coxsackie virus is another type of enterovirus. Enterovirus D68 was first discovered in 1962 in California.
What are the symptoms?
Most healthy children will have symptoms similar to the common cold. These are mild symptoms that include: fever, cough, runny nose, body aches and muscle aches. Enterovirus D68 can cause more severe respiratory symptoms as well. These would include the above symptoms with the addition of wheezing and difficulty breathing. With any viral illness, if children are not feeling well they may not drink as well. It is always important to monitor for signs of dehydration such as crying with out tears, no urine in over 6-8 hours, or lethargy. Signs of difficulty breathing include: pulling of the skin between the ribs or the clavicles, difficulty talking in sentences, the sides if the nose flaring out, audible wheezing or grunting. If your child is experiencing any of these symptoms or shows signs of dehydration, you should call your doctor right away. In general infants, babies, and children with underlying medical problems such as asthma, prematurity or congenital heart disease are more likely to experience more severe symptoms. If your child is having symptoms of enterovirus D68 and has an underlying medical condition it is best to have a very low threshold for going to the pediatrician.
How do you get the virus?
Enterovirus D68 is spread from person to person when there is contact with respiratory secretions (saliva, mucous, sputum) from an infected individual. A common example is a child sneezes on a surface and another child touch that surfaces and then puts their fingers in their mouths. This virus is most common in the summer and the fall.
What are the treatments for this illness?
Unfortunately, there is no specific medication that directly targets this virus. Treatment is supportive care. In children with mild symptoms this involves encouraging liquid intake, medications to reduce fever and discomfort and keeping your child comfortable. Children with more severe symptoms may require nebulized aerosol treatments to improve breathing. In some cases children will require hospitalization and additional medical intervention.
How will I know if my child has enterovirus D68 or the common cold?
The truth is in most cases you will not know. As the treatment is supportive, the medical managment of a child’s illness does not differ between the two. Hospitals and some doctors offices can send off a swab for enterovirus infection, however they can not differentiate between specific types of enterovirus viruses. The Center for Disease Control and some local health departments have laboratories that can identify the specific type of enterovirus it is. The CDC has prioritized specimens from children with severe respiratory illness. Given that only really sick children will have specific enterovirus testing, it is best to be with the majority of parents who don’t know for sure.
What can I do to prevent my child from getting sick?
Good hand hygiene can not be underestimated. Keeping your child’s hands clean and as much as possible away from their eyes, nose and mouths is the best prevention. Do not let your child share drinks with other children. Clean surfaces and toys thoroughly. If your child is sick please keep them home to prevent the spread of disease.
Hopefully this helps clarify things for you. While this diseases is often mild, severe respiratory problems can occur in children. This is particularly true of high risk children mentioned above. Remember if your child is not well or you have questions or concerns it is always best to reach out and talk to your pediatrician. Hopefully, as this is a fall virus we will see declining numbers as we enter the winter season.