Enterovirus


Boy with a tissue and momEnterovirus D68 (EV-D68)

You may have seen reports in the media about clusters of a respiratory illnesses, Enterovirus D68 (EV-D68, occuring in parts of the United States, including Virginia. The Centers for Disease Control and Prevention (CDC) is gathering information to better understand:

  • EV-D68 and the illness caused by this virus;
  • how widespread EV-D68 infections may be and the populations affected; and
  • whether other states are experiencing severe respiratory illness, possibly due to EV-D68.

In addition, as of October 1, 2014, the CDC is working closely with the Colorado Department of Public Health and Environment (CDPHE) and Children’s Hospital Colorado to investigate reports from August 9 to September 17, 2014 of nine children hospitalized for sudden onset of neurologic illness with limb weakness of unknown cause.

  • Respiratory specimens from eight of the children were tested for rhinovirus/enterovirus; two were negative and six were positive. Of the six, four were positive for enterovirus D68 (EV-D68); two are pending.
  • The CDC is investigating whether this cluster of neurologic illness in Colorado may be linked to this large EV-D68 outbreak.

View the latest updates on EV-D68 from the CDC.

The Virginia Department of Health and the Fairfax County Health Department are continuing to work with hospitals and health care providers to monitor for severe respiratory illnesses, particularly in young children, that may be caused by EV-D68. The Health Department encourages parents, children and all members of our community to take the prevention steps listed below, which are the same steps that help prevent colds, the flu, and other common illnesses.

What Steps Can I Take to Avoid Becoming Sick?

  • Picture of hand washingIt is important to understand:
    • No vaccine to prevent EV-D68 is currently available.
    • Enteroviruses are spread person-to-person through close contact with an infected person, or by touching objects or surfaces that are contaminated with the virus and then touching the mouth, nose, or eyes.
  • To help protect yourself and others from EV-D68 infections:
    • Wash your hands often with soap and water for 20 seconds.
    • Avoid touching eyes, nose and mouth with unwashed hands.
    • Avoid close contact (touching and shaking hands) with people who are sick.
    • Disinfect frequently-touched surfaces, such as toys and doorknobs, especially if someone is sick.
    • Cover coughs and sneezes with a tissue or the upper sleeve of your shirt.
    • Stay home from school or work when sick. This is the season for respiratory illnesses and in general it is important to stay home when sick, particular if you or your child has a fever. (Fairfax County Public Schools policy states that students stay home until 24 hours after fever resolves.)
  • In addition, the CDC recommends that everyone 6 months of age and older receive an annual flu vaccine. The flu vaccine won't prevent EV-D68, but it will protect you against influenza, another potentially severe respiratory illness.

What are the Symptoms of EV-D68?

  • EV-D68 has been reported to cause mild to severe respiratory illness, such as low-grade fever, cough, runny nose, sneezing and body/muscle aches. Some people also may have a rash.
    Infants, children, and teenagers are most likely to get infected with enteroviruses and become sick.
  • Some people, especially those with weakened immune systems or underlying medical conditions, such as asthma, may have severe complications and need to be hospitalized.

Infected individuals generally recover on their own without incident by treating symptoms.

How Does EV-D68 Spread?

  • EV-D68 causes respiratory illness, and the virus can be found in respiratory secretions such as saliva, nasal mucus, or sputum.
  • The virus likely spreads person-to-person when a sick person coughs or sneezes. The infected droplets from a cough or sneeze may land on a nearby person or infect surfaces that are later touched by other people.

What is the Treatment for EV-D68?

  • There is no specific treatment for EV-D68 infections. If you, or your child, are experiencing cold-like symptoms and are having difficulty breathing, contact your health care provider right away.
    • Many infections will be mild and self-limited, requiring only treatment of the symptoms.
    • Some people with severe respiratory illness caused by EV-D68 may need to be hospitalized and receive intensive supportive therapy.
  • No antiviral medications are currently available for treating of EV-D68 infections.

Background

Enteroviruses

  • Enteroviruses are very common viruses; there are more than 100 types.
  • CDC estimates that 10 to 15 million enterovirus infections occur in the United States each year.
  • Enteroviruses can cause respiratory illness, febrile rash, and neurologic illnesses, such as aseptic meningitis (swelling of the tissue covering the brain and spinal cord) and encephalitis (swelling of the brain).
  • Most infected people have no symptoms or only mild symptoms, but some infections can be serious.
  • Most enterovirus infections in the United States occur seasonally during the summer and fall.

Enterovirus D68

  • In August 2014, hospital officials in Kansas City, MO and Chicago, IL notified CDC of an increase in severe respiratory illness among children seen in the emergency rooms and admitted to the hospitals.
  • Enterovirus D68 (EV-D68) infections are thought to occur less commonly than infections with other enteroviruses.
  • The EV-D68 strain currently circulating is not a new strain; it is the same strain of EV-D68 found last year and in previous specimens from other countries.
  • EV-D68 was first identified in California in 1962. Compared with other enteroviruses, EV-D68 has been rarely reported in the United States.

Learn more about EV-D68 and follow updates on the CDC’s website.


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