A rare and usually mild virus is sending kids in several Midwest cities to the hospital, worrying parents and doctors alike. No child has died and they’re all likely to get better, but state and federal health officials are taking the reports seriously. Here’s what you need to know about enterovirus D68:
How dangerous is this virus?
It’s serious enough to worry the Centers for Disease Control and Prevention, and has definitely put a few children into the hospital. How many exactly, CDC doesn’t know yet — while there are clusters of serious respiratory disease caused by EV-D68 in the Midwest — 19 in Kansas City and 11 in Chicago, for example — not all the sick children have had tests out find out what they have. And some of the sick kids have something else. No child has been reported to have died from EV-D68, however. It also does not seem to be causing an epidemic, or at least not yet. CDC monitoring systems have not picked up any national increase in respiratory disease. Most kids infected with EV-D68 will likely have mild cold-like symptoms and will get better on their own. Children with asthma are most at risk, just as they are from any respiratory virus.
Where did it come from?
It’s not a new virus. EV-D68 was first identified back in 1962, in a child with pneumonia, and while it seems to be fairly unusual, it does circulate and make kids sick. Adults are usually immune. Viruses change a little all the time and cause outbreaks of infection, but CDC says nothing yet explains why EV-D68 is worse this summer. “Our laboratory staff here at CDC have had a chance to sequence some of the recent specimens, and I can tell that you it's not a new strain,” CDC’s Dr. Anne Schuchat says.
How can I prevent it?
As with any infectious disease, your best defense is to wash your hands. Sneezing and coughing both spread germs, but you’re not catching them from breathing the air, usually. Colds, flu and viruses like EV-D68 are spread when people touch a surface the virus had landed on, like a desk, and then touch their mouths, noses or eyes. Kids touch their own faces on the order of once a minute, says Dr. Charles Gerba, a germ expert at the University of Arizona. But a good handwashing with soap, or an alcohol-based hand sanitizer, removes most infectious germs. Wiping tables and desks with a disinfectant wipe, even just once a day, also reduces infection rates, Gerba says.
Is this the tip of the iceberg?
It may be. Infections with EV-D68 look pretty much like infections with any of the hundreds of different viruses out there that cause the same types of symptoms — rhinoviruses, adenoviruses, influenza, parainfluenza, metapneumoviruses, coronaviruses, to name a few. They all can cause fever, muscle aches and coughing. Pediatricians and clinics almost never test for the underlying cause of such an infection unless a child is very seriously ill. “There is nothing strange about the virus,” says Dr. Giovanni Piedimonte, chief pediatric pulmonologist at the Cleveland Clinic. “What is strange — I have been in this business for more than 20 years and I have never seen children coming into the hospital with severe symptoms caused by this virus.” But other viruses, such as respiratory syncytial virus (RSV), do wax and wane in intensity from year to year and EV-D68 may be doing the same.
What’s the best treatment?
“It is very important that the public understands that there is no therapy for this virus,” Piedimonte says. Antibiotics are useless against it. There’s no vaccine, either. For a child who’s not seriously ill, the best course is rest, fluids and perhaps ibuprofen or acetaminophen to ease the fever and achiness. Children should not be given aspirin because it can cause a life-threatening side effect called Reye’s syndrome. Doctors also do not recommend cough suppressants — they don’t really work and can be dangerous. But children with signs of trouble breathing — breathing, wheezing, struggling for breath — should be taken to an emergency room right away. If in doubt, a quick call to the pediatrician is in order.
“The main message is if your child’s symptoms are atypical from that of a common cold, check with your doctor sooner rather than later,” says the American Lung Association's Dr. Albert Rizzo.
How can we prevent its spread?
Rule No. 1 — don’t send your kid to school or daycare if he or she is sick. Doctors agree this virus is spreading now because schools are starting back after the summer break, and kids catch the virus from other children. Children with fevers or respiratory symptoms that aren’t caused by asthma should be kept home. Good hygiene helps too, and that means using disinfectants such as quaternium wipes to keep desks, doorknobs and tabletops clean.
