Enterovirus Is Here

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Sunday, September 14, 2014, 5:08 pm
Robert Mavrogordato

Enterovirus is sweeping across the Midwest – and according to a local pediatrician, it may now have reached the East Lansing area. We are in the middle of enterovirus season, which runs largely unnoticed each year from July through October despite millions of infections, but the presentation of one particular strain of enterovirus has been garnering the attention of many East Lansing-area experts and laypersons alike for the volume of cases and severity of symptoms being attributed to it.

It is called EV-D68, and it is a respiratory virus that can cause symptoms including wheezing, trouble breathing, fever, high heart rate, and low oxygen saturation severe enough to require hospitalization. Enteroviruses affect the entire population, but they typically more heavily affect the pediatric population, especially children with underlying respiratory histories such as asthma and wheezing and those who are immunocompromised. Even some severe cases may not involve fever.

There have been 97 confirmed cases of EV-D68 across six states in the Midwest. Michigan has had no confirmed cases, but unconfirmed cases of EV-D68 are possible. Per the Ingham County Health Department, healthcare professionals across the state have been seeing suspected cases of EV-D68.

Healthcare facilities like Sparrow Hospital and public health authorities locally and statewide are on alert for cases of EV-D68. “It’s here”, warns MSU pediatrician Dr. Jane Turner.  “The pediatric ward floor [at Sparrow] is full; and some children have been admitted to the pediatric intensive care unit because of difficulty breathing.”

It may take days to weeks for confirmation as to which cases are EV-D68. Regardless of pathogen, symptom severity should dictate intervention. “Symptoms that indicate a more serious case”, Turner states, “are fast respiratory rate, extra effort to breathe, wheezing and difficulty keeping hydrated.“ The presence of these symptoms warrants further investigation, so parents or patients are advised to call their healthcare provider or visit an urgent care facility or emergency department if these symptoms are observed.

The dictum, “an ounce of prevention is worth a pound of cure” applies to enteroviruses as it does other pathogens. EV-D68 is spread through respiratory secretions and no vaccine is available. One must endeavor to practice proper hand hygiene, which the CDC defines as the single most important tool against infection, and to follow proper respiratory etiquette, such as covering coughs and sneezes, cleaning infected surfaces, avoiding contact with sick people as well as avoiding touching one’s hands to one’s own eyes, mouth, and nose.

When prevention fails, care for confirmed and unconfirmed cases alike of enterovirus is considered “supportive,” which means that respiratory and other symptoms are managed with medications and supplemental oxygen, if necessary, depending on symptom severity. According to Dr. Turner, “most people who get EV-D68 will simply have a bad cold and treatment includes plenty of fluids, rest and acetaminophen or ibuprofen for fever and discomfort.”

Robert Mavrogordato, RN, is a resident of the Glencairn Neighborhood of East Lansing.

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