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Respiratory Virus Hitting Kids in at Least 12 States
Health officials concerned about a wider outbreak, urge good hygiene to limit exposureMonday, September 8, 2014
MONDAY, Sept. 8, 2014 (HealthDay News) -- A respiratory virus has stricken more than 1,000 children across 12 states, causing many to wind up in the hospital and prompting concerns of a wider outbreak.
About 15 percent of more than 300 children treated for respiratory illness in Missouri have ended up in an intensive care unit, according to a health alert from the Missouri Department of Health and Senior Services.
Children's Hospital Colorado reports that 86 kids have been hospitalized out of more than 900 treated for severe respiratory illness since Aug. 18.
The number of hospitalizations reported so far could be "just the tip of the iceberg in terms of severe cases," Mark Pallansch, director of the U.S. Centers for Disease Control and Prevention's Division of Viral Diseases, told CNN.
Public health officials fear the beginning of the new school year could allow the virus to gain momentum. But illness associated with the infection typically lasts about a week with cold-like symptoms, and all children have recovered completely, health officials said.
The CDC has identified the culprit as a rare respiratory virus known as Enterovirus D68, or EV-D68, that's part of the family of viruses that includes the common cold.
EV-D68 is largely responsible for two clusters of respiratory illness in Kansas City, Mo., and Chicago, Assistant Surgeon General Dr. Anne Schuchat, director of the U.S. National Center for Immunization and Respiratory Diseases, said during a Monday news conference.
A CDC lab found that 19 of 22 specimens from Kansas City and 11 of 14 samples from Chicago tested positive for EV-D68, Schuchat said. The virus has targeted children, infecting kids from 6 weeks to 16 years old, she said.
The CDC is asking doctors and public health officials to consider EV-D68 a potential suspect if widespread respiratory illnesses start occurring in their communities, she said.
"We believe that the unusual increases in Kansas City and Chicago may be occurring elsewhere over the weeks ahead, so we want people to be on the lookout," Schuchat said.
Schuchat was reluctant to estimate how many children nationwide have come down with EV-D68, given that many other respiratory illnesses are also making the rounds.
"We're in a stage where it's difficult to say just how big this is, how long it will go on for, and how widespread it will be," she said.
Children infected with this virus will appear to have a severe cold, with runny nose, sneezing and cough, according to Children's Hospital Colorado. But the illness can escalate quickly in some cases, and the child may start to have trouble breathing.
Missouri, Colorado, Georgia, Illinois, Iowa, Kansas, Kentucky, North Carolina, Ohio and Oklahoma have sent samples to the CDC for analysis, according to news reports.
Antibiotics won't work against a virus, and there is no antiviral treatment available for EV-D68, public health officials said.
Children's Mercy Hospital in Kansas City, Mo., began seeing an increase in pediatric respiratory cases in mid-August, said Dr. Mary Anne Jackson, the hospital's division director for infectious diseases.
"We saw an unusually high number of children with respiratory viral disease that appeared to trigger asthma attacks," Jackson said. About a third of the kids who suffered an asthma attack from the disease had never experienced asthma before, she said.
Since then, Children's Mercy has treated 498 children for respiratory infection, with most admitted to the hospital. Of those, 61 have ended up in the intensive care unit, Jackson said.
Despite these numbers, Jackson said hospital officials believe most children are going to wind up with a common cold as a result of the virus, and even those with more severe symptoms will recover.
"The vast majority of kids we saw stabilized within 24 hours," she said. "The average kid goes home in four or five days. That's not a short hospitalization, but they are going home."
EV-D68 has been confirmed in most patients, but not all, Jackson said. It appears other respiratory illnesses are also going around, complicating efforts to identify and treat this specific virus.
Good hygiene is the best defense against a child catching the EV-D68 virus, said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City.
"Hand washing is paramount, and teaching kids not to touch their faces with unwashed hands is the point," Horovitz said. "Any child or adult with flu-like symptoms or common cold symptoms should be seen, evaluated and followed by doctors for any respiratory complications."
Children and adults should wash their hands with soap and water for at least 20 seconds on a regular basis. They also should avoid contact with people who are sick, and stay home if they themselves fall ill. Kids with asthma need to stay on top of their symptoms and take their medication, public health officials said.
"Children with an underlying history of asthma are especially at risk for significant illness which may require hospitalization," said Dr. Roya Samuels, a pediatrician at the Steven & Alexandra Cohen Children's Medical Center in New Hyde Park, N.Y.
Enteroviruses are very common, according to the CDC. There are more than 100 types of enteroviruses, and they cause about 10 million to 15 million infections in the United States each year. People who come down with a bad summer cold often have been laid low by an enterovirus, the federal agency said.
"Most enterovirus infections in the U.S. occur in the summer and fall, so this is the right time of the year," Schuchat said.
EV-D68 was first identified in the 1960s, Samuels said, but up to now there have been fewer than 100 reported cases.
"Enterovirus usually presents itself as a mild cold or diarrheal illness," Samuels said. "It is unclear as to why infected children [now] are presenting with severe upper respiratory infection symptoms."
SOURCES: Mary Anne Jackson, M.D., director for infectious diseases, Children's Mercy Hospital, Kansas City, Mo.; Roya Samuels, M.D., Steven & Alexandra Cohen Children's Medical Center, New Hyde Park, N.Y.; Len Horovitz, M.D., pulmonary specialist at Lenox Hill Hospital, New York City; Missouri Department of Health and Senior Services; Sept. 8, 2014, news conference with Anne Schuchat, M.D., assistant surgeon general, and director, U.S. National Center for Immunization and Respiratory Diseases
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