Brandon Regional Hospital September 15, 2014

Brandon, FL

– A fast spreading virus relating to hand, foot, and mouth disease is hospitalizing kids across the Midwest and parts of the South. The virus, enterovirus D68, or EV-D68, was first discovered in 1962 in California. Until now it has only been tied to smaller clusters of disease around the United States.

However, 12 states are now reporting clusters of enterovirus D68 illness: Alabama, Colorado, Michigan, Georgia, Ohio, Iowa, Illinois, Missouri, Kansas, Oklahoma, Kentucky and Utah. This is the first time it has caused such widespread misery, and it seems to be particularly hard on the lungs. Florida, at the time of this release, has not identified any cases but parents should be cautious because this virus does not respect state borders.

According to the Center for Disease Control (CDC), enteroviruses are very common and can infect anyone. If you or your child has ever had a cold in the summer or fall, it was likely caused by an enterovirus. The CDC estimates there are 10 to 15 million viral infections each year in the United States. But Enterovirus D68, which is less common, is a more severe version of the virus and can cause respiratory illness. The virus can spread from person to person when an infected person coughs, sneezes or touches a contaminated surface.

“Only 25 percent to 30 percent of kids have fever, so the vast majority does not,” says John Prpich, MD, pediatric pulmonologist at Brandon Regional Hospital. “Instead, kids with D68 infections have cough and trouble breathing, sometimes with wheezing. They act like they have asthma even if they don’t have a history of it,” he says. “They’re just not moving air.”

“Although no deaths have been reported at this time, severe cases can be potentially life-threatening. The virus may appear as a common cold but if a child begins to have difficulty breathing and begins wheezing, you need to seek medical attention from a physician or hospital,” says Dr. Prpich.

Why are there so many cases now?

The typical enterovirus season runs from July through October, so we are currently in an enterovirus season, according to Dr. Prpich. What’s unusual about this one is that it’s a virus that hasn’t widely spread through the United States before. “If you have a new virus that has not widely circulated, most people are going to be susceptible,” said Dr. Prpich.

The spreading of the virus coincided with the start of the new school year. Many hospitals noticed a big uptick in cases when kids went back to their classrooms. Unfortunately, according to Dr. Prpich, the outbreak can get worse before it gets better. “In order for this virus to stop, it’s going to have to infect enough of the population to provide immunity and essentially burn itself out,” he says.

Who is at greatest risk?

Recent cases have been in children ages 6 months to 16 years, with most hovering around 4 and 5, according to the Center for Disease Control and while many kids are coming down with milder symptoms the virus seems to be hitting children with a history of breathing problems particularly heart.

How is this infection treated? There is no specified treatment for the virus; because it is a virus, antibiotics will not help. As long as the virus does not escalate, the treatment would be the same for a severe cold: pain relievers, fluids and plenty of rest. “Many that have had escalating symptoms and had to be taken to the hospital appear to be those with asthma, but all parents are encouraged to closely watch their children for any signs of respiratory distress,” adds Dr. Prpich.

“The main thing in the treatment is giving supplemental oxygen to the children who need it,” he says. Children may also get medications, such as albuterol, which can help relax and open the air passages of the lungs. Most kids who get D68 infections will milder course of disease that just needs extra TLC, including lots of rest and plenty of fluids. But it’s time to head to the doctor’s office or emergency room “if there is any rapid breathing, and that means breathing more than once per second consistently over the span of an hour, or if there is any labored breathing,” says Dr. Prpich. Labored breathing means kids are using smaller muscles around the chest wall to help move air in and out of their lungs. “If you see the skin pulling in between the ribs or above the collarbone, or if there’s any wheezing, those are clear signs that the child needs to be evaluated,” he says.

How do you catch it?

The bad news is that enteroviruses are pretty hardy. The “entero” part of name means that the viruses can survive stomach acids and infect the gut as opposed to their cousins, the rhinoviruses which can’t. The CDC says that germs can live on surfaces for hours and maybe as long as a day, depending on the temperature and humidity. The viruses can be found in saliva, nasal mucous, or sputum, according to the CDC. Touching a contaminated surface and then rubbing your nose or eyes is the usual way someone catches it. You can get it from close person-to-person contact.

Encourage children to wash their hands for at least 20 seconds with warm water and soap, keep surfaces disinfected, wash any toys, wipe down doorknobs and any other common surfaces, and if you suspect a cold or virus, please make sure to keep your child home to help prevent the spread of the virus. The basic practices apply to many during cold and flu season in school and at home will help keep those children affected at a minimum.

Again, at this time, no cases have been reported in Florida, but if your child develops a cold that becomes more serious affecting their breathing, seek medical attention immediately.

To help halt transmission, Brandon Regional Hospital now provides masks at its entrances for visitors or patients entering the hospital with respiratory symptoms.