Parents have long been accustomed to the back-to-school cold, which always seems to sweep through schools at the beginning of the year. This year, however, some children across the country have come home not with the common cold, but with a respiratory illness dubbed Enterovirus D68. Though similar to the common cold, Enterovirus D68 can cause a more severe illness, and is sending children to the hospital with symptoms including wheezing, difficulty breathing and other respiratory ailments.
We asked Sheila Nolan, M.D., Chief of Pediatric Infectious Diseases at Maria Fareri Children’s Hospital at Westchester Medical Center, to shed some light on Enterovirus D68, and to help educate us as to the nature of the illness, when parents should be concerned, and what they can do to protect their children.
Q: What is Enterovirus D68 and where did it come from?
A: Enterovirus D68 is a virus that’s been around for a long time. It was first identified in 1962, but more than likely has been around for much longer. Enteroviruses can cause a variety of symptoms from runny nose and cough to fevers, body aches and mouth blisters. Enterovirus D68, is genetically very similar to a rhinovirus, essentially the common cold virus. For most people Enterovirus D68 is probably not much different than a common cold, but we definitely know from experience that it can cause severe wheezing and breathing difficulty in children. This is especially true in children with underlying respiratory problems such as asthma. While we have seen patients with Enterovirus D68 range in age from 6 months to 18 years, the average age of those afflicted in our community has been about 7 years old.
Q: Why has there been such an increase of Enterovirus D68 this year?
A: Infectious disease experts don’t know exactly why we are having a larger countrywide outbreak this year; it might be that we just haven’t recognized it specifically in the past. Rates of rhinovirus (common cold) infections generally increase in September and October. Enterovirus D68 was detected this year because it was diagnosed in several areas of the country in August as opposed to September. However, we didn’t start to detect it in Westchester County until about the second week of September. Since the beginning of October, the number of cases we’ve seen has declined significantly.
Q: When should parents be concerned their children might have Enterovirus D68?
A: Pay attention to your child’s respiratory health. The severe symptoms caused by the virus affect a child’s breathing. Warning signs can include wheezing when your child hasn’t wheezed before, or if he or she is an asthmatic and needs his or her rescue medications more frequently. If your child is breathing faster than normal, you see his muscles working hard to breathe, or she has a prolonged cough, these could also be signs and symptoms of a more severe respiratory illness due to Enterovirus D68. Parents should call their child’s pediatrician first if something seems out of the ordinary. Of course, if your child is really working hard to breathe or has any kind of respiratory distress, then parent and child should go directly to the emergency room.
Q: How does the virus spread?
A: Most enteroviruses spread through contact transmission, meaning the hands touch something that’s infected and the hands then touch the eyes, nose, or mouth. However, rhinoviruses, like the common cold, are transmitted through respiratory droplets from coughs and sneezes. When the droplets from infected people land on the mucous membranes of the eyes, nose and mouth, an infection can occur. Since Enterovirus D68 acts like both an enterovirus and a rhinovirus, we are presuming it can be transmitted this way.
Q: How can parents protect their children from this virus?
A: The best way to protect yourself and your children from this virus is to take the same preventative measures you take to protect yourself from every other virus. Children should wash their hands often and thoroughly, and parents should teach good cough etiquette. That means coughing and sneezing into their bent arm. If they do sneeze into their hands, they should clean their hands immediately and definitely before they eat, or touch their eyes, nose, or mouth. There’s no vaccine for this virus, but there are vaccines for other illnesses, so get your vaccines. Get your flu shot each year, especially if your child has an underlying respiratory issue. For asthmatic children, make sure they are on their inhaled medication and get their asthma plans ready with their physician and keep them up to date.
Sheila Nolan, M.D., is Chief of Pediatric Infectious Diseases at Maria Fareri Children’s Hospital at Westchester Medical Center, the children’s hospital for Westchester County the Hudson Valley and Fairfield County. For more information about the hospital or to schedule an appointment with a Children’s Hospital doctor, please visit www.westchestermedicalcenter.com/mfch or call 877-WMC-DOCS (877-962-3627).
