Tuesday, September 30, 2014

EV-D68 Outbreak Heralds the End of Summer

If you were a schoolchild with asthma, your parents might have thought twice about sending you off to resume classes at the end of this past summer.   A recent outbreak of human enterovirus D68 (EV-D68) has many schools on alert and parents have been advised to keep sick children at home, lest they risk infecting classmates.  According to the Centers for Disease Control’s (CDC) Morbidity and Mortality Weekly Report published September 12th of this year, the first area of the country to note an increase in severe respiratory illnesses that were ultimately attributed to EV-D68 was Children's Mercy Hospital in Kansas City, Missouri.  Since these cases in early August, the virus has been laboratory confirmed to be present in 40 states and the District of Columbia as of September 29th.   A total of 443 individuals have been affected and there have been no fatalities.  There is no vaccine or targeted cure for EV-D68 at present.

States with Cases of EV-D68 as of September 29th, 2014

Cases in the current outbreak have appeared primarily among children with asthma or a history of wheezing.  The high incidence of the virus among children is unsurprising.  Enteroviruses are common---causing between 10 and 15 million infections annually in the United States alone---and most adults have developed adaptive immune defenses against them through previous exposure.  Infants, children and teens, however, often have not been previously exposed to the virus and thus represent a particularly vulnerable population.  In part, the frequent occurrence of enterovirus infections is attributable to the diversity of ways the virus can spread, including through physical contact with infected individuals, contact with fomites (objects infected individuals have touched that now harbor the virus), and drinking contaminated water.

Symptoms of infection are often relatively mild (runny nose, sneezing, coughing, fever, aches, etc.) but can sometimes be so severe as to require hospitalization.  Though a typically rare occurrence, enterovirus infections have been associated with paralysis.  It is instances of paralysis, especially in Colorado, that have prompted worry regarding the current outbreak.

Image courtesy of CNN.

To learn more about cases of EV-D68 in your region and about the virus itself, visit the CDC website here: http://www.cdc.gov/non-polio-enterovirus/outbreaks/EV-D68-outbreaks.html

--Laurie Rumker

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