Pharmacist Raises Concerns Over Enterovirus as Illness Spreads

The severe respiratory virus that is hospitalizing children across the United States has now been confirmed in 17 states.

New Jersey and Virginia are the latest states to confirm cases of enterovirus D68 (EV-D68), which causes symptoms similar to those of a severe cold, including respiratory illness, febrile rash illness, and neurologic illness, such as aseptic meningitis and encephalitis. Other states with confirmed EV-D68 cases are Alabama, Colorado, Connecticut, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Missouri, Montana, Nebraska, New York, Oklahoma, and Pennsylvania.

In New Jersey, which only has 1 confirmed case of EV-D68 thus far, officials are cautioning parents to be on the lookout for signs of the illness.

"The New Jersey Department of Health (NJDOH) is closely monitoring for increases in respiratory illness in hospitals around the state," said agency Commissioner Mary E. O'Dowd in a press release. "If you, or your child, are experiencing cold-like symptoms and are having difficulty breathing, contact your health care provider right away.”

To date, more than 140 children have been confirmed to have EV-D68. Those who have tested positive for EV-D68 all presented with symptoms that included difficulty breathing, hypoxemia, and some with wheezing, according to the US Centers for Disease Control and Prevention (CDC). Approximately two-thirds of the patients had a previous medical history of asthma or wheezing.

In Maryland, which has yet to report a confirmed case of EV-D68, a pharmacist noted an increase in the number of children presenting with respiratory issues.

"I am noticing it more than the normal year sickness,” Zaheer Ahmed said in a report from WBOC 16 in Maryland. “This is the time when the kids go to school and the weather is cold, (and) they get sick. But this is more than that. When they go to lunch and they're in the walkways, they see a lot of kids who are coughing, and that is a concern."

There are more than 100 different strains of the enterovirus, which are estimated by the CDC to impact 10 million to 15 million people each year. In general, infants, children, and teenagers face the greatest risk for the illness because they lack immunity from previous exposures to those viruses.

Once the presence of EV-D68 has been confirmed in a region, there is still not a need for routine testing for the pathogen, and testing for EV-D68 does not change the treatment a patient will receive.

Because there are no vaccines or specific antiviral medications for the enterovirus, patients are urged to take steps similar to those for preventing the flu.

“Good hand hygiene is your best defense against getting infected with enterovirus,” the NJDOH stated in a press release.

Additionally, the CDC offers the following tips to protect against respiratory illnesses:

• Wash hands often with soap and water for 20 seconds, especially after changing diapers.
• Avoid touching the eyes, nose, and mouth with unwashed hands.
• Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick.
• Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.