Amisha Malhotra, a pediatric infectious disease expert at Rutgers Robert Wood Johnson Medical School, explains the symptoms of enterovirus D68, why children are more susceptible and which children are at risk for developing more serious illness. Melvin Weinstein, chief of infectious disease at the medical school and Robert Wood Johnson University Hospital, also provides guidance for adults who are at risk due to immune or respiratory disorders.
What is an enterovirus and what makes the designation D68 different from other forms of enteroviruses?
Amisha Malhotra: A virus, in general, is a germ that spreads quickly throughout the body causing illness. Unlike a bacterial infection, such as strep throat, most viruses cannot be treated with antibiotics, although some viruses, such as polio and the flu, can be prevented with a vaccine. The group of non-polio enteroviruses -– there are more than 60 types -– are very common and generally cause minor illness, such as a cold. However, enterovirus D68, which was discovered in the 1960s, is not a common strain and because of its rarity, children have not built up immunity to fight the virus. Therefore, in some cases, they are experiencing more severe symptoms.
What are the symptoms of enterovirus D68?
Malhotra: The symptoms of enterovirus D68, also referred to as EV-D68, are very similar to the flu: fever, runny nose, cough, sneezing and muscle aches. In addition to these symptoms, many children are wheezing and experiencing difficulty breathing. It is these respiratory symptoms that are of most concern, particularly in children with asthma or other respiratory disorders.
How should parents care for children with these symptoms?
Malhotra: Children who have a fever may be given the prescribed amount of acetaminophen or ibuprofen for their age and weight to control the fever and they should be kept home from school and other activities to help prevent the spread of any illness. If the symptoms worsen or the child is wheezing or having difficulty breathing, parents should immediately contact their physician, who can determine if the child needs to be seen in the doctor’s office or recommend additional treatments at home. If your child is experiencing severe symptoms and you cannot reach your physician, bring your child to the emergency room.
Parents with children who have asthma or other respiratory illnesses may use a nebulizer as treatment, but should also contact their physician, as children with already established respiratory disorders are those who are experiencing the most severe symptoms and have, in some cases, been hospitalized.
Can adults contract EV-D68?
Melvin Weinstein: Yes, anyone can be affected by the enterovirus; however, since EV-D68 has been around since the 1960s, adults may have been exposed to the virus at some point during their lifetime and will have built up immunity to fight the virus. For many adults, the symptoms of the virus may be more like a cold. Adults with immune deficiencies or respiratory disorders may experience more severe symptoms and should contact their physician immediately if they experience labored breathing or a high fever.How can the spread of EV-D68 be controlled?
Malhotra: Following the basic rules of hygiene will help prevent the spread of the enterovirus. The most important rule is to wash your hands often. In addition, avoid contact with an ill person as best as possible and sneeze directly into your elbow to limit the spread of germs and prevent hands from becoming contaminated. Also keep your hands away from your mouth and nose. It’s also important to thoroughly clean and disinfect surfaces in the home and even at work.
What additional guidance do you have to help people to manage the enterovirus?
Malhotra: There is no treatment for enterovirus D68; however, I recommend that parents speak with their child’s doctor about other medications, such as fever reducers that may be used to help alleviate symptoms. Managing asthma symptoms in children also is very important. If asthma is controlled and a child becomes ill, it is easier to determine if the cause of breathing difficulties is from an illness, such as EV-D68. I also highly recommend that children and adults get the flu vaccine. Unlike EV-D68, influenza, another respiratory virus that circulates in the fall and winter, can be prevented with a vaccine.
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