Human enterovirus 68 has not yet spread to Casper, but doctor urges awareness

By Kristy Bleizeffer Sep 9, 2014

Dr. Elizabeth Wuerslin, a pediatric hospitalist, says the enterovirus 68 hasn't shown up in Casper, but that could change if it continues to spread.

Dr. Elizabeth Wuerslin, a pediatric hospitalist at Wyoming Medical Center, says while the human enterovirus 68 hasn't yet appeared in Casper, parents should be aware of its symptoms.

In August, a surge of children in Illinois and Missouri reported to emergency rooms with respiratory distress, and doctors identified enterovirus D68 (EV-D68) as the culprit. EV-D68 was first identified in 1962, but has been rarely reported in the United States, according to the Centers for Disease Control and Prevention.

No so this summer. The virus has now spread to a dozen states in the Midwest and recently spread to Colorado. More than 900 children with respiratory illness have been treated in Denver hospitals. It doesn’t appear to have shown up in the Casper area yet, but that could change, said Dr. Elizabeth Wuerslin, a pediatric hospitalist at Wyoming Medical Center.

“We’re not seeing a lot of kids presenting to the emergency room here with acute asthma, but I think it’s just a matter of time given the spread through the Midwest and now in the Rocky Mountain area,” she said.

Dr. Wuerslin says parents should be aware of the virus in case it does show up here. Here’s what you need to know.

What is human enterovirus 68?
“It’s a seasonal virus that comes in the late summer. It happens to occur in clusters and very often school-age children. We think the reason that there are so many cases right now is that kids have returned to school,” Wuerslin said.

The virus, while rare, is part of much more common class of non-polio enteroviruses that cause between 10 to 15 million infections each year in the United States, according to the CDC. While anyone can catch them, children more often become sick because they don’t have immunity.

How common is it?
“It’s not very common but it has clustering seasons. In some viruses, they have seasonalities and also some years where they are more prominent than others. This particular virus, they’re not sure why it’s so prominent right now,” Wuerslin said.

Who is most at risk?
School-age kids are more at risk because of their lack of immunity and increased chance of exposure when around other children. Kids who have asthma are most at risk because of the virus' effects on the respiratory system.

What are the symptoms?
“It starts off looking like a common cold. In some cases, especially our asthmatic kids, it can escalate into wheezing and respiratory distress. Some of these children are in the ICU,” Wuerslin said.

How is it spread?
It is spread through droplets, the same way a cold or flu is spread. That means, you can also prevent its spread with good hygiene and hand washing.

“We recommend good hand washing, sneezing and coughing into the crook of your elbow instead of your hand, and getting immunized for those other respiratory illness that spread between kids, such as pertussis (whooping cough),” Wuerslin said.

To prevent the virus’ spread, “don’t send your children to school if they are sick, and if you are sick yourself don’t go and spread the virus at work, if at all possible.”

How is it treated?
According to the CDC, there are no antiviral medications, vaccines or specific treatments for EV-D68. Treatment includes supportive care for patients with respiratory illness until the virus runs its course.

“For kids with asthma, it’s sometimes serious enough that the children require a ventilator,” Wuerslin said.

How can parents tell the difference between a cold and EV-D68?
Symptoms of the common cold include coughing, sneezing, sore throat, runny nose or any combination of these symptoms. Watch for progression of these symptoms, particularly if your child complains about any difficulty in breathing.

“With this virus you can get sick pretty quickly, and it’s usually respiratory. At any point your child is not breathing properly, or they say I’m short of breath or my chest hurts, those are things that would prompt a visit to the emergency room,” Wuerslin said.

“For kids who have asthma, they are outside doing a lot of their fall sports. So the change in temperature and humidity can provoke some kids to wheeze. If you have an asthmatic child, be on the lookout for changes in asthmatic status.”

Has the virus made it to the Casper area?
Testing for enterovirus 68 requires a specialized test that must be sent out, so we don’t test for it here as a matter of course. Wyoming Medical Center has not seen a marked increase in children with acute asthma at this time, but are keeping tabs on the virus’ spread.

Are there any preventative measures?
While there is no vaccine or antiviral medication, Dr. Wuerslin recommends simply taking extra care of yourself to boost your immune system. It is especially important this time of year when parents and children are readjusting to hectic school schedules and are being exposed to their classmates’ germs.

“All those good things that we always say: eat healthy, get enough sleep,” Wuerslin said. “For this virus, watch for signs of illness, and if your child has what you think is a cold, be a little more cautious and make sure it’s not progressing to difficulty breathing or problems with the lungs.”

Dr. Wuerslin is a pediatric hospitalist. She grew up on Long Island. Her work as a summer swim coach and working with children helped develop her interest in pediatrics. She graduated from Cornell University Medical College in New York and trained in pediatrics at New York Hospital. She completed an adolescent medicine fellowship at Boston Children’s Hospital and earned a master’s degree in public health from Harvard. Since 1991, she has volunteered for overseas medical trips to correct cleft lip palates and congenital abnormalities in children. 

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