Ktvb news... BOISE -- An outbreak of a severe respiratory virus has sent at least a thousand kids to the hospital across a dozen states. It seems to start as a cold, but then gets much worse. The CDC is warning what doctors are seeing could be the tip of the iceberg. In Denver, the outbreak is so severe that there have been 900 cases in the last month. Some children are so sick theyre put in intensive care. Its called entrovirus 68, or EV-D68, and it has doctors very concerned. A lot of kids have been on the verge of respiratory failure or severe respiratory distress requiring escalating therapies and care, Ive been an ICU physician for 15 years. Ive never seen this before. The virus has the following symptoms: Extreme trouble breathing Severe coughing Sometimes wheezing Fever Rash Infants, children, and teenagers are most vulnerable to the virus, especially those with asthma. The virus is spread by sneezing, coughing, and close personal contact and is easily transmissible. The new school year is likely to be helping the spread of the virus with children together in close vicinities for long periods of time. There is no vaccine for EV-D68. Currently, doctors provide treatments to support breathing, check fluids, and ensure the child is comfortable until the virus goes away. Cnn news...... Respiratory illness hits children (CNN) - A respiratory virus that has sent hundreds of children to hospitals in Missouri is causing alarm across the Midwest and beyond. Ten states have contacted the Centers for Disease Control and Prevention for help investigating clusters of the virus thats being blamed for the illness. Health officials say theyre still figuring out whats going on. The bug that appears to be causing most of the concern has a typically arcane name -- Enterovirus EV-D68 -- but many of its symptoms are very common. Heres what you need to know about the virus. What are enteroviruses? Enteroviruses, which bring on symptoms like a very intense cold, arent unusual. Theyre actually very common. When you have a bad summer cold, often what you have is an enterovirus, said Mark Pallansch, a virologist and director of the Centers for Disease Control and Preventions Division of Viral Diseases. There are more than 100 types of enteroviruses causing about 10 to 15 million infections in the United States each year, according to the CDC. They are carried in the intestinal tract and often spread to other parts of the body. The season often hits its peak in September, as summer ends and fall begins. So why all the concern now? Whats unusual at the moment is the high number of hospitalizations. The virus has sent more than 30 children a day to a Kansas City, Missouri, hospital, where about 15% of the youngsters were placed in intensive care, officials said. Its worse in terms of scope of critically ill children who require intensive care. I would call it unprecedented, said Dr. Mary Anne Jackson, a director for infectious diseases at Childrens Mercy Hospital, where about 475 children were recently treated. Ive practiced for 30 years in pediatrics, and Ive never seen anything quite like this, she said. Whats special about this particular type of enterovirus? An analysis by the CDC showed at least 30 of the Kansas City children tested positive for EV-D68, Missouri health officials said. Its a type of enterovirus thats uncommon, but not new. It was first identified in the 1960s and there have been fewer than 100 reported cases since that time. But its possible, Pallansch said, that the relatively low number of reports might be because EV-D68 is hard to identify. EV-D68 was seen last year in the United States and this year in various parts of the world. Over the years, clusters have been reported in Georgia, Pennsylvania, Arizona and various countries including the Philippines, Japan and the Netherlands. Experts say they dont know why its flared up this time around. Why one virus or another crops up in one part of the country or another part of the country from one year to the next is inexplicable, said William Schaffner, head of the Department of Preventive Medicine at Vanderbilt University. Its a mystery to me. What are the symptoms? The virus can start as just a cold. Signs include coughing, difficulty breathing and in some cases a rash. Sometimes they can be accompanied by fever or wheezing. Respiratory problems appear to the hallmark of EV-D68, according to the Missouri Department of Health and Senior Services. Most enteroviruses cause either a little bit of a cold or a diarrheal illness -- a few cause meningitis, said Schaffner. This one is the, if you will, odd cousin. It causes prominent respiratory symptoms. Why it does that, were really not sure. How serious is it? The good news is that enteroviruses usually arent deadly. All of these folks are going to get better, said Schaffner. Some of them have more severe illness, such as these children who have developed asthma and are hospitalized. But they should all get better. Many of the EV-D68 infections will be mild and self-limited, requiring only symptomatic treatment, the Missouri health agency said. Some cases could, in theory, contribute to death, but none of the Missouri cases have resulted in death and no data are available for overall morbidity and mortality from the virus in the United States, the agency said. How widespread are the cases? Beyond the surge in infections in Missouri, there are signs of a possible regional outbreak of EV-D68. Colorado, Illinois and Ohio are reporting cases with similar symptoms and are awaiting testing results, according to officials and CNN affiliates in those states. The 10 states that have reached out to the CDC for assistance are Colorado, North Carolina, Georgia, Ohio, Iowa, Illinois, Missouri, Kansas, Oklahoma, and Kentucky. The unusually high number of hospitalizations reported now could be just the tip of the iceberg in terms of severe cases, said Pallansch of the CDC. What can be done to prevent it? Like other enteroviruses, the respiratory illness appears to spread through close contact with infected people. That makes children more susceptible. Theres not a great deal you can do, health officials say, beyond taking commonsense steps to reduce the risk. Wash your hands with soap and water for 20 seconds -- particularly after going to the bathroom and changing diapers. Clean and disinfect surfaces that are regularly touched by different people, such as toys and doorknobs. Avoid shaking hands, kissing, hugging and sharing cups or eating utensils with people who are sick. And stay home if you feel unwell. Theres no vaccine for EV-D68. Mystery Respiratory Virus Likely to Hit Kids Across Country A respiratory illness that has already sickened more than a thousand children in 10 states is likely to become a nationwide problem, doctors say. Rare Lung Virus Affects Kids Across the Country Getty Images The disease hasnt been officially identified but officials suspect a rare respiratory virus called human enterovirus 68. According to the U.S. Centers for Disease Control and Centers for Disease Control and Prevention, the virus is related to the rhinovirus, which causes the common cold. According to Mark Pallansch, director of the Division of Viral Diseases at the CDC, similar cases to the ones in Colorado have been cropping up across the U.S. At least 10 states -- Missouri, Kansas, Illinois, Kentucky, Iowa, Colorado, Ohio, Oklahoma, North Carolina, and Georgia -- have reported suspected outbreaks of human enterovirus 68 and requested CDC support. Abc news..... Viruses dont tend to respect borders, ABC News Chief Health and Medical Editor Dr. Richard Besser said. It is only 10 states now, but its going to be across the country. So if your state doesnt have it now, watch for it, its coming. Doctors say they are not even sure yet how this particular virus spreads, though the back-to-school season is a normal time for illnesses to spread among children. This is a very common time for outbreaks. Kids come back to school, they like to share things, they bring them home to their little brothers and sisters, and enteroviruses tend to occur in the summer, Besser said. But this one, this particular Enterovirus 68, is very rare and they have no idea why it showed up this year. At Childrens Hospital Colorado in Denver, officials say that between Aug. 18 and Sept. 4, doctors saw more than 900 pediatric patients with symptoms of the respiratory virus in the emergency room. Of those who came in, 86 were admitted into the hospital and a handful ended up in the intensive care unit. It can start just like a cold -- runny nose, sneezing, coughs -- but its the wheezing you have to watch out for, Besser said. Dr. Christine Nyquist, a pediatrician at Childrens Hospital Colorado, said the virus usually ends up appearing similar to a severe cold but can be particularly dangerous for children with asthma because of how it affects the respiratory system. The kids are coming in with respiratory symptoms, their asthma is exacerbated, Nyquist said. Kids with no wheezing are having wheezing. At Rocky Mountain Hospital for Children, Dr. Raju Meyappan, a pediatric critical care physician, said hes seen at multiple children end up in the pediatric intensive care unit after being infected with the virus and that children under the age of 5 or those with asthma appear to be most at risk. In one particularly severe case, Meyappan said a 13-year-old asthmatic patient ended up in the emergency room just one day after showing basic cold-like symptoms, including cough and runny nose. His asthma became so severe on the second day the teenager turned blue and was rushed to the emergency room, where doctors gave him an emergency breathing tube. The patient was one of multiple asthmatic pediatric patients who ended up sedated in the intensive care unit with a breathing tube, Meyappan said. Patients who needed breathing tubes spent between four to seven days sedated and intubated as they recovered, he said. As a pediatric ICU doctor, we try our best not to intubate kids with asthma at any point in time, said Meyappan, who added that only the most severe cases warranted intubation. They all needed it. The onset [of the virus] is severe. Meyappan said currently four patients were in the pediatric ICU recovering. There are multiple reasons why the outbreak was hitting Denver now, instead of later in the fall or winter when flu.htm id=ramplink_cold and flu_ target=_blank>cold and flu infections start to rise, Nyquist said. In addition to school starting, Nyquist said, some children with asthma could have seasonal allergies that are exacerbated by the virus. Any kind of viral infection can kick off wheezing and asthmas, she said. People with asthma know what triggers their asthma. A viral infection is one thing and this is the one that is circulating. To stay healthy, the CDC recommends basic sanitary practices to avoid spreading the virus, including washing hands, avoiding those who are sick, and covering the nose and mouth during sneezes or coughs. Meyappan said parents of asthmatic children should make sure that their childrens inhalers are easily accessible and that there is a treatment plan in place if an asthma attack continues to get worse. Make sure [parents] talk to all their caregivers about what to do if [the child has] an asthma attack and where to go if they need help, Meyappan said. I think having a game plan in place helps.
Posted on: Tue, 09 Sep 2014 07:21:25 +0000
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