Tag Archives: D68

New D68 Virus Test Likely To Significantly Increase Number Infected

New D68 Virus Test Likely To Significantly Increase Number Infected

NEW TEST TO BUMP UP DIAGNOSES OF ILLNESS IN KIDS

BY MIKE STOBBE, AP MEDICAL WRITER
girl hospital sick child

NEW YORK (AP) — For more than two months, health officials have been struggling to understand the size of a national wave of severe respiratory illnesses caused by an unusual virus. This week, they expect the wave to start looking a whole lot bigger.

But that’s because a new test will be speeding through a backlog of cases. Starting Tuesday, the Centers for Disease Control and Prevention is using a new test to help the agency process four or five times more specimens per day that it has been.

The test is a yes/no check for enterovirus 68, which since August has been fingered as the cause of hundreds of asthma-like respiratory illnesses in children – some so severe the patients needed a breathing machine. The virus is being investigated as a cause of at least 6 deaths.

It will largely replace a test which can distinguish a number of viruses, but has a much longer turnaround.

sick girl child virus

The result? Instead of national case counts growing by around 30 a day, they’re expected to jump to 90 or more.

But for at least a week or two, the anticipated flood of new numbers will reflect what was seen in the backlog of about 1,000 specimens from September. The numbers will not show what’s been happening more recently, noted Mark Pallansch, director of the CDC’s division of viral diseases.

Enterovirus 68 is one of a pack of viruses that spread around the country every year around the start of school, generally causing cold-like illnesses. Those viruses tend to wane after September, and some experts think that’s what’s been happening.

One of the places hardest hit by the enterovirus 68 wave was Children’s Mercy Hospital in Kansas City, Missouri. The specialized pediatric hospital was flooded with cases of wheezing, very sick children in August, hitting a peak of nearly 300 in the last week of the month.

But that kind of patient traffic has steadily declined since mid-September, said Dr. Jason Newland, a pediatric infectious diseases physician there.

“Now it’s settled down” to near-normal levels, Newland said. Given the seasonality of the virus, “it makes sense it would kind of be going away,” he added.

The germ was first identified in the U.S. in 1962, and small numbers of cases have been regularly reported since 1987. Because it’s not routinely tested for, it may have spread widely in previous years without being identified in people who just seemed to have a cold, health officials have said.

But some viruses seem to surge in multi-year cycles, and it’s possible that enterovirus surged this year for the first time in quite a while. If that’s true, it may have had an unusually harsh impact because there were a large number of children who had never been infected with it before and never acquired immunity, Newland said.

Whatever the reason, the virus gained national attention in August when hospitals in Kansas City and Chicago saw severe breathing illnesses in kids in numbers they never see at that time of year.

Health officials began finding enterovirus 68. The CDC, in Atlanta, has been receiving specimens from severely ill children all over the country and doing about 80 percent of the testing for the virus. The test has been used for disease surveillance, but not treatment. Doctors give over-the-counter medicines for milder cases, and provide oxygen or other supportive care for more severe ones.

The CDC has been diagnosing enterovirus 68 in roughly half of the specimens sent in, Pallansch said. Others have been diagnosed with an assortment of other respiratory germs.

As of Friday, lab tests by the CDC have confirmed illness caused by the germ in 691 people in 46 states and the District of Columbia. The CDC is expected to post new numbers Tuesday and Wednesday.

Aside from the CDC, labs in California, Indiana, Minnesota and New York also have been doing enterovirus testing and contributing to the national count. It hasn’t been determined if or when the states will begin using the new test, which was developed by a CDC team led by Allan Nix.

Meanwhile, the virus also is being eyed as possible factor in muscle weakness and paralysis in at least 27 children and adults in a dozen states. That includes at least 10 in the Denver area, and a cluster of three seen at Children’s Mercy, Newland said.

What is the Enterovirus D68 Virus (EV-D68)?

What is the Enterovirus D68 Virus (EV-D68)?

by AbosluteNews.com

A fast-spreading virus related to hand-foot-and-mouth disease is hospitalizing kids across the country.

The virus, called enterovirus D68 or EV-D68, was first discovered in 1962 in California. But until now, it has only been tied to smaller clusters of disease around the U.S.

This is the first time it’s caused such widespread misery, and it seems to be particularly hard on the lungs.

As of Oct. 6, the CDC has confirmed more than 590 cases of EV-D68 in 43 states and Washington, DC. All of the cases have been in children except for one adult case.

Two confirmed cases of children have died in the US in October: a 21 month old girl in Detroit and a 4 year old body in New Jersey.

What Parents Need to Know about EV-D68 and Respiratory Illness, CDC
What Parents Need to Know about EV-D68 and Respiratory Illness, CDC

What are the symptoms of EV-D68 infection?

EV-D68 can cause mild to severe respiratory illness.

  • Mild symptoms may include fever, runny nose, sneezing, cough, and body and muscle aches.
  • Severe symptoms may include wheezing and difficulty breathing. See EV-D68 in the U.S., 2014 for details about infections occurring this year.

Anyone with respiratory illness should contact their doctor if they are having difficulty breathing or if their symptoms are getting worse.

respiratory virus flu D68 sick

How does the virus spread?

Since EV-D68 causes respiratory illness, the virus can be found in an infected person’s respiratory secretions, such as saliva, nasal mucus, or sputum. EV-D68 likely spreads from person to person when an infected person coughs, sneezes, or touches a surface that is then touched by others.

What time of the year are people most likely to get infected?

In the United States, people are more likely to get infected with enteroviruses in the summer and fall. Cases are likely to decline later in the fall.

How common is EV-D68 in the United States?

In general, a mix of enteroviruses circulates every year, and different types of enteroviruses can be common in different years. Small numbers of EV-D68 have been reported regularly to CDC since 1987. However, this year the number of people reported with confirmed EV-D68 infection is much greater than that reported in previous years. See EV-D68 in the U.S., 2014for details about infections occurring this year.

Who is at risk?

In general, infants, children, and teenagers are most likely to get infected with enteroviruses and become ill. That’s because they do not yet have immunity (protection) from previous exposures to these viruses. We believe this is also true for EV-D68. Adults can get infected with enteroviruses, but they are more likely to have no symptoms or mild symptoms.

Children with asthma may have a higher risk for severe respiratory illness caused by EV-D68 infection.

How is it diagnosed?

EV-D68 can only be diagnosed by doing specific lab tests on specimens from a person’s nose and throat.

Many hospitals and some doctor’s offices can test ill patients to see if they have enterovirus infection. However, most cannot do specific testing to determine the type of enterovirus, like EV-D68. CDC and some state health departments can do this sort of testing.

CDC recommends that clinicians only consider EV-D68 testing for patients with severe respiratory illness and when the cause is unclear.

What are the treatments?

There is no specific treatment for people with respiratory illness caused by EV-D68.

Source: CDC website

Enterovirus D68 And Influenza Far More Dangerous Than Ebola In US

Enterovirus D68 And Influenza Far More Dangerous Than Ebola In US

Say Top Infectious Diseases Physicians

by Forbes.com

sick girl child virus

A panel of infectious diseases experts this morning expressed far more grave concerns for Americans about the risks of flu and enterovirus D68 than for Ebola virus disease.

That’s noteworthy because the group included Bruce Ribner, MD, MPH, the Emory University Hospital doctor who led the team that successfully treated two Ebola-infected medical missionaries, Dr. Kent Brantly and Nancy Writebol.

Of these three diseases, one kills 3,000 to 49,000 Americans each year, yet is preventable: Influenza.

As a result, all Americans are urged to take advantage of access to this year’s flu vaccine, a sentiment strongly expressed by panel moderator, Jeff Duchin, MD, University of Washington associate professor of allergy and infectious diseases and chief of communicable disease control for the Seattle & King County Public Health Department.

What is the Enterovirus D68 Virus, Prevention, and Treatment?

And even if the vaccine is not 100% effective for a given person, the severity of the disease is reduced significantly, if you still get it.

Listen to sick children for wheezing, a major enterovirus D68 sign.

The vast majority of today’s panel discussion focused on enterovirus D68, or EV-D68 for short, a virus that’s causing particularly severe respiratory illness in children nationwide.

The Centers for Disease Control and Prevention (CDC) reported yesterday that EV-D68 infections have been confirmed in 45 states. Five children with the virus have died thus far and some children, especially in the Denver area, are experiencing muscle paralysis.

Child Hospital sick

Neurology experts are still not certain if it’s EV-D68 is causing the paralysis and muscle weakness but enteroviruses have occasionally been associated with nervous system effects such as meningitis and brain stem and spinal cord inflammation, said Mary Anne Jackson, MD, director of infectious diseases at Children’s Mercy Hospital in Kansas City, the first institution to report this current outbreak of EV-D68.

Jackson also said that it’s not clear if the paralysis is unique to the currently-circulating strain of EV-D68 virus or whether the sheer number of patients with the infection is just larger than usual, allowing rare complications to be seen in more patients.

“At this point, it’s very clear that this is the largest national outbreak of the virus that’s ever been recorded,” said Jackson.

The virus was first discovered in 1962 but not seen again in the U.S. for 36 years. Over 100 types of enterovirus are known, but they are distinct from polioviruses, stressed Aaron M. Milstone, MD, an assistant professor of infectious diseases at the Johns Hopkins Children’s Center.

In the current outbreak, Jackson said that EV-D68 is primarily affecting children. No cases have been identified in adults, suggesting that some previous exposure to EV-D68 conferred immunity to the currently-circulating virus.

Jackson said that the more severe form of the disease is more prevalent in the Midwest than either coast. At the peak of the Kansas City-area outbreak, from August 19 through September 2, their 354-bed hospital was filled.

At one point, Children’s Mercy had 100 patients in their pediatric intensive care unit (PICU), three times the number this time of the last two years. Most often, patients end up on the PICU because of unusually severe bronchospasms. The treatment is generally supportive because antiviral drugs lack effectiveness against EV-D68.

girl hospital sick childThe children start with a typical “cold,” exhibiting fever, runny nose, and body aches. The important sign of concern is if the child begins wheezing, a usually high-pitched squeaking or squeezing sound when exhaling. The video below plays the sound of wheezing (hat-tip to Amy Hubbard at the Los Angeles Times). This is the YouTube link in case your browser doesn’t play the clip.

Jackson noted that the infection can sometimes show a positive result for rhinovirus, a less-worrisome family of viruses most often responsible for the common cold. Most hospital laboratories can do the rhinovirus test but the confirmatory D68 test must be sent out to state reference labs or the CDC. The lack of a real-time, rapid test is a problem.

Another risk factor for EV-D68 infection is a history of asthma. Jackson says that about one-third of patients have a history of asthma that requires medication, one-third had previously experienced wheezing but weren’t on medications, and one-third have no previous asthma history.

Jackson notes that the CDC now has two specific efforts to monitor eneterovirus-D68 infections, one focusing on the severe respiratory effects and the other on the muscle paralysis and its cause.