Enterovirus D68 Not Life-Threatening

As Enterovirus D68 continues to spread across the US, the prognosis for children who are hospitalized with infections tends to be good. That applies to children with asthma, as well.

“It’s hard to say whether this virus is hitting kids with asthma harder than other viruses—but it is not causing as severe symptoms as other viruses out there, like adenovirus, “ said Christopher Carroll, MD, a pediatric intensivist and asthma specialist at Connecticut Children’s Medical Center in Hartford, CT.

“Even certain strains of rhinovirus are worse,” Carroll said.

He is caring for several children in the hospital’s pediatric intensive care unit who may have the illness. “We have a strong clinical suspicion,” Carroll said, but specimens sent to the US Centers for Disease Control and Prevention (CDC) are still awaiting testing.

“We expect to hear by Friday,” a hospital spokeswoman said.

Carroll said he called his contacts at the CDC Tuesday, Sept. 16, to check on progress and learned that “they were pretty busy because President Obama was there,” a visit related to efforts to fight the Ebola epidemic in Africa.

The CDC lab is testing specimens from many states and the list of states that suspect they have cases of EV-D68 keeps growing.

In Hartford, Carroll said that like many urban areas where the EV-D68 infections have spiked and sent children to the hospital, that’s because rates of asthma are higher than in the suburbs.

Children with asthma are generally at higher risk for having severe breathing problems related to colds, he said, known as viral-triggered asthma. But EV-D68 has not proved to be a difficult foe.

“Once these kids get to a hospital they are pretty safe,” he said, “the danger period is before they get here.” That is because it can be difficult to assess how much wheezing means respiratory distress.

After a child is admitted he or she gets oxygen, albuterol, a bilevel positive airway pressure device, and intravenous terbutaline or magnesium, he said.

These patients generally improve enough after two days to leave the PICU, Carroll said.

The Connecticut Department of Public Health announced there are possible outbreaks both at the Hartford hospital and one other facility it has not named.

New York State’s Department of Health announced Friday it has confirmed more than a dozen cases of EV-D68 infection in the northern and central regions of the state.

The state is doing its own testing at its Wadsworth Laboratory in Albany, NY.

In addition to the confirmed cases, specimens for testing are coming in from other parts of NY. So far there have been no confirmed cases in the New York City metropolitan region, the most densely populated part of NY.

The CDC so far has confirmed cases in Colorado, Illinois, Iowa, Kansas, Kentucky, and Missouri. Officials in two other states, Indiana and Montana, have also said they have confirmed cases.