Vigilant versus virus

COEUR d'ALENE - Idaho public health officials are closely monitoring respiratory infections and working to identify respiratory illnesses caused by enterovirus D68 (EV-D68), according to a press release from Idaho Health and Welfare.

"I think you have to be concerned about it everywhere, even outside of Idaho," said Tom Shanahan, public information manager for Health and Welfare in Boise. "We are seeing the spread of the disease throughout different states."

EV-D68 is one of numerous non-polio enteroviruses. It can cause mild to severe respiratory illness. Mild symptoms include fever, runny nose, sneezing, cough, and body and muscle aches. Severe symptoms include wheezing and trouble breathing. People with asthma may have a higher risk of severe respiratory illness.

"The biggest concern is for children who have asthma or other underlying health conditions because it seems to hit them pretty hard," Shanahan said Thursday.

He said that many people who contract EV-D68 experience what is similar to a late summer cold and won't feel the need to see a doctor, but children with respiratory conditions or weakened immune systems are more susceptible to experiencing severe symptoms. He advises parents to talk to their kids about frequently washing their hands and covering their mouths when they cough.

Amy Ward, infection prevention coordinator for Kootenai Health, and Audra Dawson, supervisor of infection prevention at Kootenai Health, recommend people use "good respiratory etiquette," stay home when they're sick and keep sick children home. Dawson said EV-D68 is not a concern right now and most likely won't be.

Although no cases have been reported in North Idaho or in Washington state, she said Kootenai Health officials are looking for any trends or increases in severe respiratory illness in pediatric patients who are being admitted.

"Concern would be if the child would have difficulty breathing or wheezing," she said.

The disease can be found in respiratory secretions such as saliva, nasal mucus or sputum (a mix of saliva and mucus coughed up from the respiratory area). EV-D68 is also likely to spread when an infected person coughs, sneezes or touches contaminated surfaces.

"We at Kootenai Health are aware of the situation that is going on and we have a plan in place if we do notice any increase in respiratory illness," Ward said.

According to the Centers for Disease Control and Prevention website, EV-D68 was first identified in California in 1962, but has not been commonly reported in the U.S.

"It's kind of interesting because up until recently, they had rarely seen the virus," Shanahan said.

As of Thursday, the CDC control reported 82 confirmed cases of EV-D68 in Colorado, Kansas, Missouri, Illinois, Iowa and Kentucky. Shanahan said he believes there to be more than 100 different enteroviruses and more cases that exist than are listed on the CDC website.

"In eastern Idaho there were five cases that a lab diagnosed that tested positive for enterovirus, so those samples are being sent to the CDC," he said.

Idaho's Health and Welfare has been sending in a lot of samples to test for the specific virus, Shanahan said.

"The more data we have, the better," he said.

CDC reports that EV-D68 infections are thought to occur less commonly than other enteroviruses, "however, CDC does not know how many infections and deaths from EV-D68 occur each year in the United States," its website reads. "Healthcare professionals are not required to report this information to health departments. Also, CDC does not have a surveillance system that specifically collects information on EV-D68 infections. Any data that CDC receives about EV-D68 infections or outbreaks are voluntarily provided by labs to CDC's National Enterovirus Surveillance System (NESS). This system collects limited data, focusing on circulating types of enteroviruses and parechoviruses."

Anyone is susceptible to the disease. Among the recent cases, CDC reports that children with asthma seem to be at a higher risk for severe illness, but this is still under investigation. Many hospitals and doctors' offices cannot do testing to determine the specific type of enterovirus, but CDC and state health departments can conduct this sort of testing.

While no specific treatments for respiratory illness caused by EV-D68 exist, those with mild illness can relieve symptoms with other-the-counter medications and those exhibiting severe illness may need to be hospitalized.

There is no vaccine for the virus, but people can protect themselves from the virus by washing hands often with soap and water for 20 seconds especially after changing diapers. Also, disinfect frequently touched surfaces such as toys and doorknobs, avoid touching your eyes, nose and mouth with unwashed hands, and avoid kissing, hugging and sharing cups or eating utensils with people who are sick.