Enterovirus: A Q&A with Dr. James Thompson

  • Even though experts say the rate of Enterovirus D68 infections is expected to decline by late fall, the virus continues to spread across the United States. According to the latest report, eight states have experienced rising infection rates.  

    We asked Dr. James Thompson, a board-certified allergist and immunologist, some frequently asked questions on eveterovirus. 

    What is an enterovirus? 

    Enteroviruses are a group of infectious viruses that have more than 100 different serotypes. Serotyping is a laboratory procedure  which helps to identify different subcategories of virus particles. There are polio and non-polio  forms of enteroviruses. Enterovirus D68 is a non-polio serotype of enterovirus and has gained a lot of attention  this year. Other types of non-polio viruses include Coxackie A and Coxackie B viruses, and Echovirus. Non-polio enteroviruses have been associated with hand foot and mouth disease, upper respiratory tract infections that may mimic  the common cold, flu-like diseases and other illnesses that may inflame the heart, brain and spinal cord.

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    When these viruses commonly occur?
    Enteroviruses associated with upper respiratory conditions often show up during the summer and fall seasons.

    What are some of the common symptoms?
    Actually, most people don’t get sick from enteroviruses. Some have symptoms similar to the common cold. A small percentage of people experience more severe symptoms of cough, shortness of breath and flu-like illness. Rarely, people may have heart-related problems, severe headaches and stiff necks and paralysis. 

    Enterovirus D68 (ED68) has been associated with symptoms of runny nose, cough, muscle and body aches, and in severe cases, wheezing and shortness of breath.

    How is an enterovirus spread?
    Enterovirus spreads by having contact with infected mucus from the nose or mouth (sputum from a cough) or from the stool. The small particles may live on hard surfaces for hours and even days.

    Who is at greater risk /Who should be tested?
    Young children and teenagers are at greater risk because of their immature immune systems and lack of immunity to enteroviruses. Children with a history of asthma or other respiratory diseases are at higher risk for severe respiratory complications from ED68.

    Anyone suspected of having a severe respiratory illness of unclear cause may be considered for ED68 testing. Tests are done by swabbing the throat or nose for mucus sample.

    Is there a vaccine?
    Currently there is no vaccine to prevent enterovirus infection.

    How is an enterovirus treated, and how long will it last?
    Supportive care is recommended for treatment. Patients may require intravenous fluids, bed rest and inhaled asthma medication. There are no antiviral medications. Children with more severe disease may be sick for several days. There have been five reported deaths, although direct cause of death from ED68 has not been proven.

    Should I keep my child home from school?
    Children and adults with moderate to severe illness and especially coughing and sneezing should stay home.

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    Will my child be safe at day care or school?
    As long as adequate safety measures are being maintained at day care, school and work environments, there is a good chance to avoid the infection.

    How can I protect my children and myself from an enterovirus?
    Frequent hand washing with soap and water or antibacterial soap may reduce risk of infection.

    Wiping down counter tops, tables and keyboards with an appropriate disinfectant solution is also recommended. Avoiding the sharing of cups and eating utensils may prevent transmission.

    Encourage children to properly cover their mouth when coughing and sneezing. Getting a flu shot is highly recommended. 

    Anything else you’d like to add?
    Children should have an Asthma Action Plan that is up to date and readily available. Worsening asthma control should prompt a call to the doctor in order to allow for appropriate aggressive treatment early in the course. ED68 is particularly dangerous in children who have asthma. 

    ED68 has been found in the tested material of eight patients who subsequently died. Almost 200 more people have fallen ill from ED68 in the last week of October 47 out of 50 states in the U.S. have reported illnesses from it.

    For up-to-date reports on enterovirus, visit the Centers for Disease Control (CDC) website.



Published On: November 03, 2014