What Parents Should Know About Enterovirus: Symptoms and Risks

Issued by the Centers for Disease Control and Prevention advice inform health care providers about the recent increase in severe respiratory illness requiring hospitalization in children, encouraging them to consider an enterovirus as a possible cause.

In July and August, hospitals and medical professionals in some parts of the United States reported an increase in infections caused by enterovirus D68, or EV-D68, which usually causes mild, similar symptoms. like a cold but can also lead to more serious respiratory illness. The number of detected cases is the highest since the 2018 seasonal outbreak. A CDC representative confirmed there were 84 cases of EV-D68 between March and August 4.

The recent warning was directed at doctors and hospitals because – in addition to causing respiratory symptoms – EV-D68 has been associated with acute myelitis, or AFM, a rare but serious neurological complication can lead to permanent paralysis or death. More than 90 percent cases of AFM in the United States are in young children.

CDC has not received a reported increase in AFM cases so far this year, but because the spike in EV-D68 infections tends to precede AFM cases, the agency hopes It hopes to put pediatricians and other frontline health care providers around the country on alert. It is important that diagnostic tests are done as soon as possible after a child develops symptoms.

“Increasing vigilance for AFM in the coming weeks will be essential,” the CDC warned.

Non-polio enteric viruses such as EV-D68 are very common, causing up to 15 million infections each year in the United States. There are more than 100 known types, and they tend to spread in late summer and early fall, although infection occurs year-round.

“They circulate every year,” said Dr. Alejandro Jordan Villegas, a pediatric infectious disease physician at Orlando Health Arnold Palmer Children’s Hospital. “Some years we see more cases than others, but this is not something new.”

Most people who are infected have no symptoms or have mild, cold-like symptoms, such as fever, runny nose, cough, sneezing, or body aches. Two of the better known enteroviruses – enterovirus A71 and Coxsackie virus A6 – can cause hand, foot and mouth disease, a mild infectious disease that is very common in children under 5 years of age.

The CDC warning also notes that some patients recently hospitalized for respiratory illness have tested positive for the hinovirus, the virus that commonly causes the common cold.

EV-D68 was first identified in 1962, although the CDC has only been closely monitoring it since 2014, when it caused a nationwide outbreak of respiratory illness. That year, body confirmed 1,395 cases in 49 states and the District of Columbia, although they believe there may be thousands of other mild cases unconfirmed.

“In most people, it is an acute viral illness that comes and goes without incident; in a very small number, it can cause neurological symptoms such as this acute myelitis,” said Dr Amy Arrington, medical director of the special isolation unit and global head of biological preparedness. at Texas Children’s Hospital said. “But it’s very rare.”

Had 693 confirmed cases of AFM since the CDC began tracking the virus in 2014, including those 120 years. About 10% of EV-D68 cases in 2014 caused AFM, although that may be an overestimate since many enterovirus infections are thought to go unreported. Since then, there have been further increases in AFM cases in 2016 and 2018 – an increase that the CDC believes is caused by EV-D68, although experts are still investigating how the virus affects nervous system and why a few people develop AFM after contracting the virus.

There have been 14 confirmed cases of AFM in the United States this year.

The most common symptoms of AFM are sudden weakness in the arms or legs, loss of muscle tone, and loss of reflexes. In addition to those warning signs, the CDC also let parents know Seek medical attention if children develop symptoms such as difficulty swallowing or stuttering, drooping eyelids or facial weakness, especially after a child has a respiratory illness.

Non-polio enteroviruses are spread when an infected person coughs, sneezes, or touches a surface that is then touched by another person. So the best practices many families, schools and child care centers have adopted during the Covid-19 pandemic can also help prevent the spread of common seasonal viruses, including the EV-D68, this fall.

“The main thing, the main thing, is washing your hands,” says Dr. Villegas, noting that soap and water are often thought to be better than hand sanitizer when it comes to infection control.

He also emphasized the importance of “respiration etiquette”. “If you are sick, try not to let other people come into contact with you,” Dr. Villegas recommends. Children with asthma may be at higher risk of severe symptoms from EV-D68.

Parents should watch out for signs of serious illness in their children, but also remember that the purpose of these types of CDC health warnings – which frequent agency problems, and sometimes picked up by mainstream news outlets – is to put pediatricians and other frontline health care providers on the alert. There is no specific treatment for AFM, but doctors may recommend physical or movement therapy.

“It’s extremely rare, but it’s something that you don’t want to miss when you have a child with these neurological symptoms, because getting that child checked and treated and started rehabilitated. It’s really important as soon as possible.” Dr. Arrington said.

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