August 19, 2019
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Maine child being tested for respiratory virus spreading in Northeast

A respiratory virus that has sickened nearly 100 people across the United States may have infected at least one child in Maine, according to Dr. Sheila Pinette, director for the Maine Centers for Disease Control and Prevention.

The virus, named enterovirus D68, has been confirmed in 97 cases in Colorado, Illinois, Iowa, Kansas, Kentucky and Missouri since mid-August. Suspected cases have also been reported in New York, Connecticut and Massachusetts over the last week, Pinette said.

This is the first suspected case in Maine.

“We have had a case that is concerning,” Pinette said. “That hasn’t been positively identified as enterovirus D68. We will be sending out a sample to the [federal] CDC.”

Enterovirus D68 causes fever, runny nose, sneezing, cough and muscle aches, with recent cases also including difficulty breathing and/or wheezing in children who have a history of respiratory problems, such as asthma, according to the CDC.

The CDC also said that among the cases confirmed in Missouri and Illinois, children with asthma seem to be at a higher risk. An advisory released by the Maine CDC Monday afternoon indicated that two-thirds of confirmed cases of enterovirus D68 were in patients with a medical history of asthma or wheezing.

“Ages ranged from 6 weeks through 16 years, with median ages of 4 and 5 years in Kansas City and Chicago, respectively. Most patients were admitted to the pediatric intensive care unit,” the release stated.

However, only the most severe cases have been tested for this strain of the virus so this might not be reflective of the full spectrum of the virus, the Maine CDC said.

Pinette said the enterovirus is common and highly contagious. It spreads from person to person through coughs, sneezes and touching contaminated surfaces. Children are most vulnerable to the virus, but cases have been reported in teens as well.

“Anybody who is immunocompromised is at risk,” Pinette said.

However, since contact is necessary for the spread of the disease, adults with impaired immune systems who aren’t regularly in contact with children are less likely to contract the virus.

“Most importantly, if they are having symptoms, they [must] get evaluated and treated,” Pinette said.

She said if someone with symptoms experiences an “acute change in health status,” they should be taken to the hospital right away as it could be a severe case of enterovirus D68, like the ones making news right now.

To prevent the spread of enterovirus D68, Pinette recommends frequent hand washing and coughing into your elbow to prevent mucus spray. Also, loved ones should avoid kissing, sharing cups and utensils and also should regularly wipe down surfaces with bleach to prevent the spread of germs.

She cautioned that antibacterial gels like Purell are alone insufficient — handwashing with soap and water is necessary.

Parents of young children in diapers also should take care to wash well after changing diapers. Pinette said the virus is “carried in the stool for weeks,” so when changing diapers, be sure to wash hands and properly dispose of diapers immediately.

Enterovirus refers to a variety of strains of the virus, which include everything from polio-causing viruses to D68, which does not cause polio.

“There’s over a hundred different strains of enterovirus,” Pinette said. “The disease spectrum is very broad. The ones that are the most concerning is this particular viral strain [D68]. We are looking at it very closely right now.”

Testing for enterovirus D68 is done via a nasal or oral swab. If it is confirmed to be an enterovirus, Pinette said the sample goes to the Federal CDC for typing — how the strain of the virus is determined.

There is no vaccine and no antiviral treatment for this illness, Pinette said. Treatments for enterovirus D68 now includes intravenous fluids, oxygen and sometimes steroid treatments, she added, with fewer than 10 percent of cases so serious as to require a ventilator.

While the virus can cause severe symptoms, Pinette said there have been no deaths from it since it was first discovered in California in 1962. That year, four children were diagnosed.

This outbreak is more widespread than previous ones, said Amesh A. Adalja, MD, an infectious disease physician at the University of Pittsburgh Medical Center.

“In the past [enterovirus D68] has caused sporadic infections and clusters. This outbreak, by contrast, is much larger and likely represents a change in the pattern of infection. It will be important to understand what has changed (better diagnostic ability vs. the virus vs. some other factors),” said Adalja, in an email to the Bangor Daily News.



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