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Pediatrician Dr. Eric Freeman answers questions about Enterovirus EV-D68

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RICHMOND, Va. -- Dr. Eric Freeman of Old Dominion Pediatrics, off Midlothian Turnpike near the Arboretum, answered viewer questions about Enterovirus EV-D68.

At least 10 children were admitted to the pediatric intensive care unit at St. Mary’s Hospital this week with acute respiratory illness and VCU Medical Center also received patients.

Twelve states are reporting clusters of enterovirus illness: Alabama, Colorado, Michigan, Georgia, Ohio, Iowa, Illinois, Missouri, Kansas, Oklahoma, Kentucky and Utah.

Enteroviruses, which can cause a variety of symptoms, aren't unusual. If you've ever had a bad summer cold, it was likely caused by an enterovirus. The CDC estimates there are 10 to 15 million viral infections each year in the United States. The season often hits its peak in September.

But this particular type of enterovirus -- EV-D68 -- is less common. And health officials are concerned by the number of hospitalizations it has caused this year.

Due to the concern, CBS 6 brought in Dr. Freeman to answer your questions. The full thread with questions and answers can be found here.

Wallace asks: Does it affect people with heart conditions as well?

"People with underlying heart conditions should be careful if they come down with cold-like symptoms. There are some type of enterovirus that can cause damage or inflammation to the heart called myocarditis."

Angela asks: My daughter is 5 and has reactive airway disease. She is also very allergic to oral steroids. what meds are they using to treat the symptoms? I am in a total panic that she would not be able to receive medication to treat..... what is the duration?

"With respect to asthma and reactive airway disease I think it is important to talk to your pediatrician about whether albuterol (a bronchodilator) would be helpful to your child. I think the most wise advice to give you is if your child develops any abnormal respiratory symptoms to contact your pediatrician or seek emergency care. Most common viral illness can last anywhere from 7-14 days. Enterovirus itself has an incubation period of 3-10 days before some symptoms will present."

Kim asks: Is this mainly effecting younger kids or teens?

"The primary age of concern that we are noticing from the American Academy of Pediatrics (AAP) and Centers for Disease Control (CDC) is 6 weeks to 16 years. Also, any pediatric patient with an underlying history of being immunocompromised or having a diagnosis of asthma may be more suspectible to this strain of enterovirus. Thanks for your question."

Amanda asks: I would love to know what signs should direct us to take a child to seek immediate medical help?

"Things to consider with this illness is high fever, progressive cough or distressful breathing, fatigue, malaise, in addition to a rash. Many virus when they infect children will cause what is called a viral exanthem - this is a way for the body to show us that it is fighting an illness.

Jessica asks: What does the rash look like and what part of the body will it most likely be on?

"Some but not all children with enterovirus may develop a rash. We typically call this a viral exanthem. Most viral exanthems look like a pinpoint generalized rash that is blanchable."

Jackie asks: My concern is how about kids in play rooms.

"Places such as childcare or fitness centers or even playrooms can be a place of increased infectivity. If someone who is sick wipes their nose or coughs they may contaminate equipment, door handles, or other areas of that facility. Typically enterovirus can be cleaned with standard disinfectant or heat but sometimes it may not be in time for people who are sick and in close contact with others."

Kelly asks: Can this be treated at home? My son has an inhaler (albuterol)and is on singular. How would I know that he needs emergency care? If he can't breathe after taking albuterol?

"This is a great question. One thing I teach my patients especially with asthma is took look for any concerning change in their breathing. Also, I would definitely be concerned with any change is breathing associated with fever, cough/breathing concerns not improving over 48 hours, or post-tussive emesis. Post-tussive emesis is when children or adults cough so hard that they are forced to vomit. This can be a strong red flag of an inflammed swollen airway that may require medical attention or intervention. In any instance if you think your child is in trouble reach out to your pediatrician or local ER for guidance."

Amanda asks: Is Enterovirus airborne or does there need to be physical contact to be exposed?

"In most instance enterovirus is spread through oral or respiratory secretions. This includes saliva, sputum, or nasal drainage. Some strains of enterovirus can also be spread through what is called a fecal-oral route - this means that people who are infected can shed the virus in their stool and can spread from person to person in this way. This is always a big concern with infants in diapers and the parents and caregivers who change them."

Debbi asks: Should adults with chronic lung diseases (COPD, Alpha 1-antitrypsin deficiency, etc.) need to be concerned or is this ONLY for children?

"Any individual with underlying respiratory disease is more suspectible to enterovirus. With respect to children the most concerning age group appears to be 6 weeks to 16 years of age."

1 Comment

  • kmanthie

    Sounds like a lot of new parents -those w/their 1st kid who’s still under 7-are freaked out about these kind of health risks. As long as the parent/guardian, etc is never stupid enough to think that treating with antibiotics will do anything at all to a virus, then at least they’re on the right track (anyone who goes to a dr. when they only have a cold or the flu and ask for antibiotics are stupid. Antibiotics DO NOT KILL viruses. Antibiotics only treat/kill bacterial infections. If you’re a doctor and a parent comes to you, all freaked out & asks for antibiotics because their kid has a nasty flu or cold – DO NOT GIVE THEM A PRESCRIPTION!!!!- no matter how much they beg or whine, because they won’t do a bit of good. There are antiviral drugs that can treat certain viruses, but there is NO CURE for any virus whatsoever. Keep that in mind. And use common sense when dealing w/a sick kid (or whomever that’s sick): give them plenty of rest, lots of fluid, things like vitamin C certainly won’t hurt and don’t always jump the gun w/fevers: remember that when one has a fever it is a sign that the body’s immune system is in full gear; working to eradicate w/the various tools in the immune system -i.e. the lymphatic system, T-cells, etc. -now, of course, if one has a high fever, that is >101, it should not be left to its own devices, a couple aspirin is something that will reduce the fever, but remember that a fever is not necessarily a symptom of the illness, it’s a sign that one’s immune system is working hard to combat the virus by flushing it out w/antibodies, etc. And finally, if it is a virus that one has, since there’s no drug that will kill it off,like antibiotics would if it were a bacterial problem, the best thing to do is to stay in bed, keep hydrated, maybe some chicken soup and OJ, etc. In other words, rushing to the E.R. isn’t always the smartest thing, unless it’s a quite virulent strain of whatever illness it is. In the final analysis, a doctor’s advice can be at the very least, a way to soothe your nerves and assuage your worries about your kid’s illness. Unless the sick one has an immunodeficiency and/or is in a high-risk category, chances are that, with care and the above precautions, he/she will get better, it just takes time for the virus to go through its cycle.

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