You can be excused if you think enterovirus D68 is a new virus that first appeared in the United States two months ago and is a serious threat to every child’s health.
But you would be wrong.
The virus, first discovered in 1962, is one of more than 100 enteroviruses that circulate in the late summer and early fall and cause 10 to 15 million cases of infection every year.
This year, enterovirus D68 (pronounced ENT-er-o-virus) is unusually prevalent. The rare strain was reported to the Centers for Disease Control and Prevention in August by Missouri and Illinois hospitals that were seeing an increase in children with a severe respiratory illness who needed intensive care. This is the largest outbreak ever and is causing particular problems for children with asthma.
But most people who contract enterovirus D68 will think they just caught a cold and never know exactly what caused it. The flu is more of a threat, but it doesn’t sound as scary.
I blame the Internet and television news, especially cable TV, for spreading panic. Even after the CDC had documented the enterovirus D68 outbreak in multiple states, Mika Brzezinski on MSNBC’s “Morning Joe” expressed disbelief and shock one recent morning when she was told it had spread.
One website referred ominously to “the deadliness, the randomness and the pervasiveness of enterovirus D68.”
The same article quoted the CDC: “Enteroviruses commonly circulate in summer and fall. We’re currently in the middle of the enterovirus season.” But instead of finishing the CDC statement – “and EV-D68 infections are likely to decline later in the fall” – the article added scarier words: “There’s no reason to think it won’t get even worse.”
Testing is haphazard
No one knows what prompted this year’s outbreak of enterovirus D68. The CDC has confirmed 664 cases, mostly in children with asthma, in 45 states and Washington, D.C. Across the country, enterovirus D68 may be responsible for five deaths. North Carolina has confirmed nine cases, none fatal.
But the numbers don’t mean much. State and federal health officials don’t track those viruses systematically the way they track flu-like illness. Testing for enteroviruses happens haphazardly.
“The number of positives is just a factor of how many doctors are choosing to submit specimens (for testing),” said Dr. Zack Moore, an epidemiologist with the North Carolina Division of Public Health.
Every year, health officials monitor the number of patients seeking treatment for respiratory illnesses and asthma in emergency rooms across North Carolina. “This time of year we expect to see those increasing,” Moore said. “(But this year) it was more than we would have expected based on earlier years.”
ER visits for those two causes peaked in mid-September, Moore said. “Overall it seems to be getting better.
“It seems that the eastern part of the state has probably been harder hit,” Moore added. “But we are confident this is not limited to one area. It’s safe to assume that it is present all across the state.”
Assume D68 is present
The entry of influenza confounds the situation. Both North Carolina and South Carolina have already confirmed their first flu deaths this season. “We don’t have a great way to filter out what’s related to enterovirus specifically” and what’s related to flu, Moore said.
Unlike flu, there is no vaccine and no treatment for enterovirus D68. So health officials give the standard advice: Assume it’s everywhere and take the same precautions you would to prevent the spread of any virus.
But that advice doesn’t satisfy some parents of children with asthma.
Anita Blanchard, a Charlotte mother of three, would like to know specifically if enterovirus D68 is in Mecklenburg County.
“I understand that for the majority of children, this is just a cold. But for us, this is not just a regular bug. We are really trying to be on top of this.”
Her 5-year-old twins both have asthma. One was hospitalized for 23 days, off and on, during the nine months ending last January. For part of the time, she was in intensive care. “This is really serious for my daughter,” Blanchard said.
When it was recently announced that North Carolina has nine confirmed cases of enterovirus D68, health officials declined to release information about the children, such as home county, “to protect patient confidentiality.”
I’ve objected to that interpretation of the privacy law, arguing that naming the county wouldn’t identify the sick person. Blanchard agrees. “It doesn’t make sense ....,” she said.
She knows she must always be vigilant about her children’s health and there there’s not much she would do differently if she knew there were cases of enterovirus D68 in Charlotte. But she says it might give her peace of mind.
“If it’s all on the east coast or from Raleigh east, I’m not going to be as concerned as if I find out that three kids have been diagnosed in Charlotte. It would be reassuring. We don’t have to be on red alert for every cough.”
Instead, we must follow the advice for all viruses. Wash your hands with soap and water. (Health officials say alcohol-based hand sanitizers aren’t as effective against enteroviruses.) And stay home if you’re sick.
As Moore said, this year’s outbreak of enterovirus D68 appears to be waning. But the flu, which kills several hundred children every year, is probably on the rise. Beware of headlines peddling panic.