Published: Thursday, September 11, 2014 at 2:11 p.m.
Last Modified: Thursday, September 11, 2014 at 2:11 p.m.
Outbreaks have been confirmed in Missouri and Illinois and suspected in 10 other states including Georgia. Florida is not yet on the list, according to the federal Centers for Disease Control and Prevention (CDC) and the Florida Department of Health.
The disease hasn't been officially identified. Officials suspect a rare respiratory virus called Enterovirus D68. The virus is related to the rhinovirus, which causes the common cold, but symptoms can quickly escalate, according to the CDC.
Nearly 500 children have been treated at Children's Mercy hospital in Kansas City, Missouri, alone.
The CDC has thus far tested patient samples from Kansas City and Chicago hospitals. Most of the samples tested positive for the rare Enterovirus D68 (EV-D68).
Dr. Richard Petrick, medical director of emergency services at Ocala Regional Medical Center and West Marion Community Hospital, said there has not been an uptick in the number of respiratory cases at his facilities. But that is not to say that EV-D68 could not eventually be seen in Florida, he said.
“Florida is a little different,” he noted, adding that Florida typically sees the bulk of its respiratory cases later in the fall, when snowbirds begin to arrive.
Alachua County Public Schools spokeswoman Jackie Johnson said there have so far been no reported symptoms at any schools. She said the school nurses work closely with the Alachua County Health Department to monitor the activity of any communicable diseases and contagious infections.
With the new school year underway, the public school system’s nurses had a routine meeting this week to discuss health issues and EV-D68 was one of the topics covered.
Nadia Kovacevich, an epidemiologist with the Alachua County Health Department, said county and state health officials conduct routine surveillance of hospitals and medical clinics to monitor for cases of respiratory illnesses, including EV-D68 and influenza.
Vickie Sullivan, nursing director of emergency services at Munroe Regional Medical Center, said her hospital has not seen any respiratory cases that are out of the ordinary. In fact, there has been a slight decline at Munroe's emergency department.
But in light of the EV-D68 outbreak, Sullivan said patients are being asked where they have recently traveled. The answer could prompt additional testing, she said.
Nicole Iovine, hospital epidemiologist at UF Health Shands Hospital, said her emergency room has seen nothing to suggest any EV-D68 cases. But since there are so many cases nationwide, she said, Shands remains on the lookout, especially as flu season begins.
Enteroviruses are common, and there are about 100 types of them. U.S. health officials estimate there are 10 million to 15 million enterovirus infections nationwide each year.
Most people infected with enteroviruses have no symptoms or only mild symptoms. But in the case of the EV-D68, symptoms can become severe, especially among children already suffering from breathing problems.
Little is known about the EV-D68 virus and how far it will spread, if at all, beyond the states where it's currently suspected. Georgia is the closest state to Florida on the list, which also includes Alabama, Colorado, Illinois, Iowa, Kansas, Kentucky, Michigan, Missouri, Oklahoma, Ohio and Utah.
“It's just too soon to say,” Dr. Anne Schuchat, assistant surgeon general and director of the CDC's National Center for Immunization and Respiratory Disease, said this week. “I can't say if we'll be seeing this (EV-D68) in any more states.”
CDC spokesman Benjamin Haynes later said, “The list of states with suspected cases of EV-D68 is constantly changing.”
Schuchat said the CDC's focus now is to encourage state health departments to report suspected EV-D68 cases in their areas.
The most susceptible children appear to be those who already have respiratory problems such as asthma and wheezing. Of those children hospitalized with the EV-D68 virus, or other respiratory viruses, more than half already had a respiratory history before being admitted, she said.
The EV-D68 virus causes similar symptoms to other flus or colds: runny nose, fever, coughing and difficulty breathing.
But the symptoms can quickly become more problematic, with patients needing help breathing. There are no vaccines or antiviral medications for the disease, Schuchat said. Instead, the symptoms are typically treated and, in the case of asthma, the asthma is treated to aid in breathing.
Thus far there have not been any fatalities because of the virus, which is typically associated with children. The average age of those affected is about 4 or 5, she said.
Here are some symptoms parents should be looking for:
• The child making a grunting noise when breathing.
• The child having to take deep breaths to get enough air.
• The child employing all of their stomach muscles to be able to breath.
• The child's nostrils flare when breathing.
• The child wheezing.
Schuchat said that while little is known about the virus, it is suspected that it is transferred in the same way as other virus: by contaminated door handles and other surfaces and contact with body fluids.
Sheri Hutchinson, spokeswoman for the Florida Department of Health, said that while no cases have been reported in Florida, her agency remains diligent.
“We monitor and we conduct surveillance” of healthcare facilities to find any potential cases, she said.
The FDOH has the ability to test for the virus if it receives samples and does not need to send samples to the CDC for confirmation, Hutchinson said.
While the virus has been rare in the United States, Shands' Iovine suspects that the EV-D68 virus has possibly genetically changed on its own.
That change may have allowed it to more effectively be transferred from one person to the next, she said. And that mutation might now be making its symptoms more severe.
As for why more children get the disease than adults, Iovine said adults might have contracted the virus years ago and are now mostly immune.
Schuchat recommended people concerned about the virus take the same precaution as they would for any flu-like virus — namely, to avoid contact with contaminated areas and avoid touching your eyes and mouth after contact with an ill person.
The CDC does not know why some people get seriously ill from the virus while others do not, other than a higher percentage already having respiratory problems.
As for how long someone would remain sick once infected, Schuchat said, “This is so relatively new…it would be hard to say.”
But she suspects that, like other flu-like viral infections, this one would run its course in about seven days.
And while most children will not get infected or show serious symptoms, Schuchat said reports of the virus can be unnerving.
“This can be a scary thing to hear about for parents,” she said.
Staff writer Christopher Curry contributed to this report.
Last Modified: Thursday, September 11, 2014 at 2:11 p.m.
Outbreaks have been confirmed in Missouri and Illinois and suspected in 10 other states including Georgia. Florida is not yet on the list, according to the federal Centers for Disease Control and Prevention (CDC) and the Florida Department of Health.
The disease hasn't been officially identified. Officials suspect a rare respiratory virus called Enterovirus D68. The virus is related to the rhinovirus, which causes the common cold, but symptoms can quickly escalate, according to the CDC.
Nearly 500 children have been treated at Children's Mercy hospital in Kansas City, Missouri, alone.
The CDC has thus far tested patient samples from Kansas City and Chicago hospitals. Most of the samples tested positive for the rare Enterovirus D68 (EV-D68).
Dr. Richard Petrick, medical director of emergency services at Ocala Regional Medical Center and West Marion Community Hospital, said there has not been an uptick in the number of respiratory cases at his facilities. But that is not to say that EV-D68 could not eventually be seen in Florida, he said.
“Florida is a little different,” he noted, adding that Florida typically sees the bulk of its respiratory cases later in the fall, when snowbirds begin to arrive.
Alachua County Public Schools spokeswoman Jackie Johnson said there have so far been no reported symptoms at any schools. She said the school nurses work closely with the Alachua County Health Department to monitor the activity of any communicable diseases and contagious infections.
With the new school year underway, the public school system’s nurses had a routine meeting this week to discuss health issues and EV-D68 was one of the topics covered.
Nadia Kovacevich, an epidemiologist with the Alachua County Health Department, said county and state health officials conduct routine surveillance of hospitals and medical clinics to monitor for cases of respiratory illnesses, including EV-D68 and influenza.
Vickie Sullivan, nursing director of emergency services at Munroe Regional Medical Center, said her hospital has not seen any respiratory cases that are out of the ordinary. In fact, there has been a slight decline at Munroe's emergency department.
But in light of the EV-D68 outbreak, Sullivan said patients are being asked where they have recently traveled. The answer could prompt additional testing, she said.
Nicole Iovine, hospital epidemiologist at UF Health Shands Hospital, said her emergency room has seen nothing to suggest any EV-D68 cases. But since there are so many cases nationwide, she said, Shands remains on the lookout, especially as flu season begins.
Enteroviruses are common, and there are about 100 types of them. U.S. health officials estimate there are 10 million to 15 million enterovirus infections nationwide each year.
Most people infected with enteroviruses have no symptoms or only mild symptoms. But in the case of the EV-D68, symptoms can become severe, especially among children already suffering from breathing problems.
Little is known about the EV-D68 virus and how far it will spread, if at all, beyond the states where it's currently suspected. Georgia is the closest state to Florida on the list, which also includes Alabama, Colorado, Illinois, Iowa, Kansas, Kentucky, Michigan, Missouri, Oklahoma, Ohio and Utah.
“It's just too soon to say,” Dr. Anne Schuchat, assistant surgeon general and director of the CDC's National Center for Immunization and Respiratory Disease, said this week. “I can't say if we'll be seeing this (EV-D68) in any more states.”
CDC spokesman Benjamin Haynes later said, “The list of states with suspected cases of EV-D68 is constantly changing.”
Schuchat said the CDC's focus now is to encourage state health departments to report suspected EV-D68 cases in their areas.
The most susceptible children appear to be those who already have respiratory problems such as asthma and wheezing. Of those children hospitalized with the EV-D68 virus, or other respiratory viruses, more than half already had a respiratory history before being admitted, she said.
The EV-D68 virus causes similar symptoms to other flus or colds: runny nose, fever, coughing and difficulty breathing.
But the symptoms can quickly become more problematic, with patients needing help breathing. There are no vaccines or antiviral medications for the disease, Schuchat said. Instead, the symptoms are typically treated and, in the case of asthma, the asthma is treated to aid in breathing.
Thus far there have not been any fatalities because of the virus, which is typically associated with children. The average age of those affected is about 4 or 5, she said.
Here are some symptoms parents should be looking for:
• The child making a grunting noise when breathing.
• The child having to take deep breaths to get enough air.
• The child employing all of their stomach muscles to be able to breath.
• The child's nostrils flare when breathing.
• The child wheezing.
Schuchat said that while little is known about the virus, it is suspected that it is transferred in the same way as other virus: by contaminated door handles and other surfaces and contact with body fluids.
Sheri Hutchinson, spokeswoman for the Florida Department of Health, said that while no cases have been reported in Florida, her agency remains diligent.
“We monitor and we conduct surveillance” of healthcare facilities to find any potential cases, she said.
The FDOH has the ability to test for the virus if it receives samples and does not need to send samples to the CDC for confirmation, Hutchinson said.
While the virus has been rare in the United States, Shands' Iovine suspects that the EV-D68 virus has possibly genetically changed on its own.
That change may have allowed it to more effectively be transferred from one person to the next, she said. And that mutation might now be making its symptoms more severe.
As for why more children get the disease than adults, Iovine said adults might have contracted the virus years ago and are now mostly immune.
Schuchat recommended people concerned about the virus take the same precaution as they would for any flu-like virus — namely, to avoid contact with contaminated areas and avoid touching your eyes and mouth after contact with an ill person.
The CDC does not know why some people get seriously ill from the virus while others do not, other than a higher percentage already having respiratory problems.
As for how long someone would remain sick once infected, Schuchat said, “This is so relatively new…it would be hard to say.”
But she suspects that, like other flu-like viral infections, this one would run its course in about seven days.
And while most children will not get infected or show serious symptoms, Schuchat said reports of the virus can be unnerving.
“This can be a scary thing to hear about for parents,” she said.
Staff writer Christopher Curry contributed to this report.
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