Enterovirus is a common family of viruses that affects millions of children every year. The subtype that has been making the news this fall, D-68, has been around for a long time but it is not the typical type that is seen this time of year. Infants and children have not built up immunity from previous exposure and therefore are more likely to become ill when exposed to the virus. There are now more cases in the state of Illinois than in previous years.
What are the symptoms to look for?
For most children, the symptoms are consistent with a mild respiratory illness: low-grade fever, cough and runny nose. Some children may develop a rash, blisters in the mouth and muscle aches. This virus seems to be especially troublesome to children who are predisposed to wheezing. Some children with asthma have had a significant increase their symptoms, requiring increased use of their medication and sometimes hospitalization.
How can I protect my child?
Enterovirus D-68 is spread when a healthy person comes in contact with an infected person who is coughing and sneezing and then touches his or her own mouth, nose and eyes. As with any other viral illness the most important action to take to prevent spread is to wash your hands often. Everyone should avoid sharing food and drinks, and ill members of a family should have their own towels. Unfortunately, hugging and kissing is a good way to spread viruses! Using a disinfectant on frequently touched surfaces such as sinks, toys, and doorknobs will also help prevent spread of the virus.
Is there a test for Enterovirus D-68?
There is a test for this virus, but it is not recommended in the outpatient setting. Knowing if it is specifically this virus versus another will not alter treatment.
What is the treatment?
Antibiotics do not treat Enterovirus, and there are no antiviral agents or specific vaccines for it. Most children will be mildly affected and only require treatment to help alleviate symptoms. It is important to get plenty of rest, increase fluids and humidity and encourage good nutrition. Fever and pain relievers such as acetaminophen and ibuprofen are helpful to make a child more comfortable during the illness. Most children will feel better in a few days.
However, if your child’s cough is worsening, he or she is short of breath, or they are known to wheeze, it is vitally important to seek medical care. Although the virus itself cannot be treated, the respiratory problems caused by this virus can be treated. For children with asthma, a control plan can be developed or reviewed with your pediatrician. This type of plan can help a parent make decisions regarding when to increase or decrease the use of bronchodilators and inhaled corticosteroids. The plan also will guide parents on when to come back if the symptoms are worsening.
In some cases, children who do not normally wheeze may experience some respiratory compromise from Enterovirus D-68. Bronchodilators may be of some use in these children as well, but these children need evaluation and close supervision by a medical professional. In many cases, a child may need multiple office visits to monitor their respiratory symptoms.
When can my child go back to school?
Since the virus is spread through respiratory droplets, your child should stay home until the cough and sneezing are minimal. Your child should be fever-free for 24 hours as well. Children who had more significant respiratory symptoms should gradually return to their regular activities and be allowed to rest when needed.