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

Posted at 6:06 PM, Sep 09, 2014
and last updated 2014-09-10 09:16:53-04

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."