Enterovirus D68: Difference between revisions
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[http://www.cdc.gov/non-polio-enterovirus/about/EV-D68.html cdc.gov Enterovirus D68] | [http://www.cdc.gov/non-polio-enterovirus/about/EV-D68.html cdc.gov Enterovirus D68] | ||
==Sources== | ==Sources== | ||
[http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e0908a1.htm?s_cid=mm63e0908a1_x CDC Outbreak- Chicago, Kansas City] | |||
Revision as of 22:56, 8 September 2014
Background
Enterovirus D68, one of many viruses in the Enterovirus family which also includes: coxsackie, echovirus, rhinovirus, poliovirus and enteroviruses. Infection in the U.S. rarely identified, with outbreak in Missouri and Illinois in 8/2014.
Clinical Features
Mild to severe respiratory distress, otherwise not well defined, spread via respiratory secretions and body fluids. 30 confirmed cases in Kansas City and Chicago via PCR of nasopharyngeal secretions with the following features: age range 6 weeks to 16 years, febrile- 23%, prior asthma/wheezing- 70%, 20% required NIV, 7% required intubation. All patients in Kansas City showed hypoxemia and difficulty breathing.
Differential Diagnosis
- Asthma
- Foreign Body
- Pneumothorax
- Pneumonia
Workup
- CXR
- Labs
- Cultures
- Serum Studies(check with micro lab regarding available studies)- Enteroviral infections reportable to (NESS) National Enteroviral Surveillance System.
Management
- Supportive care
- Close observation for respiratory failure and possible need for NIV or ETI.
- No antiviral medications available
Prevention
- Wash hands often with soap and water for 20 seconds, especially after changing diapers
- Avoid touching eyes, nose and mouth with unwashed hands
- Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick
- Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick
Disposition
- Admit to ICU for respiratory support and observation