Enterovirus D68
Background
- A viruses in the Enterovirus family
- Infection in the U.S. rarely identified
- 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[1]
- All patients in Kansas City showed hypoxemia and difficulty breathing
Differential Diagnosis
- Asthma
- Foreign Body
- Pneumothorax
- Pneumonia
Evaluation
- 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
See Also
External Links
References
- ↑ Midgley CM, Jackson MA, Selvarangan R, et al. Severe Respiratory Illness Associated with Enterovirus D68 — Missouri and Illinois, 2014. MMWR. 2014; 63(36):798-799