Be prepared for enterovirus; rare strain can cause severe respiratory distress in kids

WHAT TO LOOK FOR• The initial symptoms of the enterovirus are much like the common cold, with running nose and coughing.• This particular strain of virus will typically not cause a fever.• If children start showing signs of respiratory distress - shortness of breath, wheezing, turning blue - parents should isolate the child and immediately seek medical help.STAY ON GUARDThere is no vaccine or specific treatment for Enterovirus D-68 or other common enteroviruses. It's best to take traditional preventive measures: hand washing, cleaning frequently touched surfaces, and keeping children home if they start showing symptoms of illness.

photo Dr. Melissa Keene discusses the affects of Enterovirus D68 during a news conference Monday afternoon at the Niswonger Children's Hospital in Johnson City, Tenn.

As a growing number of children in surrounding states show up in hospitals with severe respiratory problems from a rare virus strain, Tennessee health officials say it is likely just a matter of time before the virus arrives up in the state.

"We will eventually see this enterovirus in Tennessee," said Dr. Mark Rowin, associate professor of pediatrics at the University of Tennessee. "We're surrounded by it right now, and it's going to cross the border."

Enterovirus is a very common virus, with hundreds of strains that usually appear during late summer and early autumn. But the strain going around this year, Enterovirus D-68, is more rare and has been more severe.

"When it [the virus] first appears, it is much like the common cold," Rowin said. "But then there's a rapid progression of respiratory distress."

Children with asthma have been especially susceptible.

Cases of the virus been confirmed in Missouri and Illinois, where hundreds of children have been hospitalized with respiratory problems. The U.S. Centers for Disease Control and Prevention said it is testing for the virus in about 10 other states, including Georgia, Alabama and Kentucky.

"Most of our activity now has been to step up our surveillance," said Dr. Tim Jones, Tennessee's state epidemiologist.

Health officials have been contacting pediatric hospitals throughout the state, telling them to be on the lookout and sending information to infection control officials at hospitals.

On the cusp of flu season, hospitals already are putting plans in place for coping with an influx of respiratory illnesses, said Jones - which should make them better prepared for a potential increase in enterovirus cases.

It is a strain of the virus that is not routinely tested for, said Margaret Zylstra, epidemiology manager for the Chattanooga-Hamilton County Health Department.

"It's good that we have begun to see this in the news, because now families and doctors alike know to be aware of this as a possibility," Zylstra said.

One of the unique things about this virus is that it doesn't cause a fever, the CDC has reported.

But if children start showing signs of respiratory distress - shortness of breath, wheezing, turning blue - parents should immediately seek medical help, said Rowin.

Medical officials also stressed the importance of getting children who are showing symptoms isolated quickly.

In most cases, children will recover from the illness with no lasting problems.

Contact staff writer Kate Harrison Belz at kbelz@timesfreepress.com or 423-757-6673.

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