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9/9/14blog post

just another virus?

It’s not JUST another virus… or is it?? Enterovirus D68.

As the mother of a now school age child with Audrey starting kindergarten AND the recently appointed medical director of the Urgent Care in Springboro, I have been watching this viral outbreak closely. We have seen a dramatic increase in patient volumes over the past couple of weeks and we believe that two of the main culprits are Rhinovirus (the common cold) and enterovirus D68. Although Audrey is symptom free, for now, here is what you are looking out for and what you can do to prevent or treat it.

What is it?

Enterovirus D68 is a virus that mostly causes respiratory symptoms. Remember that viral infections are common. This particular strand of EV-D68 is not a new or mutated virus, however is has not been one of the more common strands seen in recent years. There are more than 100 types of enterovirus and this is a family of viruses we commonly see this time of year, especially with the return of our children to the classroom. This particular strand is causing more severe respiratory symptoms then we typically experience, even causing wheezing and breathing difficulties in children who have not previously wheezed. The need for more significant supportive care are requiring more children to be hospitalized, even in the ICU’s, then has been typically seen.

What are the symptoms?

Common cold like symptoms: runny nose, cough, and congestion. Although similar to the common cold this virus can also cause fevers, body and muscle aches and a rash – with blisters in the mouth. This virus seems to be affecting children more than adults, but then again the children have returned to school and are in closer contact with one another then we adults, so they are more likely to spread the virus. The respiratory symptoms can be quite significant leading to your child having trouble breathing. Monitor how fast and how hard your children are breathing. A playing child or a talkative, chatty child are good signs that they are tolerating the symptoms well.

How do I prevent it?

1.) Good hand washing – Check out these handwashing tips

2.) Good hygiene with your secretions: cough into your elbow, throw away your tissue after using it

3.) Do not eat or drink after other people, especially if they show signs of illness

4.) Stay home if you are ill. We recommend staying home until 24 hours after a fever goes away (no cheating and using Tylenol or Motrin to make it look gone eitherJ). Stay home if you have a developing rash. Stay home if you are coughing or feeling ill enough that you are not going to be able to learn and pay attention or you are going to disrupt others around you.

What if my child is ill, what should I do?

As always look at your child.

They need to be seen right away if they are having trouble breathing: breathing faster or harder than typical, or are having trouble talking in full sentences.

Otherwise you can provide care at home. This illness will likely last about a week. If your child is having fevers for more than 4-5 days, having trouble drinking or not using the bathroom as often, then it is time for them to be evaluated. I know school policies for absenteeism also dictate when your child should be seen.

Supportive care at home for the cough, congestion and runny nose include:

  • Use a cool mist humidifier to keep the secretions thin and easier to cough up or blow out.
  • Spray nasal saline in the nose to do the same and to keep your child’s passages moist and not dry or cracking which can lead to nose bleeds. Ethan and Audrey really tolerate the nasal saline with the mist applicator tip.
  • Have your child drink plenty of fluids to stay hydrated. For the first few days do not concentrate as much on food as on drinking. Also, remember fruits and soups which have a lot of fluid in them.
  • Treat fevers if your child is feeling ill or not drinking as well. Remember to NOT succumb to fever phobia thoughJ
  • I KNOW that the cough can be very frustrating, to both you and your child. Remember that a teaspoon of honey may just help if your child is over 12 months of age. Sometimes mixing the honey with some water and lemon, lemonade, or apple juice can also help break up the congestion and soothe the throat.

For more information regarding this illness you can check out the CDC’s website Non-Polio Enterovirus Infection: Site Home Page – CDC

Stay tuned to Dayton Children’s as we follow this outbreak as well as address your children’s other health care needs.

By: Melissa King, DO “Dr. Mom Sqaud”

Dr. King is a general pediatrician in the Children’s Health Clinic at Dayton Children’s and the mother of two kids. As part of the “Dr. Mom Sqaud,” Dr. King blogs about her experiences as both as doctor and a mom and hopes to share insight to other parents on issues related to both parenting and kids health. Learn more about Dr. King.