What is Enterovirus (EV-D68)?

John Goldman, MD

EV-D68 – What is this and why should we be concerned?

There has been quite a bit of alarming information about Enterovirus (EV-D68) making the news. Several states – including Colorado, Missouri, Kansas, Illinois, Kentucky, Ohio, Oklahoma, Utah and Georgia – have contacted the Centers for Disease Control and Prevention for help investigating clusters of the virus that’s being blamed for the illness.

Here is the 411 from PinnacleHealth Infectious Disease Specialist, John Goldman, MD.

What are Enteroviruses?

Enteroviruses, which bring on symptoms like a very intense cold, aren’t unusual. They’re actually very common. When you have a bad summer cold, often what you have is an enterovirus. There are more than 100 types of enteroviruses causing about 10 to 15 million infections in the United States each year, according to the CDC. They are carried in the intestinal tract and often spread to other parts of the body. The “cold” season often hits its peak in September, as summer ends and fall begins. The good news is that enteroviruses usually aren’t deadly. While children have been hospitalized, no one has died.

How is EV-D68 different?

This virus is causing more respiratory problems than usual in children. Symptoms are starting like the common cold, but then escalating to wheezing and shortness of breath. Children, who already have respiratory issues such as asthma, are at increased risk of becoming sicker with this virus.

What can parents do?

Enteroviruses spread easily so it could be likely that it will make its way here.

• The best prevention is good hygiene. Properly wash your hands throughout the day. Consider sending your children to school with hand sanitizer.
• Clean and disinfect surfaces that are regularly touched by different people, such as toys and doorknobs.
• Avoid shaking hands, kissing, hugging and sharing cups or eating utensils with people who are sick. And stay home if you feel unwell.
• If you have children with respiratory issues, make sure to have medications, such as inhalers or nebulizers, on hand should they become sick, even if the child has very mild disease and only requires their medications infrequently.

If your child has a cold and begins to wheeze or have shortness of breath, seek medical attention. Use your best parental judgment. If your children are experiencing symptoms, please contact your primary care physician. 

Why aren’t adults getting it?

No one is absolutely sure, but most likely adults have been previously exposed to the virus and have built an immunity to it.

What is the treatment?

There is no antiviral to treat EV-D68. Doctors can offer supportive treatments while the body works to heal itself. Its course is similar to the flu with being very sick for a few days and then fully recovering in a few weeks.

The Common Cold

It’s October! It’s back to school time, and the beginning of cold and flu season. Colds and flu tend to be spread more this time of year in part because we all tend to be indoors more, and children are back in school so we are often in closer quarters. But what causes colds? How can we protect ourselves? Are there any good treatments?

Colds and bronchitis are typically caused by viruses. Cold viruses can cause a lot of different symptoms, including sore throat, runny nose and congestion, cough, sinus pressure, headache, ear pressure, and even fever, nausea, vomiting and diarrhea, and rash in some cases. They can make us feel miserable, but are usually not serious. Antibiotics are useless against viruses.

The average viral cold lasts for 7 to 10 days, but some symptoms (especially cough) can last for several weeks. Sore throats from colds usually resolve in the first few days. (Note: If you have a cough with your sore throat, it probably isn’t strep throat.)

Although most colds resolve on their own no matter what we do, occasionally bacteria can start to grow in the mucus in your respiratory tract and cause a secondary infection. Unlike viruses, which can cause symptoms all over your body, bacteria tend to hit only one area. Secondary infections following a cold include sinus infections (sinusitis), ear infections (otitis media), and pneumonia. Signs of a secondary bacterial infection include a prolonged illness (more than 10 days) or new symptoms such as earache, high fever, sinus pain, or loss of appetite several days into a cold. (Yellow or green nasal drainage is common during a cold, and does not necessarily indicate a sinus infection.)

Antibiotics are used to treat bacterial infections like sinusitis or pneumonia, but are useless against viruses. Using antibiotics unnecessarily can cause problems. Antibiotics can cause side effects like yeast infections or diarrhea, or occasionally allergic reactions. In addition, when antibiotics are used frequently, bacteria can become resistant to them and they will no longer work. Unfortunately, antibiotic resistance is becoming more and more common, and there are now bacteria that are resistant to many antibiotics. Because of these risks, we try to prescribe antibiotics only when we feel they will be effective, such as for sinusitis or pneumonia. Please don’t pressure your doctor to prescribe an antibiotic if he or she feels it isn’t needed. Taking an antibiotic when you have a cold will not reliably prevent a bacterial infection, may give you side effects, and may increase the likelihood that your next infection will be resistant to that antibiotic.

There are several things you can do to prevent catching or spreading colds:

• Wash your hands or use hand sanitizer regularly throughout the day, especially if you touch or blow your nose, or before eating.
• Try to make sure you are getting enough sleep.  People who get less than 7 hours of sleep daily are much more likely to catch colds.
• Try to eat a healthy diet, with several servings of fruits and vegetables daily.  Better nutrition will improve your resistance to cold viruses.
• Cover coughs and sneezes by coughing into a tissue or into your sleeve.

If you do catch a cold, there are some things you can do. Get plenty of sleep. Try nasal saline spray to thin nasal mucus. Try sips of ice water or suck on throat lozenges to ease a sore throat. Cold medicines may help improve some symptoms of colds, but they will not cure a cold or get you better any faster. They can also cause side effects, so if you must take something, try to stick to products with single ingredients just for the symptoms you have.

There are some cold remedies that should be avoided by certain people:

• Avoid decongestants if you have high blood pressure. They can cause an unsafe rise in blood pressure.
• Avoid antihistamines if you have glaucoma or an enlarged prostate. They can increase eye pressure or make it difficult to urinate.
• Avoid cough suppressants if you are taking antidepressants, since they can cause a rare but serious interaction. Ask your healthcare provider if you aren’t sure.

I hope you find this information helpful.  Have a healthy, safe autumn!

Megan Borror, M.D.

Colonial Park Family Practice
PinnacleHealth Medical Group