Q: I have heard about a scary new virus (EV-D68) causing difficulty breathing in children. What is it? Should I be keeping my children home so that they don’t catch it?
A: EV-D68, or enterovirus-D68, is a virus that has been circulating in the United States over the last couple of months, including a handful of confirmed cases here in North Carolina. It is not a new virus, but the strain that’s circulating has been causing more severe respiratory disease in some children and thus has justifiably gotten a lot of attention, especially after the recent death of a preschool child in New Jersey.
For most children, the illness resembles a very mild cold — runny nose, some cough, and often no fever. For a minority of children, it has caused wheezing and difficulty breathing. The majority, but not all, of these children have underlying medical problems such as asthma. There are some reports of a link with muscle weakness and paralysis. This has yet to be confirmed but is possible.
Because EV-D68 is a virus, antibiotics are not effective to fight it. There are also no vaccines available against this particular virus, so old-fashioned hand-washing is the best way to prevent its spread. For this virus, alcohol-based soaps are less effective than hand-washing with soap and water. It is definitely hard to know when you’ve been exposed to it, because for most people, the symptoms are mild — there are many other “cold” viruses circulating in the community that cause many people to feel worse than this one.
As a pediatrician, I certainly do not advise keeping children home from school or bringing them to the doctor each time they have a runny nose, nor do I advise keeping them out of school to avoid catching this illness. Given that the majority of children will be fine even if they contract this virus, the best advice is that if your child is having difficulty breathing or showing other abnormal symptoms, such as muscle weakness, you should call your pediatrician or bring your child to a pediatric emergency room if the symptoms are severe.
It is often a better use of our time and energy to control the things we can control, so let this serve as a reminder: please make sure to get your children their flu vaccines! Although it will garner far less press than EV-D68 and Ebola, influenza will kill more people in the US (and likely the world) than these diseases combined, and flu is largely preventable by vaccine.
Brian Eichner is a general pediatrician and assistant professor of pediatrics at Duke Children's Primary Care-Roxboro Street in Durham.