Enterovirus D68 has received a great deal of recent news coverage – what signs and symptoms should parents look out for?
Learn more from a UVA specialist in pediatric infectious diseases.
Selected Podcast
Enterovirus in Children
Featured Speaker:
Dr. Ron Turner
Dr. Ron Turner is a board-certified specialist in pediatric infectious diseases. Transcription:
Enterovirus in Children
Melanie Cole (Host): Every year, millions of children in the United States catch enteroviruses that can cause coughing, sneezing, and fever. This year, the enterovirus that is most commonly causing respiratory illness in children across the country is enterovirus D68. My guest today is Dr. Ron Turner. He is a board certified specialist in pediatric infectious diseases. Welcome to the show, Dr. Turner. What is enterovirus, and what conditions is it most similar to?
Dr. Ron Turner (Guest): Well, enterovirus is a very common virus of children that causes a whole spectrum of different diseases. The most common diseases that it’s associated with are summertime fevers and rashes. Hand-foot-mouth disease is a commonly known variant of this. That’s one of the syndromes that it causes. The enteroviruses are cousins, if you will, to another group of viruses called rhinoviruses, which are more commonly associated with common colds and asthma attack. The interest in enterovirus 68 is because it has some features of the standard enteroviruses but also has some features of the rhinoviruses, and so, it’s this year causing a fair amount of respiratory disease.
Melanie: What are the most common symptoms, and are children at higher risk for EV-68?
Dr. Turner: Well, it certainly seems that this virus is preferentially attacking children, and that would be consistent with what we know about both enteroviruses and the rhinoviruses, that that’s where these infections tend to occur. The symptoms that the virus is causing are basically common cold symptoms. They are more likely to be associated with a fever than the typical or common colds, but other than that, they are a fairly typical common cold. The thing that seems to be a little bit atypical this year for this virus is that there seemed to be more asthma attacks associated with this infection than there maybe have been in the past.
Melanie: If a child has enterovirus-like symptoms, when does a parent say, “Okay, this may not be just the flu or a cold or seasonal allergies”? When do they take them to the doctor?
Dr. Turner: Well, I think the best advice for parents is really to not focus so much on the enterovirus story, but most parents whose children have asthma or have had asthma attacks in the past are pretty familiar with the symptoms of those illnesses. There’s no real reason to see a physician for this infection if all your child has is common colds. There’s no treatment. There’s nothing that anybody is going to do to intervene, and it will resolve on its own. On the other hand, if your child has asthma and begins to develop symptoms associated with their asthma attack, and you have routine medications that you use at home for that and those don’t seem to be working, obviously, that’s the time to take your child to a physician.
Melanie: If there are no treatments, Dr. Turner, for this EV-68, what about the symptoms? Is there symptom management that parents can do? Should they be using acetaminophen or ibuprofen to get the fever down? Is there anything they can do for coughs and the sneezing and just the overall general ill feelings the kids get?
Dr. Turner: Well, I think parents can manage this infection the way they would typically manage a cold in their child. Of course, as you know, the American Academy of Pediatrics has recommended against the use of common cold medicines in children under the age of six. We wouldn’t recommend that, but certainly for fevers, to use treatments like Tylenol or ibuprofen to bring the fever down as it is appropriate. Other treatments are, bless you, but parents can manage this just the way they would any other common cold illness.
Melanie: Is there a way to protect our families from EV-68?
Dr. Turner: Well, I think it’s always reasonable to suggest good hand washing, good hand hygiene. There seems to be evidence that these enteroviruses are spread by hand contact, and so that certainly helps. Obviously, when there’s this much disease in the community, the risk that you’re going to become infected goes up regardless of those types of intervention. In spite of meticulous hand washing, it’s still possible to become ill.
Melanie: Now, what about school, Dr. Turner? Because that’s every parent’s sort of quandary. As the specialist that you are, when would you say, “Yes, you must keep your child home from school during this if they’re coughing or fever,” or if it’s just the coughing and sneezing without a fever? When can they go back to school?
Dr. Turner: Well, the typical guidelines for when children can be in school, certainly, if they have fever, they should be excluded from school. That’s a relatively easy line to recognize. The other criteria for when a child can go to school really involve when they can actively participate in the class and productively participate in their class instead of if a child had so much cough going on or so much… if there’s a will that they would not be able to participate in class, then obviously, they should not be in school. There is no recommendation that children be kept out of school for mild symptoms.
Melanie: The newest flu vaccine, does that have any effect on the immune system to help fight this enterovirus, Dr. Turner? And why are we seeing so many cases of it now?
Dr. Turner: Well, the flu vaccine, obviously everybody should get their flu vaccine. There’s no question about that. But the flu vaccine won’t have any effect on this virus. They’re different viruses. The mechanism of the vaccine is such that it won’t have any impact on this infection. I think the question about the number of infections we’re seeing, first of all, I think it is unusual, but these infection -- particularly that they came so early. They started in August, which is atypical. They do seem to be on the wane now, and we would expect that in early November, these will kind of go away. The reason why this year enterovirus 68 was the virus that popped up as the major virus, that’s not really known.
Melanie: Really, why should families come to UVA Children’s Hospital for treatment of enterovirus and other similar conditions?
Dr. Turner: Well, I think it is important to have your child cared for in a facility that has a specialist for pediatrics. These children can be taken care of by a variety of different specialists as needed. We, of course, have all of that here at the University, and so I think that makes us a reasonable place to come.
Melanie: Thank you so much, Dr. Ron Turner. For more information about the enterovirus and whether you and your family should get seen, you can go to uvahealth.com. That’s uvahealth.com. You’re listening to UVA Health Systems Radio. This is Melanie Cole. Thanks so much for listening, and have a great day.
Enterovirus in Children
Melanie Cole (Host): Every year, millions of children in the United States catch enteroviruses that can cause coughing, sneezing, and fever. This year, the enterovirus that is most commonly causing respiratory illness in children across the country is enterovirus D68. My guest today is Dr. Ron Turner. He is a board certified specialist in pediatric infectious diseases. Welcome to the show, Dr. Turner. What is enterovirus, and what conditions is it most similar to?
Dr. Ron Turner (Guest): Well, enterovirus is a very common virus of children that causes a whole spectrum of different diseases. The most common diseases that it’s associated with are summertime fevers and rashes. Hand-foot-mouth disease is a commonly known variant of this. That’s one of the syndromes that it causes. The enteroviruses are cousins, if you will, to another group of viruses called rhinoviruses, which are more commonly associated with common colds and asthma attack. The interest in enterovirus 68 is because it has some features of the standard enteroviruses but also has some features of the rhinoviruses, and so, it’s this year causing a fair amount of respiratory disease.
Melanie: What are the most common symptoms, and are children at higher risk for EV-68?
Dr. Turner: Well, it certainly seems that this virus is preferentially attacking children, and that would be consistent with what we know about both enteroviruses and the rhinoviruses, that that’s where these infections tend to occur. The symptoms that the virus is causing are basically common cold symptoms. They are more likely to be associated with a fever than the typical or common colds, but other than that, they are a fairly typical common cold. The thing that seems to be a little bit atypical this year for this virus is that there seemed to be more asthma attacks associated with this infection than there maybe have been in the past.
Melanie: If a child has enterovirus-like symptoms, when does a parent say, “Okay, this may not be just the flu or a cold or seasonal allergies”? When do they take them to the doctor?
Dr. Turner: Well, I think the best advice for parents is really to not focus so much on the enterovirus story, but most parents whose children have asthma or have had asthma attacks in the past are pretty familiar with the symptoms of those illnesses. There’s no real reason to see a physician for this infection if all your child has is common colds. There’s no treatment. There’s nothing that anybody is going to do to intervene, and it will resolve on its own. On the other hand, if your child has asthma and begins to develop symptoms associated with their asthma attack, and you have routine medications that you use at home for that and those don’t seem to be working, obviously, that’s the time to take your child to a physician.
Melanie: If there are no treatments, Dr. Turner, for this EV-68, what about the symptoms? Is there symptom management that parents can do? Should they be using acetaminophen or ibuprofen to get the fever down? Is there anything they can do for coughs and the sneezing and just the overall general ill feelings the kids get?
Dr. Turner: Well, I think parents can manage this infection the way they would typically manage a cold in their child. Of course, as you know, the American Academy of Pediatrics has recommended against the use of common cold medicines in children under the age of six. We wouldn’t recommend that, but certainly for fevers, to use treatments like Tylenol or ibuprofen to bring the fever down as it is appropriate. Other treatments are, bless you, but parents can manage this just the way they would any other common cold illness.
Melanie: Is there a way to protect our families from EV-68?
Dr. Turner: Well, I think it’s always reasonable to suggest good hand washing, good hand hygiene. There seems to be evidence that these enteroviruses are spread by hand contact, and so that certainly helps. Obviously, when there’s this much disease in the community, the risk that you’re going to become infected goes up regardless of those types of intervention. In spite of meticulous hand washing, it’s still possible to become ill.
Melanie: Now, what about school, Dr. Turner? Because that’s every parent’s sort of quandary. As the specialist that you are, when would you say, “Yes, you must keep your child home from school during this if they’re coughing or fever,” or if it’s just the coughing and sneezing without a fever? When can they go back to school?
Dr. Turner: Well, the typical guidelines for when children can be in school, certainly, if they have fever, they should be excluded from school. That’s a relatively easy line to recognize. The other criteria for when a child can go to school really involve when they can actively participate in the class and productively participate in their class instead of if a child had so much cough going on or so much… if there’s a will that they would not be able to participate in class, then obviously, they should not be in school. There is no recommendation that children be kept out of school for mild symptoms.
Melanie: The newest flu vaccine, does that have any effect on the immune system to help fight this enterovirus, Dr. Turner? And why are we seeing so many cases of it now?
Dr. Turner: Well, the flu vaccine, obviously everybody should get their flu vaccine. There’s no question about that. But the flu vaccine won’t have any effect on this virus. They’re different viruses. The mechanism of the vaccine is such that it won’t have any impact on this infection. I think the question about the number of infections we’re seeing, first of all, I think it is unusual, but these infection -- particularly that they came so early. They started in August, which is atypical. They do seem to be on the wane now, and we would expect that in early November, these will kind of go away. The reason why this year enterovirus 68 was the virus that popped up as the major virus, that’s not really known.
Melanie: Really, why should families come to UVA Children’s Hospital for treatment of enterovirus and other similar conditions?
Dr. Turner: Well, I think it is important to have your child cared for in a facility that has a specialist for pediatrics. These children can be taken care of by a variety of different specialists as needed. We, of course, have all of that here at the University, and so I think that makes us a reasonable place to come.
Melanie: Thank you so much, Dr. Ron Turner. For more information about the enterovirus and whether you and your family should get seen, you can go to uvahealth.com. That’s uvahealth.com. You’re listening to UVA Health Systems Radio. This is Melanie Cole. Thanks so much for listening, and have a great day.