Enterovirus D68: Difference between revisions

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==Background==
==Background==
*A viruses in the [[Enterovirus]] family
*A viruses in the [[Enterovirus]] family
*Infection in the U.S. rarely identified,
*Infection in the U.S. rarely identified  
*Outbreak in Missouri and Illinois in 8/2014
*Outbreak in Missouri and Illinois in 8/2014


==Clinical Features==
==Clinical Features==
Mild to severe respiratory distress, otherwise not well defined, spread via respiratory secretions and body fluids. 30 confirmed cases in Kansas City and Chicago via PCR of nasopharyngeal secretions with the following features: age range 6 weeks to 16 years, febrile- 23%, prior asthma/wheezing- 70%, 20% required NIV, 7% required intubation. All patients in Kansas City showed hypoxemia and difficulty breathing.
*Mild to severe respiratory distress, otherwise not well defined, spread via respiratory secretions and body fluids
*30 confirmed cases in Kansas City and Chicago via PCR of nasopharyngeal secretions with the following features: age range 6 weeks to 16 years, febrile- 23%, prior asthma/wheezing- 70%, 20% required NIV, 7% required intubation<ref>Midgley CM, Jackson MA, Selvarangan R, et al. Severe Respiratory Illness Associated with Enterovirus D68 — Missouri and Illinois, 2014. MMWR. 2014; 63(36):798-799</ref>
*All patients in Kansas City showed hypoxemia and difficulty breathing


==Differential Diagnosis==
==Differential Diagnosis==
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*[[Pneumonia]]
*[[Pneumonia]]


==Workup==
==Diagnosis==
*CXR
*CXR
*Labs
*Labs
*Cultures
*Cultures
*Serum Studies(check with micro lab regarding available studies)- Enteroviral infections reportable to (NESS) National Enteroviral Surveillance System.
*Serum Studies(check with micro lab regarding available studies)- Enteroviral infections reportable to (NESS) National Enteroviral Surveillance System


==Management==
==Management==
*Supportive care
*Supportive care
*Close observation for respiratory failure and possible need for NIV or ETI.
*Close observation for respiratory failure and possible need for NIV or ETI
*No antiviral medications available
*No antiviral medications available


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==External Links==
==External Links==
[http://www.cdc.gov/non-polio-enterovirus/about/EV-D68.html cdc.gov Enterovirus D68]
[http://www.cdc.gov/non-polio-enterovirus/about/EV-D68.html CDC - Enterovirus D68]
==Sources==
 
[http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e0908a1.htm?s_cid=mm63e0908a1_x CDC Outbreak- Chicago, Kansas City]
==References==
<references/>


[[Category:ID]][[Category:Featured]]
[[Category:ID]][[Category:Featured]]

Revision as of 13:46, 26 June 2016

Background

  • A viruses in the Enterovirus family
  • Infection in the U.S. rarely identified
  • Outbreak in Missouri and Illinois in 8/2014

Clinical Features

  • Mild to severe respiratory distress, otherwise not well defined, spread via respiratory secretions and body fluids
  • 30 confirmed cases in Kansas City and Chicago via PCR of nasopharyngeal secretions with the following features: age range 6 weeks to 16 years, febrile- 23%, prior asthma/wheezing- 70%, 20% required NIV, 7% required intubation[1]
  • All patients in Kansas City showed hypoxemia and difficulty breathing

Differential Diagnosis

Diagnosis

  • CXR
  • Labs
  • Cultures
  • Serum Studies(check with micro lab regarding available studies)- Enteroviral infections reportable to (NESS) National Enteroviral Surveillance System

Management

  • Supportive care
  • Close observation for respiratory failure and possible need for NIV or ETI
  • No antiviral medications available

Prevention

  • Wash hands often with soap and water for 20 seconds, especially after changing diapers
  • Avoid touching eyes, nose and mouth with unwashed hands
  • Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick
  • Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick

Disposition

  • Admit to ICU for respiratory support and observation

See Also

External Links

CDC - Enterovirus D68

References

  1. Midgley CM, Jackson MA, Selvarangan R, et al. Severe Respiratory Illness Associated with Enterovirus D68 — Missouri and Illinois, 2014. MMWR. 2014; 63(36):798-799