Enterovirus D68

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. All patients in Kansas City showed hypoxemia and difficulty breathing.

Differential Diagnosis

Asthma
Foreign Body
Pneumothorax
Pneumonia

Workup

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

External Links

cdc.gov Enterovirus D68

Sources

CDC Outbreak- Chicago, Kansas City

Authors: