Tuesday, September 09, 2014

The CDC’s EV-D68 Update Page

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# 9057

 

Since it first gained national notoriety two weeks ago (see Kansas City Outbreak Identified As HEV 68), the EV-D68 virus has gone from relative obscurity – with mentions relegated to scientific journals or occasional blog posts -  to being the sole topic of a CDC press briefing yesterday.

 

Late yesterday the CDC unveiled an EV-D68 specific webpage, where we can expect to see updates on this emerging enterovirus as their investigation goes forward. 

 

As Dr. Schuchat stated yesterday, this is a rapidly evolving and dynamic situation, and right now we don’t know how long, or severe, this outbreak will be.  While for the vast majority of people infection will be mild or moderate, for some small percentage – often kids with asthma – serious illness can result.

 

The CDC provides advice to the public, and health care providers, below:

 

Enterovirus D68

Enterovirus D68 (EV-D68) is one of many non-polio enteroviruses. Enterovirus D68 (EV-D68) infections are thought to occur less commonly than infections with other enteroviruses. EV-D68 was first identified in California in 1962. Compared with other enteroviruses, EV-D68 has been rarely reported in the United States for the last 40 years.

EV-D68 Infections Reported

Hospitals in Missouri and Illinois are seeing more children than usual with severe respiratory illness caused by enterovirus D68.

Several other states are investigating clusters of children with severe respiratory illness, possibly due to enterovirus D68.

CDC is watching this situation closely and helping the states with testing of specimens.

For General Public

Symptoms
  • EV-D68 has been reported to cause mild to severe respiratory illness. However, the full spectrum of EV-D68 illness is not well-defined.
Transmission
  • EV-D68 is not frequently identified, so it is less studied and the ways it spreads are not as well-understood as other enteroviruses. EV-D68 causes respiratory illness, and the virus can be found in respiratory secretions such as saliva, nasal mucus, or sputum. The virus likely spreads from person to person when an infected person coughs, sneezes, or touches contaminated surfaces.
Treatment
  • There is no specific treatment for EV-D68 infections.
    • Many infections will be mild and self-limited, requiring only treatment of the symptoms.
    • Some people with severe respiratory illness caused by EV-D68 may need to be hospitalized and receive intensive supportive therapy.
  • No antiviral medications are currently available for treating of EV-D68 infections.
Prevention
  • There are no vaccines for preventing EV-D68 infections.
  • You can help protect yourself from respiratory illnesses by following these steps:
    • 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

Top of Page

For Healthcare Professionals

Guidance

Healthcare professionals should

  • Be aware of EV-D68 as a potential cause of clusters of severe respiratory illness, particularly in young children.
  • Consider laboratory testing of respiratory specimens for enteroviruses when the cause of infection in severely ill patients is unclear. State health departments or CDC can be approached for typing enterovirus.
  • Report cases and clusters of severe respiratory illnesses to state and local health departments for further guidance.
Surveillance
  • U.S. healthcare professionals are not required to report known or suspected cases of EV-D68 infection to health departments because it is not a reportable disease in the United States. Also, CDC does not have a surveillance system that specifically collects information on EV-D68 infections.
  • No data is currently available regarding the overall burden of morbidity or mortality from EV-D68 in the United States. Any data CDC receives about EV-D68 infections or outbreaks are voluntarily provided by labs to CDC’s National Enterovirus Surveillance System (NESS). NESS collects limited data, focusing on circulating types of enteroviruses and parechoviruses.
Laboratory Testing
  • Many hospitals can test for enteroviruses, but they are probably not able to perform enterovirus typing. State health departments or CDC can be approached for typing.
  • CDC is working with state and local health departments and clinical and state laboratories to
    • enhance their capacity to identify and investigate outbreaks
    • perform diagnostic and molecular typing tests to improve detection of enteroviruses and enhance surveillance
  • Before sending specimens to CDC:
    • contact your state or local health department, and
    • consult with CDC by sending an email to wnix@cdc.gov
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