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Enterovirus D68: Public Health Advisory (September 2014)

Enterovirus D68 (EV-D68) is one of about a hundred of a group of viruses called enteroviruses. This virus was first identified in California in 1962, but it has not been commonly seen. 

While some enteroviruses are common, this one has not been seen as frequently in Canada or the United States. As of September 2014, many children have become ill and 84 people in six states have been confirmed to have respiratory illness caused by EV-D68. 

Reports from across Canada are indicating cases may be present in Ontario, British Columbia and Alberta. Saskatchewan has had 17 confirmed cases since August. 

Children and teenagers appear to be at increased risk of infection from EV-D68. It is thought they may lack protection from previous exposures to the virus. The virus can infect adults as well. Children with asthma seem to have a higher risk for severe respiratory illness. 

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1. Symptoms

EV-D68 can cause varying degrees of respiratory illness: 
  • Many children experience only mild symptoms that may include fever, runny nose, sneezing, cough, loss of appetite, and body and muscle aches. 
  • If your child's symptoms worsen, including persistent coughing, wheezing or difficulty breathing contact your Primary Care provider (physician or Nurse Practitioner). A visit to a clinic or hospital might be necessary.
  • Symptoms may be more severe in children with asthma.
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2. How the Virus Spreads

Since EV-D68 causes respiratory illness, the virus can be found in respiratory secretions, such as saliva, nasal drainage, or mucus from coughing. 
Like other enteroviruses, anyone can get infected with EV-D68. Among the recent EV-D68 infections, children with asthma seem to have a higher risk for severe respiratory illness. 

EV-D68 likely spreads from person to person when someone touches a contaminated surface that an infected person has touched, coughed or sneezed on and, then touches their eyes, nose or mouth without washing their hands. 


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3. Diagnosis and Treatment

The Saskatchewan Disease Control Laboratory (SDCL) can test for this virus. However, doctors don't need to test for Enterovirus D68 to be able to take care of a child who is sick from this virus. Test results take several days and are not required to manage the care of the patient. 

Most children will experience mild symptoms and do not need to be tested. However, severely ill or hospitalized children may be tested as part of their investigation. 

There is no specific treatment for people with respiratory illness caused by EV-D68.

For mild respiratory illness, you can help relieve symptoms by taking over-the-counter children's medications for pain and fever. Aspirin should not be given to children. Some people with more severe respiratory illness may need to be hospitalized.

Since EV-D68 is a virus, antibiotics will not help. There are also no antiviral medications to treat people with respiratory illness caused by EV-D68 and no vaccine to prevent it. 

For mild respiratory illness like body aches and fever, you can help relieve symptoms by giving your child over-the-counter medications made for children. If your child has asthma or is wheezing, the illness may be more severe and you should call your doctor, Nurse Practitioner or clinic. You may also call HealthLine 811. If your child has difficulty breathing, take him/her to the emergency room.


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4. Protecting Yourself from Enterovirus D68

You can help protect yourself from respiratory illnesses by following these steps: 
  • Avoid close contact with sick people. Stay home if you or your child is ill;
  • Wash hands often with soap and water for 20 seconds, especially after changing diapers;
  • Cover your coughs and sneezes with tissues;
  • Avoid touching eyes, nose and mouth with unwashed hands;
  • Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick; and
  • Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
Since people with asthma carry higher risk for respiratory illnesses, they should take medicine regularly and maintain control of their illness during this time. They should also take advantage of the influenza vaccine since people with asthma have a difficult time with respiratory illnesses. Asthma can also be controlled by avoiding the triggers that can cause an attack, such as tobacco smoke. 

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