Severe respiratory illness confirmed in Iowa

Clusters of EV-D68 reported in about a dozen states

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By Chelsea Keenan, The Gazette

CEDAR RAPIDS — A severe respiratory illness that has infected children in about a dozen states has been confirmed in Iowa, state public health officials said Monday.

The Iowa Department of Public Health sent samples from Central Iowa to the Centers for Disease Control and Prevention in Atlanta, which were confirmed as Enterovirus 68, or EV-D68.

Enteroviruses are common, the public health department said, with more than 100 types. It is estimated that 10 million to 15 million Enterovirus infections occur in the United States each year.

However, Dr. Anne Schuchat, the U.S. assistant surgeon general and director of the National Center for Immunization and Respiratory Diseases, told reporters on a conference call Monday morning that this strain is fairly uncommon and therefore much is unknown.

“The situation is evolving quickly,” she said. “How widespread it will be, which populations are most likely to be affected, we don’t know.”

Those with EV-D68 often have cold-like symptoms as well as difficulty breathing. Most will recover at home without complications, but some people with severe respiratory illness may wind up in the intensive care unit, the state health department said.

The CDC has confirmed cases in children ranging from 6 weeks to 16 years old. More than half of the children with the virus have a history of asthma.

Enteroviruses, including the strain EV-D68, are not tracked by states or the CDC, so the number of cases is unknown. But Reuters reported that Missouri, which was hit particularly hard by the virus, has more than 300 cases at just one pediatric hospital.

The CDC officials believe that, as with other respiratory illnesses, EV-D68 is spread through saliva and mucus. So it is possible that it could spread throughout the United States quite quickly, Schuchat said.

To help reduce the risk of infection, the CDC recommends washing hands often, avoiding the sharing of cups or eating utensils, and disinfecting frequently touched surfaces.

The CDC first became aware of the virus in August after the Children’s Mercy Hospital in Kansas City, Mo., reported an increase in the number of children hospitalized with severe respiratory illness. A similar increase in patients was seen at the University of Chicago Medicine Comer Children’s Hospital in Illinois, prompting the CDC to test specimens at both hospitals.

EV-D68 was identified in 19 of 22 specimens from Kansas City and in 11 of 14 specimens from Chicago, the CDC said. Since then, clusters of the virus have appeared in about a dozen states, the majority of which are in the Midwest.

Here in the Corridor, officials from Mercy Medical Center in Cedar Rapids said that the hospital has not seen any inpatient admissions for respiratory illness among children or any increase in its outpatient pediatrics clinic.

But Mercy’s Dr. Scott Nau said the hospital is keeping an eye on the situation and is on “high alert.”

Parents should take their children to the doctor if they are wheezing, coughing or working harder than normal to breathe, Nau said. There is no medication for EV-D68, but doctors can treat it with medicines for asthma or steroids to help soothe inflammation, he said.

The University of Iowa Hospitals and Clinics also reports no confirmed cases of EV-D68, said Eli Perencevich, professor of medicine at the UI Carver College of Medicine. But doctors have submitted several specimens to be tested, he said.

Perencevich said UIHC medical staff also have seen an increase in respritory-related illness among children earlier than normal. He added that doctors are not overly concerned about how to combat the virus.

“Perhaps a new virus is confirmed, but the actual care and management all of those things are very standard and are part of our protocol. We’re just instituting them earlier in the year than we’ve done in the past.”

Dr. Jenny Lennington, a pediatrician at UnityPoint Health-St. Luke’s Hospital, noted the Cedar Rapids hospital also has seen a slight increase in admissions for respiratory illnesses, which is normal for this time of year.

Amy Varcoe of UnityPoint Health-Des Moines, meanwhile, has seen 22 suspected cases, including 21 children, in the past three weeks, according to the Des Moines Register. The Enterovirus was responsible for at least 14 of those illnesses, the newspaper reported.

Thirteen of UnityPoint’s 22 suspected cases have been admitted to Blank Children’s Hospital, including four who were admitted to the intensive-care unit, Varcoe said. Those four all had underlying health problems, such as asthma or heart issues, she said.

Many of the cases are variations of Enterovirus.

“The difference with this strain is that in Kansas City, there was a big jump in critical care admissions that we just have not seen here,” she said.

Gazette reporter Alison Sullivan contributed to this story.

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