A rare strain of enterovirus detected in Missouri and Illinois has the ability to cause severe respiratory illness in children and spread to other states, U.S. Assistant Surgeon General Anne Schuchat said during a news briefing Monday.
"It is not a new strain," Schuchat said.
"But it is fairly uncommon, and we don't know as much about it as we do about some of the most common illnesses. The CDC is investigating how wide it may be and which populations may be affected and whether other states may be experiencing severe incidents."
Arkansas health officials have not detected clusters of the severe respiratory illness, said Dr. Dirk Haselow, state epidemiologist.
He said state officials are still preparing for the possibility that the illness is present or could be in the near future.
Children ranging from 6 weeks to 16 years old have tested positive for enterovirus D68 in Kansas City, Mo., and Chicago, Schuchat said.
She said the median age tends to be 4 to 5 years old. More than half of the patients have histories of asthma or wheezing, she said.
"What we do know is that it can cause mild or severe illness," Schuchat said.
"It likely spreads when an infected person coughs, sneezes or touches surfaces. Most symptoms will resolve on their own."
Schuchat said 12 other states have asked the Centers for Disease Control and Prevention to investigate clusters of illness in their states. She was unable to identify the other states during the briefing.
"Respiratory viruses can spread quite quickly across the U.S., and we really do think that clinicians throughout the country need to be on alert and consider this," Schuchat said.
"We think that the unusual clusters happening in Kansas City and Chicago may spread in coming weeks throughout the U.S."
Testing for the virus can be difficult, Schuchat said. She said not all states have the ability to test for the D68 strain.
Most tests only confirm that an illness is enterovirus or rhinovirus.
The Arkansas Department of Health does not have the ability to test for the specific strain, Haselow said.
He said the CDC would have to help the department administer the tests if suspicious clusters of illness became apparent in the state.
"Because enterovirus D68 is not mandatorily reportable, we do not have a great understanding of what is going on in the state," Haselow said.
"What we have done is reach out to hospitals to see if anyone is aware of untyped enterovirus."
Craig Gilliam, director of infection prevention at Arkansas Children's Hospital in Little Rock, said the hospital has seen a slight uptick of cases of respiratory illness but not enough to be alarmed.
The hospital has tested 77 children with respiratory illnesses since Aug. 1 in comparison to 60 children during the same time period last year, Gilliam said.
He said 37 of the children this year tested positive for having either enterovirus or rhinovirus.
There were 25 children who tested positive last year.
None of the tests have been sent to the CDC for further review, Gilliam said.
Gilliam said 17 of those children have been admitted to the hospital.
Eight of the children were admitted in August and nine were admitted this month.
The CDC was first alerted of an uptick of severe cases in Kansas City and Chicago in early August, according to a report it released Monday. Nineteen of 22 specimens from Kansas City were identified as having enterovirus D68. Eleven of 14 specimens had the virus in Chicago.
"Since the initial report, admissions for severe respiratory illness have continued at both facilities at rates higher than expected for this time of year," the CDC report states.
Schuchat said there is no treatment for enterovirus. Antibiotics do not work, and there is no vaccine.
She said hospitals are using supportive care such as oxygen and, at times, mechanical ventilation.
Parents should not worry if their children have coughs or runny noses, Schuchat said. They should seek immediate medical attention if children have difficulty breathing.
Haselow said the public should take precautions to prevent the spread of illness.
"Don't share food or bedding," Haselow said.
"Wash your hands. You should wash all toys that are washable and try to prevent the ongoing spread. We don't have a medicine to prevent it. We don't have a vaccine. We have to trust the people to take precautions."
Gilliam said Arkansas Children's Hospital is preparing for a possible increase of illness in the state. He said this includes making sure the hospital is properly stocked with general supplies.
NW News on 09/09/2014