Iowa, Colorado, Missouri and Illinois have confirmed EV-D68 cases
Missouri doctor calls situation "unprecedented" in terms of kids in intensive care
About 475 children were recently treated at one Kansas City hospital
Enterovirus EV-D68 causes respiratory illnesses like a cold, only worse
Respiratory illnesses caused by an enterovirus are sending hundreds of children to hospitals throughout the Midwest and Southeast, health officials say.
The unusually high number of hospitalizations reported could be “just the tip of the iceberg in terms of severe cases,” said Mark Pallansch, a virologist and director of the Centers for Disease Control and Prevention’s Division of Viral Diseases.
Twelve states are reporting clusters of enterovirus illness: Alabama, Colorado, Michigan, Georgia, Ohio, Iowa, Illinois, Missouri, Kansas, Oklahoma, Kentucky and Utah.
At a news briefing Monday, the CDC confirmed that samples it tested from children who had been hospitalized in Illinois and in Kansas City, Missouri, did show signs of the EV-D68 virus, meaning there is a possible regional outbreak.
The Iowa Department of Public Health confirmed that EV-D68 cases have been identified in Iowa. Officials are hearing of illnesses across the state, they say, though there is not a firm count of how many people have been infected.
Dr. Christine Nyquist, medical director of infection control at Children’s Hospital Colorado, said the hospital sent around 25 samples to the CDC from patients with respiratory illness. Around 75% were confirmed to be EV-D68. The hospital has seen a 12% to 15% increase in emergency room visits and admissions this month compared with the same time frame last year, she said.
Enteroviruses, which bring on symptoms like a very intense cold, aren’t unusual.
“It’s important to remember that these infections are very common,” said Dr. Anne Schuchat. Schuchat is the assistant surgeon general for the U.S. Public Health Service and the director of the National Center for Immunization and Respiratory Diseases.
When you have a bad summer cold, often what you have is an enterovirus. The CDC estimates there are 10 to 15 million viral infections each year in the United States. The season often hits its peak in September.
This particular type of enterovirus – EV-D68 – is uncommon but not new. It was identified in the 1960s, and there have been fewer than 100 reported cases since that time. But it’s possible that the relatively low number of reports might be because EV-D68 is hard to identify.
“It’s one that we don’t know as much about as we would like,” Schuchat said.
EV-D68 was seen last year in the United States and this year in various parts of the world. Over the years, clusters have been reported in Georgia, Pennsylvania, Arizona and various countries including the Philippines, Japan and the Netherlands.
The reason health officials are concerned this year is that there have been so many hospitalizations.
“That’s the scary part – the unpredictability, I think,” Nyquist said.
The virus has sent more than 30 children a day to a Kansas City, Missouri, hospital, where about 15% of the youngsters were placed in intensive care, officials said.
In Kansas City, about 475 children were recently treated at Children’s Mercy Hospital, and at least 60 of them received intensive hospitalization, spokesman Jake Jacobson said.
“It’s worse in terms of scope of critically ill children who require intensive care. I would call it unprecedented. I’ve practiced for 30 years in pediatrics, and I’ve never seen anything quite like this,” said Dr. Mary Anne Jackson, the hospital’s division director for infectious diseases.
“We’ve had to mobilize other providers, doctors, nurses. It’s big,” she said.
The Kansas City hospital treats 90% of that area’s ill children. Staff members noticed an initial spike on August 15, Jackson said.
“It could have taken off right after school started. Our students start back around August 17, and I think it blew up at that point,” Jackson said. “Our peak appears to be between the 21st and the 30th of August. We’ve seen some leveling of cases at this point.”