Wave of rare virus reaches Children’s Hospital

Physicians have treated almost a dozen cases, and researchers are working on finding a cure.

by Kaylee Kruschke

Since mid-August, an uncommon respiratory illness has sent almost 450 wheezing patients to hospitals across most of the country — including at least 11 cases at the University of Minnesota Children’s Hospital.

Enterovirus D68 made its presence known in the state in mid-September when labs at the University and the Minnesota Department of Health discovered the virus in patient samples.

The exact number of cases across the state is unknown, as many go unreported, said Jayne Griffith, senior epidemiologist at the Minnesota Department of Health.

“[But] we know it’s out there,” she said.

Mark Schleiss, director of the University’s Division of Pediatric Infectious Diseases and Immunology, said EV D68 seems to be more problematic for children — particularly those with pre-existing asthma.

At this point, there is no validated, FDA-approved EV D68 diagnostic test, said Schleiss, who is also a doctor at the University’s Children’s Hospital and a pediatrics professor.

“In the past, there’s never been such a demand for such a test,” he said, “because this is a virus that’s never really been on the horizon enough and part of our landscape that we feel we need to test for it.”

Schleiss said he has helped sequence a portion of the virus using patients’ respiratory secretions and that University researchers are planning to fully sequence the strain and characterize its molecular genetics, which may help researchers find a cure.

Patients suspected of having the virus show respiratory tract disease symptoms.

Some of those symptoms include wheezing, shortage of breath, fast respiratory rates and flaring of the nose, said Bazak Sharon, an assistant pediatrics professor who specializes in infectious diseases.

In extreme cases, according to the Centers for Disease Control and Prevention, patients with EV D68 can develop paralysis or brain or heart infections.

The illness only makes up a minority of currently spreading respiratory viruses, Griffith said.

“This is definitely not anything anyone needs to be panicked about,” Sharon said.

Despite the lack of an EV D68 test, the department’s Public Health Laboratory was able to test patient samples and prove its presence among other subtypes of enteroviruses, Griffith said.

Doctors can also run tests for known viruses, Schleiss said, and if those tests are negative, physicians can assume patients might have EV D68. But he said it’s still possible for doctors to misdiagnose.

“No one has come up with a better system yet,” he said. “It’s the art of medicine, weaving that knowledge and information together.”

If the symptoms are severe enough, patients are hospitalized and given bronchodilators, nebulizers and steroids for a few days, Sharon said. He said those at the University Children’s Hospital who have been diagnosed with the strain typically won’t remain hospitalized for longer than six days.

“When you treat them, those who stay longer get better and better and better,” he said. “They respond very well to the treatment.”

To prevent EV D68 from spreading, Sharon suggested using standard hygiene guidelines like washing hands regularly, disinfecting surfaces and toys and keeping children with fevers and runny noses out of school.

Viruses tend to flare up in the fall, Griffith said, but he added that this year’s cold season began earlier than normal, starting as early as August for some states.

“The temperatures change,” Griffith said. “Children start back at school where they’re indoors, and the sharing of germs starts really peaking.”

Influenza poses a greater threat than EV D68, Griffith said, adding that the uncommon virus’s recent spike should not prompt people to forget about the flu.

“Influenza, in comparison, is a much more dangerous virus,” Griffith said. “There have been no deaths attributed to EV D68. [The flu] kills tens of thousands of people every influenza season.”