Cape Cod Healthcare Prepares for EV-D68

Cape Cod hospitals are taking precautions to protect patients from a potentially serious respiratory virus affecting mostly infants and children.

Officials are recommending that children under 14 not be allowed to visit hospital pediatric and obstetrical units until the epidemic of enterovirus D68 has passed, said Donald A. Guadagnoli, chief medical official at Cape Cod Hospital.

The virus — known as EV-D68 — has been identified in 175 people from 27 states, including New York and Connecticut.

Children with suspected cases of EV-D68 are being treated at Children’s Hospital in Boston, which has sent 14 samples from the most seriously afflicted patients to the lab for testing, Children’s Hospital spokeswoman Meghan Weber said in an email.

Eighteen patients have been admitted to the intensive care unit and 36 patients to intermediate care with respiratory illness — three times the number that the hospital admitted at the same time last year, she said.

But as of Monday, there were no confirmed cases of the respiratory illness in Massachusetts, state Department of Public Health spokeswoman Anne Roach said in an email.

CCHConfirmation tests take a couple of weeks to complete, Dr. Alexander Heard, a Forestdale pediatrician, said in a phone interview.

Although EV-D68 is spreading across the country, the rest of the United States has not seen anything like the cluster of cases in the Midwest, Heard said.

Hundreds of children have been hospitalized with respiratory illnesses since the EV-D68 outbreak started in mid-August. No deaths have been reported.

The virus was first identified in California in 1962 but is considered uncommon in the United States, according to the Centers for Disease Control. Symptoms can range from mild — such a fever, runny nose, sniffles, cough and body aches — to severe, the CDC says.

The health agency says most of the children who got very ill with EV-D68 in Missouri and Illinois experienced problems breathing. “Many of these children had asthma or a history of wheezing,” the CDC website said.

The buildup of mucus can set off bronchial spasms, particularly in asthmatic patients, Heard said. He said treatment for EV-D68 includes fluids, increased use of an inhaler and, in some cases, steroids.

Patients in the most severe respiratory distress may have to go on life support. Twelve patients at Children’s Hospital in Boston have been put on various forms of life support to deal with respiratory distress, Weber said.

“There’s no vaccine for this. Antibiotics don’t work for this,” Heard said.

It’s time to call the doctor if the child has to use a rescue inhaler more than once every four hours, has a fever that won’t respond to Tylenol or ibuprofen or is showing signs of respiratory distress such as flaring nostrils, Heard said.

Wash hands often with soap and water for 20 seconds to keep EV-D68 — and other viruses — from spreading, Guadagnoli said.

It’s important to disinfect toys and surfaces such as doorknobs and to avoid hugging, kissing and sharing utensils with people who are sick, Roach said.

By Cynthia McCormick
September 23, 2014

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