Hawaii may have Enterovirus D-68

A virus that swept the mainland and was linked to several deaths may be here in Hawaii.

State health officials say they suspect enterovirus D-68 (EV-D68) has made its way to the islands. But because of a backlog in testing at the Centers for Disease Control and Prevention (CDC), they can’t be sure.

The CDC say that 47 states and the District of Columbia have submitted assessments of activity of EV-D68-like illness in the past week.

EV-D68 is a respiratory illness.

Symptoms include fever, runny nose, cough, and body aches. Severe symptoms may include wheezing and difficulty breathing.

Children with asthma are especially at risk because they may have a hard time breathing.

The virus can be found in an infected person’s respiratory secretions, such as saliva, nasal mucus, or sputum. EV-D68 likely spreads from person to person from coughing, sneezing, or touching surfaces that is then touched by others.

There is no treatment or vaccine.

“We may have had cases. So I find it hard to believe that it’s circulating in the mainland and we don’t have it here, you know. So I think its more of the matter of fact that we haven’t specifically identified, tested, but that doesn’t specifically mean that we do or don’t have it,” said state epidemiologist Dr. Sarah Park

The CDC has linked the virus to 11 deaths on the Continental U.S.

However, Dr. Park says we haven’t seen anything like that here.

The CDC says you can help prevent yourself from getting and spreading EV-D68 and other respiratory illnesses by following these steps:

  • Wash hands often with soap and water for 20 seconds.
  • Avoid touching eyes, nose and mouth with unwashed hands.
  • Avoid close contact such as kissing, hugging, and sharing cups or eating utensils with people who are sick.
  • Cover your coughs and sneezes with a tissue or shirt sleeve, not your hands.
  • Clean and disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
  • Stay home when you are sick.

Below is an article from Oct. 3, 2014 on EV-D68:

NEW YORK (AP) — A wave of severe respiratory illnesses has swept the country in the last two months, propelled by what was long considered an uncommon germ.

The enterovirus 68 has caused serious breathing problems in many children, and now is being eyed as possible factor in at least four deaths, and muscle weakness and paralysis in children in Colorado and perhaps other states.

The Centers for Disease Control and Prevention on Friday released a report on the Colorado cluster. The investigation continues and many questions remain unresolved.

Some questions and answers about the germ:

Q: Is this virus new?

A: No. It was first identified in the U.S. in 1962, and small numbers of cases have been regularly reported since 1987. Because it’s not routinely tested for, it may have spread widely in previous years without being identified in people who just seemed to have a cold. It’s one of a group of viruses that contribute to an uptick in cold-like illnesses every year around the start of school.

In August, the virus got more attention when hospitals in Kansas City, Missouri and Chicago had many children with trouble breathing. Some needed oxygen or more extreme care such as a breathing machine. Tests found enterovirus 68.

Q: How many people have been severely sickened by the virus?

A: Lab tests by the CDC have confirmed illness caused by the germ in 538 people in 43 states and the District of Columbia. Almost all are children. Testing is limited and has been focused on very sick children, so it’s likely that many, many more people — including adults — have been infected.

Q: Why are most of the severe cases in children?

A: They generally have not been exposed to enteroviruses as often as adults are, and are less likely to have developed immunity to them. Some children are especially vulnerable because of pre-existing conditions— for example, many hospitalized children were kids who had asthma.

Q: Why are more severe illnesses from enterovirus 68 being reported this year?

A: That’s a mystery. Health officials have not found a recent mutation or other change in the virus that would cause it to become more dangerous. Clusters have been reported in other countries, including some Asia nations and the Netherlands, in recent years.

Q: What about the reports of deaths?

A: This week the CDC said four people who were infected with enterovirus 68 died last month, but what role the virus played in the deaths is unclear. Investigators are trying to sort out if the viral infection was coincidental, a contributing factor or a main cause. One case was a 10-year-old Rhode Island girl who died last week after infections of bacteria and enterovirus 68. Rhode Island health officials suggested the bacteria — Staphylococcus aureus — and the virus may have formed a rare and deadly combination, but the investigation continues.

Q: And what about the reports of weakness?

A: Last week, the CDC sent doctors an alert about nine children at a Denver-area hospital who suffered muscle weakness or paralysis in the neck, back or limbs about a week after they had a fever and respiratory illness. The number since has grown to 10.

Four of the children tested positive for enterovirus 68. But health officials don’t know whether the virus caused any of the children’s arm and leg weaknesses or whether it’s just a germ they coincidentally picked up.

The CDC asked doctors to report patients 21 or younger who developed limb weakness since August 1 and who have had an MRI exam that showed abnormalities in the nerve tissue in the spinal cord. Since putting out the call, several reports have come in, but the CDC is still evaluating which should be counted as similar cases.

Q: What can I do to protect my child?

A: The CDC recommends making sure children and their parents are up to date on all vaccinations, including those against respiratory diseases like flu, measles and whooping cough. The other advice has to do with basic hygiene — wash hands frequently with soap and water, stay away from sick people and disinfect objects that a sick person has touched. See a doctor right away if your child starts having severe problems breathing, develops difficulty moving their limbs or walking or standing.

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