Hey there, time traveller!
This article was published 25/9/2014 (2017 days ago), so information in it may no longer be current.
Many Manitoba parents have probably read or watched media reports in recent weeks about children in other parts of Canada and the United States being struck by an exotic-sounding bug called enterovirus D68.
This respiratory virus has been reported in 12 American states, leading to the hospitalization of 130 individuals since mid-August, most of them children. In Canada, there have been reports of 18 confirmed cases of enterovirus in children in Alberta and a number of other cases in southwest Ontario.
As of Sept. 23, no cases have yet been reported in Manitoba. It is likely, however, that cases may start to be identified here as well.
There is, in any case, no reason for parents to panic. Enterovirus comes in many different strains and will often surface in the late summer and early fall. In fact, EV-D68 last appeared in Manitoba in 2009, resulting in 20 confirmed cases, mostly children.
Like most respiratory viruses, this one does pose a risk for some children, particularly those with asthma or lung problems. Children with weaker immune systems (such as those on medications that reduce the immune response including chemotherapy or steroids) may become more seriously ill. Younger children, due to limited exposure and subsequent immune responses to EV-D68, may also be more vulnerable. But otherwise-healthy children are usually able to overcome the virus without too much trouble.
As with other related viruses (EV-D68 is closely related to rhinovirus, the cause of the common cold), droplets from the respiratory tract are the main way EV-D68 moves from person to person. That is why health professionals are always encouraging lots of handwashing and coughing into your elbow.
Once enteroviruses get into the body (usually through the respiratory or gastrointestinal tract) it can cause different symptoms, depending on what type it is. Sometimes, they can cause nervous-system infections or encephalitis (swelling of the brain). It is also known to cause diarrhea or gastroenteritis (stomach flu). One of the more common presentations we see in children is hand, foot and mouth disease (a distinct rash with blisters involving the hand, feet and mouth). But the most common symptoms with EV-D68 (as well as other types of enteroviruses) are fever, cough and runny nose. It can also affect the lower respiratory tract, causing wheezing and shortness of breath.
The seasonal surge in cases of children with upper respiratory viruses can be attributed to a few factors. First, children are more likely to get a viral infection, particularly those they have not encountered before. This means they have limited immunity, which is especially true now as EV-D68 has not really been around for that long.
Second, kids can often be "germ farms." When you put them together in an environment (such as school) where they can share those germs easily, any respiratory virus (such as influenza or colds) will spread well.
Steps can be taken to protect your children from becoming infected with EV-D68.
Encouraging them to regularly wash their hands with soap and water is a good idea even though they may not be as diligent as we'd like. Get them to cough into their elbow and make this routine. Good hand hygiene and cough etiquette will serve them well, not only for EV-D68, but also for the other respiratory viruses coming in the colder months.
Remember antibiotics are not useful for viruses, so they should be avoided. Unfortunately, there is no vaccine for EV-D68, but you can help your children and others this winter by getting the seasonal influenza vaccine. Finally, if you are ever concerned about your child (high fevers, difficulty breathing, not drinking well or not urinating), it is very reasonable to call your medical practitioner or go to the clinic or emergency department.
Dr. Jared Bullard is associate medical director of Cadham Provincial Laboratory, assistant professor in the departments of pediatrics and child health and medical microbiology at the University of Manitoba and a pediatric infectious disease specialist at Health Sciences Centre's Children's Hospital.