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Enterovirus: Everything parents need to know about symptoms, treatment

WATCH ABOVE: A serious respiratory illness that’s been spreading through parts of the United States has now crossed the border into Canada. There’s always a spike in viruses when kids return to school, but the severity of this strain of Enterovirus is raising concern. Shirlee Engel explains.

TORONTO – Kids across the U.S. and some parts of Canada are turning up in hospital with cold-like symptoms and struggling to breathe. It’s no wonder Canadian parents are worried about enterovirus – a rare respiratory illness that’s been making its way across North America.

So far, cases have been confirmed in B.C. and Alberta, with the Public Health Agency of Canada and other provinces on high alert for potential outbreaks.

“Parents are obviously very scared and very nervous. We’ve been trying to impress upon them how important handwashing and other hygiene habits are to prevent spread,” Dr. B. Louise Giles told Global News.

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READ MORE: Is enterovirus D68 on Canadian health officials’ radar?

She’s a Canadian doctor and pediatrician at the University of Chicago’s Comer Children’s Hospital. Since mid-August, Giles has been treating kids with the rare virus.

“It was really profound because we normally expect to see increases when school starts but this came very, very early,” she said.

Here’s what parents need to know about symptoms, who’s most vulnerable, treatment and prevention when it comes to EV-D68.

What are enteroviruses?

Enteroviruses are a group of viruses comprised of more than 100 different types of strains, according to Canadian microbiologist and author Jason Tetro.

“Each one has a particular structure and, as a result, a different function,” he told Global News.

Only some affect humans and enterovirus D68 happens to be one of them.

READ MORE: Where is enterovirus D68 in Canada?

(Other enteroviruses that are frequently seen in Canada include Coxsackie A19 and EV-71, which has caused outbreaks of hand-foot-and-mouth disease in kids.)

It’s often called a rare virus, and the reason for that lies in its cycle. It doesn’t evolve as quickly as, say, the seasonal influenza so we only see waves of EV-D68 every few years.

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North America may be entering a wave of enterovirus now, but it might not re-emerge for another five years to a decade. In this case, it started in the Philippines in 2009; clusters were then reported in New York City that year, the Netherlands by 2010 and it spread around the world from there, Tetro said.

READ MORE: Is enterovirus D68 on Canadian health officials’ radar?

What are the symptoms?

EV-D68 presents more or less the same way as the common cold. Kids have the exact same symptoms: a runny nose, watery eyes and a cough. Some even have a fever.

What’s key is how the illness progresses so pay close attention to your child’s symptoms and if they worsen.

“Parents might say my child’s really struggling to breathe or the asthma action plan I’m told to follow isn’t working,” Giles explained.

READ MORE: Alberta Health Services confirms 18 cases of enterovirus D68

It happens quickly, too. If your child falls sick with what appears to be a cold, within 12 to 24 hours you could be in hospital if he or she is responding poorly to enterovirus.

Because it’s so similar to the common cold, testing is required to confirm what the infection is. PHAC says it conducts tests upon requests from provincial health bodies. Since 1999, it’s identified 82 cases of EV-D68 in the country.

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Who is most vulnerable?

In healthy adults, enterovirus wouldn’t lead to any serious concerns, but it’s young kids who are most vulnerable – especially if they have additional respiratory issues.

Seventy per cent of the time, the kids turning up in hospital with EV-D68 are asthmatic, Giles said. Children with allergies, cystic fibrosis or an underlying lung disease also appear to be harder hit.

READ MORE: 3 cases of enterovirus confirmed in B.C.

Younger children, between 2 and 8 years old, are also at an increased risk. But Giles has seen kids up to 17 years old with enterovirus.

No state or province has reported a death related to EV-D68.

“Children who are so sick have recovered beautifully…we’re very hopeful we can get kids through it. It’s just really horrible at the time they’re so ill,” she told Global News.

What are the treatment options?

Unfortunately there are no vaccines or medications for enterovirus; eventually people recover on their own.

It’s all about relieving the symptoms. If kids are wheezing or struggling to breathe, they’re given medication to help the airways relax. In some cases, they’re given oxygen.

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READ MORE: How do you treat the common cold? Here’s what works and what doesn’t

Bed rest, staying hydrated and monitoring patients’ health is also important. Within a few days, the kids’ immune system should take over.

Giles said some children could be in intensive care units for less than two days. Others might be taken care of for up to a week.

How do you prevent it?

EV-D68 spreads just like the flu – through coughing, sneezing or close contact with infected patients.

Because the virus is affecting North America during the back-to-school period, health officials and school boards are sending kids home with a warning of the epidemic in the U.S. and advice to parents.

The Public Health Agency of Canada (PHAC) says the most effective measures you can take to protect yourself and children against enteroviruses such as EV-D68 are:

  • Wash your hands with soap and warm water for at least 20 seconds.
  • If soap and water are not available, use a hand sanitizer.
  • Wash your hands: before and after eating, after you have been in a public place, after using the washroom, after coughing and sneezing, after touching common surfaces
  • Cough and sneeze into your arm, not your hand
  • Keep your hands away from your face
  • Keep common surface areas clean and disinfected
  • If you get sick, stay home
  • Ensure your immunizations are up to date
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Where is it in Canada?

Dozens of kids are showing up in Canadian hospitals with respiratory illnesses – some of which have been confirmed and some that require testing.

While cases in Alberta and B.C. each have confirmed cases, clusters of mild and severe illnesses are popping up in other provinces.

READ MORE: Sask. health officials closely monitor enterovirus D68 situation

“The cause of the respiratory illnesses in these additional clusters has not yet been identified. The agency’s National Microbiology Laboratory is providing guidance and assisting these provinces with additional testing of samples of the EV-D68 subtype,” the federal agency’s spokesman Robert Cyrenne said.

He said PHAC is closely monitoring the situation and is in touch with provinces and territories, along with U.S. public health officials.

The government has even issued a public health alert to more than 4,000 health professionals across the country to keep vigilant for potential cases.

carmen.chai@globalnews.ca