Enterovirus is back: Cases of EV-D68 reported across Canada, U.S.

Exactly two years ago, kids turned up in hospital with cold-like symptoms and struggling to breathe across Canada and the U.S. as enterovirus swept the continent.

Now, in 2016, the rare respiratory illness has resurfaced after disappearing last year.

So far, cases have been reported in British Columbia, Alberta and Ontario, with experts anticipating escalating numbers.

“The numbers are low so far but we can expect more infections to occur through the fall and early winter period,” Dr. Danuta Skowronski, an epidemiologist with the B.C. Centre for Disease Control, said in a statement.

READ MORE: Everything parents need to know about enterovirus symptoms, treatment

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

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. Paralysis in the face, then arms and limbs sets in in rare cases.

B.C. recorded eight cases of EV-D68 – six of which were kids under the age of two. The provincial body is now warning parents to take precautions, including cleaning kids’ hands regularly and making sure they stay home if they’re feeling ill.

In Alberta, a single case was documented in ProMED in which a toddler ended up in hospital vomiting and with paralysis on one side of his body.

Dr. Marek Smieja, out of the Hamilton Regional Laboratory Medicine Program, told Global News he’s confirmed 35 cases of the illness in 12 Ontario hospitals. But numbers have been “increasing slowly week by week.”

It has also reappeared in the U.S. The Centers for Disease Control and Prevention said it’s seen a rise in cases, too.

READ MORE: Is enterovirus more concerning than the flu? What parents need to know

Both the Public Health Agency of Canada and Public Health Ontario issued their own warnings about the resurgence of the disease.

Ottawa says it’s “closely monitoring this issue” with the help of provinces and territories.

“Anyone can get sick with EV-D68. In Canada, the risk of getting sick usually occurs in the summer and fall,” it said in its public health bulletin.

“Infants, children and teenagers are more likely to be infected and become sick because they do not yet have immunity from previous exposure,” the federal agency said.

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 described as 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.

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.

WATCH: Three cases of Enterovirus have been diagnosed in children in the Fredericton area. People working with children say they’re following strict guidelines to control the further spread of illness. Global’s Brion Robinson reports.

What are the symptoms?

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

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.

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: 5 ways to protect yourself from the flu

Younger children, between two and eight 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.

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

carmen.chai@globalnews.ca
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