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==Overview==
==Overview==
Enterovirus 68, or EV-D68 is a non-polio enterovirus.  Non-polio enteroviruses are very common viruses, causing about 10 to 15 million [[infections]] in the United States each year.  Most people who get infected with non-polio enteroviruses do not get sick. They may have mild illness, such as the common [[cold]].  Less commonly, a person may develop: [[infection]] of the [[heart]], [[pericardium|sac around the heart]], [[brain]], or [[paralysis]].  [[Transmission]] may occur by having close contact with an infected person and by touching objects or surfaces contaminated with the [[enterovirus 68|virus]].  In the United States, people are more likely to get infected with non-polio enteroviruses in the summer and fall.  People at highest risk are infants, children, and teenagers.  The virus may be detected in [[stool]] or rectal swabs and [[respiratory]] specimens.  There is no specific treatment for [[Non-Polio enterovirus infections|Non-polio enterovirus infection]]. People with mild illness caused by [[Non-Polio enterovirus infections|Non-polio enterovirus infection]] typically only need treatment of [[symptoms]].  If [[complications]] occur, patients require hospitalization.  There is no [[vaccine]] to protect against [[Non-Polio enterovirus infections|Non-polio enterovirus infection]].  Preventive measures to avoid infection include: washing hands often with soap and water; avoid close contact with people who are sick; and cleaning and disinfecting frequently touched surfaces.
Enterovirus 68, or HEV-D68 is a non-polio enterovirus.  Non-polio enteroviruses are very common viruses, causing about 10 to 15 million [[infections]] in the United States each year.  Most people who get infected with non-polio enteroviruses do not get sick. Those who do have symptoms similar to a common [[cold]].  Rarely, a person may develop [[infection]] of the [[heart]] [[pericardium|or its surrounding sac]], infection of the [[brain]], or [[paralysis]].  [[Transmission]] may occur through close contact with an infected person and by touching objects or surfaces contaminated with the [[enterovirus 68|virus]].  In the United States, people are more likely to get infected with non-polio enteroviruses in the summer and fall.  People at highest risk are infants, children, and teenagers.  The virus may be detected in [[stools]] or rectal swabs and in specimens collected from the mouth, nose, or respiratory system.  There is no specific treatment for [[Non-Polio enterovirus infections|Non-polio enterovirus infection]]. People with mild illness caused by [[Non-Polio enterovirus infections|non-polio enterovirus infection]] only need treatment of [[symptoms]].  If [[complications]] occur, patients require hospitalization.  There is no [[vaccine]] to protect against [[Non-Polio enterovirus infections|non-polio enterovirus infection]].  Preventive measures to avoid infection include: washing hands often with soap and water; avoid close contact with people who are sick; and cleaning and disinfecting frequently touched surfaces.


==What are the Symptoms of Enterovirus 68?==
==What are the Symptoms of Enterovirus 68?==
* Most people who are infected with [[Non-Polio enterovirus infections|non-polio enterovirus]]es do not get sick, or they only have mild illness. [[Symptoms]] of mild illness may include:
* Most people who are infected with [[Non-Polio enterovirus infections|non-polio enterovirus]]es do not get sick, or they only have mild disease. [[Symptoms]] may include:
:* [[Fever]]
:* [[Fever]]
:* [[Runny nose]]
:* [[Runny nose]]
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:* [[Cough]]
:* [[Cough]]
:* [[Skin rash]]
:* [[Skin rash]]
:* [[Aphthous ulcer|Mouth blisters]]
 
:* [[Body]] and [[muscle ache]]s
*The disease may be more severe in younger children and require hospitalization. Children may have:
*Some [[Non-Polio enterovirus infections]] can cause:
:*Difficulty breathing
:* [[Viral conjunctivitis]]
:*Wheezing
:* [[Hand-foot-and-mouth disease]]
:*Convulsions due to high fever
:* [[Viral meningitis]] (infection of the covering of the [[spinal cord]] and/or [[brain]])
* Less commonly, a person may develop:
:* [[Myocarditis]] (infection of the heart)
:* [[Pericarditis]] (infection of the sac around the heart)
:* [[Encephalitis]] (infection of the brain)
:* [[Paralysis]]


==What are the Causes of Enterovirus 68?==
==What are the Causes of Enterovirus 68?==
Enterovirus 68, or HEV-D68, is a non-polio virus.
Enterovirus 68, or HEV-D68, is the organism responsible for Enterovirus 68 infection.
 


Non-polio enterovirus can be shed (passed from a person's body into the environment) in your stool for several weeks or longer after you have been infected.
* The virus can be shed from your [[respiratory tract]] for 1 to 3 weeks or less
* Infected people can shed the virus even if they don't have [[symptoms]]
===Transmission===
===Transmission===
Non-polio enteroviruses can be found in an infected person's:
Non-polio enteroviruses can be passed from a person's body into the environment in the stools for several weeks or longer after you have been infected.
* Feces (stool)
 
* [[Eyes]], [[nose]], and [[mouth]] [[secretions]] (such as [[saliva]], nasal mucus, or [[sputum]])
* The virus can be transmitted by droplets released from the [[respiratory tract]] when an infected person sneezes of coughs. This form of transmission may last for 1 to 3 weeks.
* Blister fluid
* Other bodily fluids that may contain the virus include [[saliva]], nasal mucus, [[sputum]], and blister fluid (in those with rash)
* Infected people can transmit the virus even if they don't have [[symptoms]]
 
 
 
You can get exposed to the virus by:
You can get exposed to the virus by:
* Having close contact, such as touching or shaking hands, with an infected person
* Having close contact with infected persons, such as touching or shaking hands
* Touching objects or surfaces that have the virus on them
* Touching objects or surfaces that have the virus on them
* Changing diapers of an infected person
* Changing diapers of an infected child
* Drinking water that has the virus in it
* Drinking water that has the virus in it


If you then touch your [[eyes]], [[nose]], or [[mouth]] before washing your hands, you can get infected with the virus and become sick.
If you touch your [[eyes]], [[nose]], or [[mouth]] with contaminated hands, you can get infected with the virus. It is very important to practice good hand hygiene around people with enterovirus 68 infection.


==Who is at Highest Risk?==
==Who is at Highest Risk?==
Anyone can get infected with [[non-polio enterovirus]]es. However, infants, children, and teenagers are more likely to get infected and become sick since they do not have [[immunity]] (protection) from previous exposures to the viruses.
Anyone can get infected with [[non-polio enterovirus]]es. But infants, children, and teenagers are more likely to get infected and become sick. Younger children can get very sick and require hospitalization following enterovirus 68 infection.


==When to Seek Urgent Medical Care?==
==When to Seek Urgent Medical Care?==
If you are concerned about your [[symptoms]], you should contact your health care provider.
If you are concerned about your [[symptoms]] or those of a family member, you should consider seeking medical care. Symptoms of severe respiratory disease such as difficulty breathing, wheezing, severe cough, and very high fever should be investigated by your health care provider.


==Diagnosis==
==Diagnosis==
Infection with non-polio enteroviruses can be confirmed by isolating or identifying the virus
Infection with non-polio enteroviruses such as Enterovirus 68 can be confirmed by identifying the virus by a DNA test known as the polymerase chain reaction or PCR assay.
* Cell culture
* Polymerase chain reaction (PCR) assay


[[Non-polio enterovirus]]es can be detected in [[stool]] or rectal swabs and [[respiratory]] specimens (including from the [[throat]]).  Depending on the [[symptoms]] other specimen types, such as [[cerebrospinal fluid]], [[blister]] fluid, and [[blood]], can be collected for testing.
[[Non-polio enterovirus]]es can be detected in [[stool]] or rectal swabs and in specimens collected from the mouth, nose, or respiratory system.  Depending on the [[symptoms]] other specimen types, such as [[cerebrospinal fluid]], [[blister]] fluid, and [[blood]], can be collected for testing.


A positive laboratory test for non-polio enteroviruses from certain specimens, such as [[rectal]] or [[respiratory]] swab, does not necessarily mean the virus is the cause of [[infection]]. Non-polio enteroviruses can be shed for an extended period of time after the [[symptoms]] have resolved.
A positive laboratory test for non-polio enteroviruses from certain specimens, such as [[rectal]] or [[respiratory]] swab, does not necessarily mean the virus is the cause of [[infection]]. Non-polio enteroviruses can be remain present for an extended period of time after the [[symptoms]] have resolved.


==Treatment Options==
==Treatment Options==
There is no specific treatment for [[Non-Polio enterovirus infections|Non-polio enterovirus infection]]. People with mild illness caused by [[Non-Polio enterovirus infections|Non-polio enterovirus infection]] typically only need [[symptom]] treatment. They usually recover completely. However, some illnesses caused by non-polio enteroviruses, such as [[viral meningitis]], can be severe enough to require hospitalization.
There is no specific treatment for enterovirus 68 infection. People with mild illness only require treatment of their symptoms. They usually recover completely. However, more severe signs of respiratory disease require hospitalization and possibly intensive care to support and maintain breathing.


If you are concerned about your symptoms, you should contact your health care provider.
==Where to Find Medical Care for Enterovirus 68?==
[https://www.google.com/maps/search/hospitals/@33.799318,-84.328008,12z/data=!3m1!4b1 Directions to Hospitals Treating Enterovirus 68 Infection]


==What to Expect (Outlook/Prognosis)?==
==What to Expect (Outlook/Prognosis)?==
* People with mild illness caused by [[Non-Polio enterovirus infections|Non-polio enterovirus infection]] typically only need treatment of [[symptoms]].  If [[complications]] occur, patients require hospitalization.
Most persons with Enterovirus 68 infection recover fully without any long term health problems. In a minority of patients, particularly children, the virus may lead to a severe infection of the lungs (pneumonia) requiring hospitalization, and very rarely leading to death.
* People who develop [[myocarditis]] may have [[heart failure]] and require long term care. Some people who develop [[encephalitis]] or [[paralysis]] may not fully recover.
* Newborns infected with [[Non-Polio enterovirus infections|non-polio enterovirus]] may develop [[sepsis]] ([[infection]] of the [[blood]] and other organs). But this is very rare.
* [[Non-Polio enterovirus infections|Non-polio enterovirus infections]] may play a role in the development of [[type 1 diabetes]] in children.


===Pregnant Women===
===Pregnant Women===
Most pregnant women will likely be exposed to someone who is infected, especially in the summer and fall. Pregnant women have a greater chance of being infected if they do not have [[immunity]] (protection) from previous exposures to non-polio enteroviruses. However, most pregnant women who become infected will not get sick, or they will only have mild illness.
Most pregnant women will likely be exposed to someone who is infected, especially in the summer and fall. Pregnant women have a greater chance of being infected if they do not have [[immunity]] (protection) from previous exposures to non-polio enteroviruses. The effects of Enterovirus 68 in pregnant women are not clear due to the rare occurrence of this disease. Currently, there is no evidence that pregnant women with enterovirus 68 infection will have severe [[complications]], like [[miscarriage]], [[stillbirth]], or [[congenital defects]].
 
Currently, there is no clear evidence that pregnant women with [[Non-Polio enterovirus infections|Non-polio enterovirus infections]] will have severe [[complications]], like [[miscarriage]], [[stillbirth]], or [[congenital defects]].  If a pregnant woman is infected shortly before delivery, she can pass the virus to her baby. These babies usually have only mild illness. In rare cases, they may have severe [[infection]].


==Possible Complications==
==Possible Complications==
Some people can get very sick and have infection of their heart or brain or even become paralyzed. Infants and people with weakened [[immune system]]s have a greater chance of having these [[complications]].
The virus may rarely lead to a severe infection of the lungs (pneumonia) requiring hospitalization.


==Prevention==
==Prevention==
There is no [[vaccine]] to protect you from [[Non-Polio enterovirus infections|Non-polio enterovirus infection]].
Currently, there is no [[vaccine]] to protect from Enterovirus 68. The only means of prevention are:
 
* Washing your hands often with soap and water, especially after using the toilet, changing diapers, or being on contact with sick individuals
Since many infected people do not have [[symptoms]], it is difficult to prevent non-polio enteroviruses from spreading.
 
You can help protect yourself and others from non-polio enterovirus infections by:
* Washing your hands often with soap and water, especially after using the toilet and changing diapers
* Avoiding close contact, such as touching and shaking hands, with people who are sick
* Avoiding close contact, such as touching and shaking hands, with people who are sick
* Cleaning and disinfecting frequently touched surfaces
* Cleaning and disinfecting frequently touched surfaces

Revision as of 21:11, 8 September 2014

For the WikiDoc page for this topic, click here.

Enterovirus 68

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

When to seek urgent medical care?

Diagnosis

Treatment options

Where to find medical care for Enterovirus 68?

What to expect (Outlook/Prognosis)?

Possible complications

Prevention

Enterovirus 68 On the Web

Ongoing Trials at Clinical Trials.gov

Images of Enterovirus 68

Videos on Enterovirus 68

FDA on Enterovirus 68

CDC on Enterovirus 68

Enterovirus 68 in the news

Blogs on Enterovirus 68

Directions to Hospitals Treating Enterovirus 68

Risk calculators and risk factors for Enterovirus 68

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2] Alejandro Lemor, M.D. [3]

Overview

Enterovirus 68, or HEV-D68 is a non-polio enterovirus. Non-polio enteroviruses are very common viruses, causing about 10 to 15 million infections in the United States each year. Most people who get infected with non-polio enteroviruses do not get sick. Those who do have symptoms similar to a common cold. Rarely, a person may develop infection of the heart or its surrounding sac, infection of the brain, or paralysis. Transmission may occur through close contact with an infected person and by touching objects or surfaces contaminated with the virus. In the United States, people are more likely to get infected with non-polio enteroviruses in the summer and fall. People at highest risk are infants, children, and teenagers. The virus may be detected in stools or rectal swabs and in specimens collected from the mouth, nose, or respiratory system. There is no specific treatment for Non-polio enterovirus infection. People with mild illness caused by non-polio enterovirus infection only need treatment of symptoms. If complications occur, patients require hospitalization. There is no vaccine to protect against non-polio enterovirus infection. Preventive measures to avoid infection include: washing hands often with soap and water; avoid close contact with people who are sick; and cleaning and disinfecting frequently touched surfaces.

What are the Symptoms of Enterovirus 68?

  • The disease may be more severe in younger children and require hospitalization. Children may have:
  • Difficulty breathing
  • Wheezing
  • Convulsions due to high fever

What are the Causes of Enterovirus 68?

Enterovirus 68, or HEV-D68, is the organism responsible for Enterovirus 68 infection.


Transmission

Non-polio enteroviruses can be passed from a person's body into the environment in the stools for several weeks or longer after you have been infected.

  • The virus can be transmitted by droplets released from the respiratory tract when an infected person sneezes of coughs. This form of transmission may last for 1 to 3 weeks.
  • Other bodily fluids that may contain the virus include saliva, nasal mucus, sputum, and blister fluid (in those with rash)
  • Infected people can transmit the virus even if they don't have symptoms


You can get exposed to the virus by:

  • Having close contact with infected persons, such as touching or shaking hands
  • Touching objects or surfaces that have the virus on them
  • Changing diapers of an infected child
  • Drinking water that has the virus in it

If you touch your eyes, nose, or mouth with contaminated hands, you can get infected with the virus. It is very important to practice good hand hygiene around people with enterovirus 68 infection.

Who is at Highest Risk?

Anyone can get infected with non-polio enteroviruses. But infants, children, and teenagers are more likely to get infected and become sick. Younger children can get very sick and require hospitalization following enterovirus 68 infection.

When to Seek Urgent Medical Care?

If you are concerned about your symptoms or those of a family member, you should consider seeking medical care. Symptoms of severe respiratory disease such as difficulty breathing, wheezing, severe cough, and very high fever should be investigated by your health care provider.

Diagnosis

Infection with non-polio enteroviruses such as Enterovirus 68 can be confirmed by identifying the virus by a DNA test known as the polymerase chain reaction or PCR assay.

Non-polio enteroviruses can be detected in stool or rectal swabs and in specimens collected from the mouth, nose, or respiratory system. Depending on the symptoms other specimen types, such as cerebrospinal fluid, blister fluid, and blood, can be collected for testing.

A positive laboratory test for non-polio enteroviruses from certain specimens, such as rectal or respiratory swab, does not necessarily mean the virus is the cause of infection. Non-polio enteroviruses can be remain present for an extended period of time after the symptoms have resolved.

Treatment Options

There is no specific treatment for enterovirus 68 infection. People with mild illness only require treatment of their symptoms. They usually recover completely. However, more severe signs of respiratory disease require hospitalization and possibly intensive care to support and maintain breathing.

Where to Find Medical Care for Enterovirus 68?

Directions to Hospitals Treating Enterovirus 68 Infection

What to Expect (Outlook/Prognosis)?

Most persons with Enterovirus 68 infection recover fully without any long term health problems. In a minority of patients, particularly children, the virus may lead to a severe infection of the lungs (pneumonia) requiring hospitalization, and very rarely leading to death.

Pregnant Women

Most pregnant women will likely be exposed to someone who is infected, especially in the summer and fall. Pregnant women have a greater chance of being infected if they do not have immunity (protection) from previous exposures to non-polio enteroviruses. The effects of Enterovirus 68 in pregnant women are not clear due to the rare occurrence of this disease. Currently, there is no evidence that pregnant women with enterovirus 68 infection will have severe complications, like miscarriage, stillbirth, or congenital defects.

Possible Complications

The virus may rarely lead to a severe infection of the lungs (pneumonia) requiring hospitalization.

Prevention

Currently, there is no vaccine to protect from Enterovirus 68. The only means of prevention are:

  • Washing your hands often with soap and water, especially after using the toilet, changing diapers, or being on contact with sick individuals
  • Avoiding close contact, such as touching and shaking hands, with people who are sick
  • Cleaning and disinfecting frequently touched surfaces

Mothers who are breastfeeding should talk with their doctor if they are sick or think they may have an infection.

Sources

Medline Plus

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