While Ebola might dominate the front pages of health and news publications, a different virus has had a more widespread impact in Michigan. As of Nov. 7, 90 positive cases of enterovirus D68 were reported in the state out of the 139 cases sent to the Centers for Disease Control and Prevention for testing, according to Jennifer Smith, public information officer at the Michigan Department of Community Health.

This year, the Washtenaw County Department of Public Health reported two positive cases in the county. One patient is an adult with a history of asthma and the other is seven-month-old infant. The season for EV-D68 typically ends with the onset of winter.

First discovered in California in 1962, EV-D68 is most frequently diagnosed during summer and fall, causing mostly infants, children and teenagers to suffer symptoms including respiratory infection, mouth sores, diarrhea, vomiting, cold-like symptoms and wheezing. Since adult immune systems have more exposure to various kinds of viruses, they are the least susceptible age group for enteroviruses.

This year, EV-D68 is a strain that “came through with spread that makes the kids quite sick, especially those with asthma,” said Dr. Marie Lozon, division director of pediatric emergency medicine at C.S. Mott Children’s Hospital.

Lozon said the hospital’s emergency room was full of patients fighting the virus during the peak of EV-D68 season.

“We were absolutely cramped and overwhelmed; the ICU was packed,” she said.

Lozon said her department witnessed a 20- to 30-percent increase in the number of daily patient visits as a result of EV-D68. Staff would see about 70 children in most years, but this year the hospital received a record number of visits during the few weeks when EV-D68 was the most prevalent.

“We have seen more kids than we have ever seen before,” Lozon said.

On those days, the hospital housed about 105 children per day.

The CDC is current the only institution that performs the diagnostic test for EV-D68. While waiting for test results to come back, which might take several days, staff at the University Hospital apply the same treatment for potentially positive EV-D68 patients as they would for patients with rhinovirus. Preliminary test results usually indicate patients as positive for both enterovirus and rhinovirus.

Though Lozon and her colleagues do not know if EV-D68 causes flaccid paralysis — a symptom that characterizes polio, another enterovirus-related disease — her department saw a cluster of seven patients of various ages and from different parts of Michigan admitted with flaccid paralysis of lower and upper extremities in a period of a week and a half.

As flu season approaches, this situation makes it more difficult for experts to accurately detect the cause of respiratory illness since EV-D68 and influenza share similar symptoms.

Arnold Monto, a professor of epidemiology at the University’s School of Public Health, noted the difficulty in learning about EV-D68. His team is planning on tracking individuals with mild symptoms of EV-D68, but according to Monto, it is difficult to do so because EV-D68 is a seasonal virus.

He emphasized the importance of developing a faster diagnostic test for EV-D68. Developing a faster way to detect the enterovirus similar to the way potential flu cases are tested would aid Monto and his colleagues in learning about the spread of EV-D68.

According to the CDC, there were 1,116 confirmed positively tested cases of EV-D68 from mid-August to Nov. 12, 2014, across 47 states and the District of Columbia. Twelve patients have died from EV-D68, including one in Michigan. As of Nov. 13, the CDC has removed its EV-D68-like illness activity map due to the reduction in reported cases for the virus as well as the difficulty in attributing instances of respiratory illness in the winter to EV-D68 or influenza.

Similar to recommendations designed to minimize influenza, the CDC, along with state and local governments, continues to emphasize good hand hygiene in schools and at homes as a precautionary measure. They are also advising parents to seek medical attention if their child experiences any difficulty in breathing.

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