Confirmed Case of Enterovirus D68 in Los Angeles County

LOS ANGELES – The Department of Public Health has confirmed one case of enterovirus D68 (EV-D68) in Los Angeles County. The patient is a child who became ill in late August with a respiratory infection. The patient then developed acute limb weakness, which can be a symptom of EV-D68. To date, one EV-D68 infection has been documented for this year in Los Angeles County (excluding the Cities of Pasadena and Long Beach).

“It is important to note that while enteroviruses are very common, especially among children, most cases of enterovirus will not lead to serious illness,” said Jeffrey Gunzenhauser, MD, MPH, Los Angeles County Interim Health Officer. “Acute limb weakness and other neurological symptoms are uncommon with any enterovirus, including EV-D68. The best way to prevent the spread of this illness is through simple hand washing, and other basic hygiene. We recommend that all residents, especially children, wash their hands frequently with soap and water; avoid touching their face with their hands; and stay home when sick.”

A cluster of EV-D68 was first reported by the Centers for Disease Control and Prevention (CDC) earlier this year, and, as of September 29, has been detected in 443 cases across 40 states, including California. While enteroviruses seldom are tested to identify the specific virus that is causing illness, interest in this specific subtype has led to increased testing. This virus is not new and this subtype has been known to cause outbreaks in the past. Doctors are not required to report cases of enteroviruses to health departments, so historical information on this subtype is not known. Currently, reports of EV-D68 have primarily identified individuals who have illness that is toward the more severe end of the illness spectrum, such as hospitalizations or acute limb weakness.

Symptoms and Treatment
This virus usually occurs more frequently in late summer and fall. Symptoms of EV-D68 are generally mild and include runny nose, sneezing, coughing, and body and muscle aches. Some people may also have fever. Neurological disease, including viral meningitis and limb weakness, can occur in more severe cases.

Children with a history of asthma or wheezing are more likely to develop serious respiratory illness. There is no specific vaccine or treatment for people with respiratory illness caused by EV-D68. Signs of mild respiratory illness may be relieved with over-the-counter medicine for pain and fever. Children should not be given aspirin. Immediate medical attention should be sought for anyone having any difficulty breathing, like wheezing, difficulty speaking or eating, belly pulling in with breaths, or blueness around the lips, especially if the person has asthma or a history of wheezing.

Prevention
EV-D68 spreads from person-to-person when an infected person coughs, sneezes, or touches contaminated surfaces. Infants, children, and teenagers are most likely to get infected with enteroviruses and become ill because they do not yet have immunity from previous exposures to these viruses.

To help prevent the spread of illness:

• Wash hands often with soap and water for 20 seconds. Alcohol-based hand sanitizers are not effective against EV- D68.

• Avoid touching eyes, nose and mouth with unwashed hands.

• Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick.

• Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.

• Stay home if you are sick.

As for any infection, children and adults with fever, cough, wheezing, or difficulty breathing should see their usual health care provider.

For more information about enterovirus D68 and other respiratory illnesses, visit the Public Health website at www.publichealth.lacounty.gov. You may also visit the CDC website at http://www.cdc.gov/non-polio- enterovirus/about/EV-D68.html.

The Department of Public Health is committed to protecting and improving the health of the nearly 10 million residents of Los Angeles County. Through a variety of programs, community partnerships and services, Public Health oversees environmental health, disease control, and community and family health. Public Health comprises nearly 4,000 employees and has an annual budget exceeding $900 million. To learn more about Public Health and the work we do please visit http://www.publichealth.lacounty.gov, visit our YouTube channel at http://www.youtube.com/lapublichealth, find us on Facebook at http://www.facebook.com/lapublichealth, or follow us on Twitter: @LAPublicHealth.

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