I am worried about the Respiratory Virus that I keep hearing
about in the news. My son is three years
old and had a couple of bouts of wheezing, but my Pediatrician said he did not
have Asthma. I heard children are dying
from this Respiratory Virus and I am worried about my son. Is there anything that I can do to prevent him
from catching it? I heard that it is only a problem if your
child has Asthma. Since my son doesn’t
have Asthma does that mean he won’t catch it?
“Worried about the Respiratory Virus”
The Respiratory virus that has been causing children to
become ill in the Midwest is due to Enterovirus
D68. Enteroviruses are very common and
typically affect children during the summer and fall months. Enteroviruses have been circulating in the
community for a very long time. Poliovirus,
Coxsackie Virus and Echoviruses are all examples of viruses in this category. This
particular Enterovirus D68 was first identified in California in 1962. There has been an increased number of children
needing hospitalization due to severe respiratory symptoms caused by this
virus. According to the CDC, there have
been 538 cases in people in 43 states and the District of Columbia (1). Enterovirus D68 has been detected in
specimens from four patients who died (1).
The virus can be found in an infected person’s respiratory
secretions including nasal discharge, respiratory droplets from coughing or
sneezing, saliva, or sputum. Since the
germs are spread through respiratory secretions it is important to cover mouths
during coughing and sneezing and to dispose soiled tissues properly. The virus may also spread from person to
person from surfaces touched by an infected person. These surfaces may include toys, counter tops,
doorknobs, desks, or hand held electronic devices.
Measures to take in order to help reduce the spread of
infection include limiting contact with other children who are ill. Do not let your child share toys, drinks or
food with other children, especially if they have symptoms of a cold or virus. Avoid hugging or kissing people who show signs
of illness. Eliminating practices that
promote hand mouth activity, such as using a pacifier can also help avoid the
spread of germs. Caretakers should
exercise caution and maintain good hand washing and proper disposal of contaminated
items (such as dirty tissues) to help decrease the spread of infection. It is also important to clean and disinfect surfaces,
especially in child play areas, including the toys in order to reduce the
spread of infection.
Yes, it is true that children infected with Enterovirus D68 who also have Asthma or a history of wheezing tend to suffer from more severe symptoms. I understand your concern since your child has a history of wheezing.
Even if he is not officially diagnosed with Asthma, he is still at
risk because he has a history of recurrent wheezing. But there are some measures that you can
take to protect him. First of all, it is
important to follow your doctor’s direction regarding treatment for his wheezing.
Some children have medication on hand to use as needed for
episodes of wheezing. Medication to
relieve acute symptoms include Albuterol, ProAir Ventolin or Xopenex. These medications are bronchodilators and
work by opening up the bronchial tubes and promoting the clearance of mucus and
secretions from the airways. Inhaled
steroids are another category of medication that is used in children to treat Asthma and wheezing. This type of
medication addresses the inflammation that is present in the airways of children
with Asthma. Examples of this type of
medication include Flovent , Qvar and Pulmicort.
If your doctor has prescribed these medications it is
important to use them as directed.
Questions you should ask your doctor include; when should I give the
medication, how often do I give it, and for how long. It is also important to make sure the
medications that you have on hand are not expired and the equipment is in good
working order, especially if you have a nebulizer or spacer device. Make sure you
keep the follow appointments as prescribed by your doctor. It is a good idea to take a pen and paper to
the doctor’s visit and write down instructions regarding medication
administration, follow up appointments and any questions that you may have. The most important thing to do is trust your
instinct. If your child does not appear
well, seems to be having difficulty breathing, turns grayish, pale or blue,
you should seek medical attention immediately.
Be assured that the health departments, doctors and nurses
are monitoring the situation and will communicate outbreaks. In some cases there may be recommendations to
avoid large crowds or to stay home from school or daycare. It is important that parents and caregivers
follow the direction from the public health department and health care
professionals. The instructions may be
inconvenient, but the goal is to ensure the spread of infection. It is essential that children with signs of
illness stay home from daycare and school during their illness. In particular, children should stay home from
school and daycare until they are fever free for 24 hours, without the use of
fever reducing medication.
I wish you the best.
Lisa-ann Kelly R.N., P.N.P.,C.
Certified Pediatric Nurse Practitioner
References