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A dozen cases of Enterovirus D68 confirmed in Minnesota

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Officials at the Minnesota Department of Health and the University of Minnesota Hospital have confirmed 12 cases of Enterovirus D68 in the state, MPR News reports.

The Health Department announced Wednesday afternoon that it had identified one child with the virus. Later in the day, officials at the university said they had confirmed the virus in another 11 patients at theUniversity of Minnesota Children’s Hospital.

The respiratory illness, which primarily affects children and can produce symptoms of a very intense cold, and in some cases breathing difficulty, has been the focus of extra scrutiny nationwide as it has surfaced in clusters in a number of states in recent weeks – in higher numbers than previously seen.

The U.S. Centers for Disease Control and Prevention has been working with officials in a number of states to monitor the outbreaks.

From mid-August to Sept. 17, 2014, a total of 140 people in 16 states have been confirmed to have respiratory illness caused by EV-D68, the CDC says, although the new Minnesota case is not yet reflected in that total.

So far, the virus strain has not been blamed for any U.S. deaths.

The University of Minnesota didn't release any other information about the 11 patients it is treating for the virus.

The case confirmed by the state Health Department was a child hospitalized with acute respiratory symptoms, although the child has since been released from a Twin Cities hospital, state health officials announced Wednesday. The child is now recovering at home, they said.

More from the health department statement:

The MDH Public Health Laboratory confirmed the case Tuesday night in a specimen submitted by a hospital participating in Minnesota’s severe acute respiratory infections surveillance system. EV-D68 is the same strain of enterovirus that has been associated with recent increases in severe respiratory illnesses in children in a number of states and Canada. Often, but not always, these children have a history of asthma.

Over the past two weeks, through multiple surveillance systems, MDH has detected other types of enteroviruses, and other respiratory viruses including rhinovirus, adenovirus and respiratory syncytial virus (RSV).

State health officials have suspected that Enterovirus D68 has been circulating in Minnesota, and they have suspected that it was to blame for recent increases in child admissions for severe respiratory illnesses in several Minnesota hospitals.

“This highlights the importance of having a surveillance system in place which can provide information on which respiratory viruses are circulating in the state and help us understand the burden caused by a particular virus,” State Epidemiologist Dr. Ruth Lynfield said.

Background: Enteroviruses

Generally speaking, enteroviruses – there are more than 100 different types of them – are quite common, and many people who get infected do not get sick. Those who do – infants, children and teens are most likely to feel ill – typically get symptoms of a bad cold, which usually run their course.

Some people, however, particularly infants and people with weakened immune systems, are at risk of the virus worsening into heart or brain infections, and paralysis is possible, according to the CDC.

Enteroviruses tend to have a summer/fall season that often peaks in September, and can be easily spread when you have close contact with an infected person. You can also become infected by touching objects or surfaces that have the virus on them then touching your mouth, nose or eyes, the CDC says.

Enterovirus D68

Enteroviruses cause up to 10 million to 15 million U.S. infections each year, health officials say, but the specific focus of concern in recent days – Enterovirus D68 – has been rare.

What has worried health officials most recently was a sudden spike in hospitalizations, initially in the Kansas City and Chicago areas, which reported clusters of cases in August.

Earlier this month, Dr. Anne Schuchat at the CDC said it was too early to tell how fast or far Enterovirus D68 might spread. She stressed that none of the cases of Enterovirus D68 so far this year have been fatal, nor did any result in paralysis, as far as the CDC knows.

There are no current data about the number of Enterovirus D68-related deaths in the U.S. in previous years, the Missouri health department noted in an Aug. 29 health alert about the latest outbreak in Kansas City.

No specific treatment

Health officials say that there are no vaccines specifically formulated to prevent Enterovirus D68, or antiviral drugs to treat it. Nor is there a specific treatment regimen for Enterovirus D68. Patients at Children's Mercy Children’s were receiving asthma medications, oxygen and intravenous fluids as needed, the Kansas City Star reported.

Schuchat stressed that one warning sign parents should look for in their children is difficulty breathing, which should prompt parents to seek immediate medical attention.

“It seems to produce illness with a more severe component (such as) difficulty breathing,” Dr. William Schaffner, an infectious diseases expert at Vanderbilt University, told NBC News. “But the vast majority of these kids will get better.”

Enterovirus D68 was first isolated in California in 1962, and clusters have been reported on very rare occasions since that time – just 79 cases were reported from 2009–2013, the CDC says in a new report.

There's not a lot people can do to keep Enterovirus D68 at bay beyond commonsense measures, health officials say: wash hands often with soap and water; avoid touching eyes, nose, and mouth with unwashed hands; avoid contact with the sick; and stay home if you are feeling ill.

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