Health alert warning

WASHINGTON — Health care providers nationwide have been told to watch for an increase in a respiratory illness among children after the outbreak of a rare and sometimes serious virus strain that has hospitalized dozens of youngsters in Chicago and Kansas City, Mo.

The U.S. Centers for Disease Control and Prevention is conducting tests to determine whether active clusters of enterovirus D68 are present in about 10 other states.

"We believe the unusual increases in Kansas City and Chicago may be occurring elsewhere over the weeks ahead and we want people to be on the lookout," Dr. Anne Schuchat, the director of the CDC's National Center for Immunization and Respiratory Diseases, said in a conference call.

Although 10 million to 15 million Americans contract at least one of more than 100 types of enteroviruses each year, most patients have only mild symptoms, such as upper respiratory problems or rashes with fever that don't require hospitalization.

The D68 strain of enterovirus is much less common than other types, but it's more likely to cause severe respiratory problems, such as wheezing and difficulty breathing, that can require mechanical ventilation in extreme cases.

Children's Mercy Hospital in Kansas City treated more than 300 cases of respiratory illness over the summer, including roughly 45 patients who were placed in the intensive care unit, according to the Missouri Department of Health and Senior Services.

Subsequent testing of 22 Children's Mercy patient specimens by the CDC found that 19 of those patients had EV-D68. The 19 patients ranged in age from 6 weeks to 16 years. Thirteen had histories of asthma or wheezing, five had high fevers and four required mechanical ventilation to help them breathe.

Similar CDC tests showed positive results for the virus in 11 of 14 youngsters from the University of Chicago Medicine Comer Children's Hospital.

No fatalities or adult cases have been reported.

Beside Missouri and Illinois, the CDC is investigating suspected cases of EV-D68 in Alabama, Colorado, Georgia, Iowa, Kansas, Kentucky, Michigan, Ohio, Oklahoma and Utah.

First discovered in 1962, the virus spreads through respiratory secretions such as saliva and mucous during coughing and sneezing. Touching infected surfaces and then touching the face, eyes and mouth can also spread the disease.

Although infants, children and teens are more likely to become sick upon infection, it's unclear which populations are most vulnerable, which states are most at risk and how widespread the virus may be.

"The situation is evolving quickly," Schuchat said.

Authorities aren't certain why the unusual virus strain emerged this year, although summer is the prime season for enteroviruses to spread. Schuchat is urging people to wash their hands for at least 20 seconds with soapy water and to disinfect toys, doorknobs and other surfaces that might harbor the virus.

Health officials in Missouri are asking health professionals to tell their patients to avoid kissing, hugging and sharing cups or eating utensils with sick people and to stay home when they feel sick. While there is no vaccine, Schuchat said the annual flu shot could help prevent infections that would make children vulnerable.

Because respiratory viruses spread quickly across the country, health care personnel are urged to report unexplained increases to local and state health agencies. Unique patterns of respiratory illnesses involving certain age groups of children should also be reported.

"We really do think that clinicians throughout the country need to be on the alert for increases in severe respiratory illness and consider this in their differential diagnosis," Schuchat said.