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Many urgent situations are not really emergencies. "Urgent" means something you think shouldn't wait until morning or until our next office hours to be seen, or something you need advice about right away, but which does not seem immediately threatening to life or limb. Urgent situations are far more common than emergencies in childhood.

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September 2014

Enterovirus Alert Fall 2014


As many of you are aware, there is a new strain of Enterovirus (EV-68) circulating in the United States this fall. It started in the midwest but as of this past week, there have now been documented cases in New York and Massachusetts. At baseline, Enterovirus can cause a wide variety of symptoms including common cold symptoms, trouble breathing, vomiting, diarrhea, and rash (among others). This particular strain appears to cause acute onset trouble breathing without much runny nose or fever, and without the other symptoms. It is particularly dangerous for children and adults with a known diagnosis of asthma.


Unfortunately, there is no antiviral medication currently available to treat enterovirus, and antibiotics have no effect on viral infections. MOST people will have a mild and short-lived viral infection with cough. However, children with asthma and other lung abnormalities are at risk for severe respiratory distress requiring hospitalization and even intensive supportive care.


Testing for this particular strain of enterovirus is not currently widely available, and is not helpful in the acute diagnosis and management of this disease. If needed, testing will be performed in the hospital setting, and is more helpful to track the spread of the disease, rather that changing what we do to treat an individual patient.


The real question is what can we do to prevent spread of the infection and to limit symptom severity. We know that Purel and other alcohol-based hand-cleansing solutions are NOT effective against EV-68! Good old soap and water is the best way to keep hands clean in this case. The CDC gives the following advice for patients, parents, and caretakers:


* Wash hands often with soap and water for 20 seconds, especially after changing diapers

* Avoid touching eyes, nose and mouth with unwashed hands

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

* Disinfect



For asthmatics, it is extremely important that you keep a very close eye on your symptoms and breathing. If you are typically prescribed a "controller" or "prevention" medication like Flovent, Qvar, Pulmicort, or Singulair in the fall and winter months, please START taking it NOW. If you are unsure of your fall Asthma Plan instructions, or controller medications, please contact your primary provider at CMO right away.


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