Minnesota on alert for virus that has sickened children elsewhere

Federal health officials are asking physicians to be on alert for a potentially severe respiratory illness that has sickened children in at least two Midwestern states.

A dozen states are investigating potential clusters of respiratory illness that may be linked to an uncommon virus strain, called Enterovirus 68.

So far, the virus has not been detected in Minnesota, but the state Department of Health officials say it likely has arrived.

In August, two hospitals in Chicago and Kansas City notified the U.S. Centers for Disease Control and Prevention that they had been admitting higher than expected numbers of children suffering from severe respiratory illnesses. Some of the children were so sick they had to be treated in intensive care units, in some cases with mechanical ventilation, to help ease their breathing problems.

Laboratory samples taken from the children later revealed that many of them were infected with Enterovirus 68, a germ that can cause cold-like symptoms.

EV 68, as the virus also is known, is not a new virus strain but has been relatively uncommon in the United States, said Dr. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases.

Schuchat said the virus caught the attention of health workers in Chicago and Kansas City in part because it sickened a wide range of children, from 6 weeks of age to 16 years old.

"Usually the severe disease is in kids under two," she said. "So seeing several cases in 5-year-olds and 8-year-olds and 9-year-olds, that's an unusual presentation."

According to the CDC, well over half of the children with confirmed cases of Enterovirus 68 had a history of asthma or wheezing.

Schuchat said the agency raised the alert about the cases so doctors and nurses elsewhere in the country would be prepared for a possible surge in the number of children with severe respiratory illness. But she said it's unclear if that will happen.

At Children's Hospitals and Clinics of Minnesota, emergency department workers at the St. Paul and Minneapolis hospital campuses have been busier than usual lately treating children with respiratory problems.

"They're seeing more kids coming in with severe asthma symptoms. Most are getting admitted," said Patsy Stinchfield, infectious disease director at Children's. "Some are going to the ICU."

Children's has identified eight Enterovirus cases in the past few weeks linked to severe respiratory illnesses. But Stinchfield said the state Department of Health is still subtyping on the samples to see if any are Enterovirus 68. That process will determine if these cases are caused by the same virus that has sickened children elsewhere.

State health officials have identified a handful of EV 68 cases in each of the past few years. Dr. Aaron DeVries, a medical epidemiologist for the state Department of Health, said he would not be surprised if the virus is circulating again.

"I think it's very likely that instances of illness related to this particular strain of enterovirus have occurred in Minnesota and are occurring," he said.

If it turns out that there are more EV 68 cases than usual this year, DeVries said it might not mean that the virus has become more dangerous. Instead, that could indicate that it is just more widespread, he said.

"The more people who become ill, the more likely a chance you will have someone who will develop severe symptoms landing them in the hospital," he said.

There is no vaccine to prevent Enterovirus 68 and it cannot be treated with antibiotics. But hand washing and covering coughs can slow the spread of the virus.

Public health officials say many cases of the disease may be mild and require no treatment.