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Enterovirus EV-D68 Spreading in Alabama

By Brandon Moseley
Alabama Political Reporter

The Alabama Department of Public Health has confirmed that a two year old in Pell City is the ninth Alabama resident who has tested positive for the respiratory enterovirus, EV-D68. The ADPH said that they are continuing to investigate clusters of respiratory illness in children, and one additional case not reported previously has been confirmed.

As of Sept. 30, 40 patients have been evaluated as part of this ongoing investigation, 21 have met criteria for testing and results have been received on 9 of these. Five results received were positive for EV-D68, 1 was positive for rhinovirus, 1 was positive for coxsackie virus B3, and 2 results were negative.

The ADPH said in a statement that it is not counting potential cases on an individual basis, so it is unknown how many people in Alabama have been infected with enterovirus D68, nor does the Centers for Disease Control and Prevention have a total count of cases in the U.S. ADPH is however counting the number of tests submitted by the Bureau of Clinical Laboratories to CDC for testing and is tracking results.

Assistant State Health Officer Dr. Mary McIntyre said, “We have also been informed of a few potential cases of unknown neurological illness in children, but this has not been confirmed at this time. These reports may or may not be associated with the increase in enterovirus respiratory illnesses being seen.”

The Alabama Department of Public Health has sent a Health Alert Network Advisory to health care providers to report whether children with acute neurologic illness of undetermined cause are being cared for in the state. The CDC has notified states of a cluster of nine pediatric patients in Colorado with acute neurologic illness of undetermined cause. These illnesses have occurred since Aug. 1 along with an increase of respiratory illnesses among children in Colorado.

In general, enteroviruses have various symptoms, including mild respiratory, fever, rash and neurologic illness. EV-D68 has more severe respiratory symptoms than typical enteroviruses. There is no vaccine; treatment depends on the symptoms, and prevention is very important.

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According to original reporting by the Daily Homes’s Zac Al-Khateeb, two year old Ryan Rutledge of Pell City was rushed to the pediatrician on September 22. The doctor then sent him to the emergency room at Children’s of Alabama hospital in Birmingham – for difficulty breathing. He had woken up that morning wheezing, and on his way to the doctor he suffered a severe coughing fit. His oxygen levels were as low as 88, they are not supposed to go below 92.

Ryan went to intensive care where he stayed for three days.

Zach Rutledge told Al-Khateeb, “When we got there and we were in the emergency room in Children’s, I think I asked the doctor about, ‘This doesn’t have anything to do with the enterovirus thing I’m hearing about,’ and she says, ‘It’s a possibility,’ But they told me they were going to take care of him and figure out what was going on.”

Ryan is recovering with one brief return to the hospital for a high fever but is still taking breathing treatments and must take a nebulizer every six to eight hours.

EV-D68 is one of more than 100 non-polio enteroviruses. It normally affects the respiratory system of infants, children and teenagers, and is most prominent during the summer and fall.

To prevent EV-D68 and all other communicable viruses like influenza the CDC recommends that people need to seek medical care if needed and follow these precautions: Wash their hands frequently; cover their cough; keep children home if ill; avoid touching eyes, nose and mouth with unwashed hands; avoid kissing, hugging, and sharing cups and eating utensils with sick people; and disinfect frequently touched surfaces, such as toys and doorknobs.

Brandon Moseley is a former reporter at the Alabama Political Reporter.

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