There is a new virus in town. It might not be your specific town right now, but it certainly could be arriving soon.
It is a member of a group of viruses well known to doctors and patients alike. The Godfather of the group is poliovirus, an intestinal infection with the bad manners to sometimes leave you paralyzed. Jonas Salk put a stop to that nonsense, though it unfortunately still exists in several developing countries.
Another member of the group causes hand, foot and mouth disease, which sounds much worse than it is. The remaining enteroviruses are a frequent cause of upper respiratory infections, conjunctivitis and other miserable but unexciting minor illnesses.
The new guy is Enterovirus 68, whom we have known about for a while, but has not distinguished itself as the cause of any significant mayhem – at least until now. In early September, 12 states had reported suspected outbreaks of Enterovirus 68 and it’s expected to spread nationwide.
Enterovirus68 is not the next Ebola, but it can give you a heck of a chest infection – the chest cold from hell, so to speak. Being a virus, we don’t have great specific medications against it, but never fear; nobody does supportive care like we do supportive care.
What exactly is supportive care anyway? Think of it as the ultimate babysitter, ever watchful and vigilant, intervening at the least sign of trouble. If oxygen gets a little low, we’ll hook some up for you. Breathing too much work? We can do that for you as well.
The point is to keep you going long enough to make some antibodies and kill this stupid virus. You will ultimately heal yourself; we just need to buy you some time, hence “supportive care.”
How do you get Enterovirus 68? This is not a fly-through-the-air virus. This is a forgot-to-wash-your-hand-before-eating virus. There is a medical term for this, which is descriptive, in that mater-of-fact way gross medical things often are: fecal-oral transmission.
It arrives like sudden enlightenment – so “that’s why Mom made such a big deal of washing hands before dinner!” Mom grew up with (or heard about) polio, and washing your hands before eating could be a life or death decision. She remembers and wants you to as well.
Enterovirus 68 is getting a lot of attention simply because it is new. In the vast majority of patients that catch it, it’s simply a bad cold and medical care is pretty optional.
However, for the few that have other respiratory or immunological diseases, Enterovirus 68 is a threat. For someone with asthma, this virus, like many respiratory viruses, can get serious enough to land you in the hospital, even on a ventilator.
Most people with asthma and other chronic respiratory problems are very attentive to signs of a worsening chest infection.
Of the bugs in the news today, Enterovirus 68 is relatively well behaved, and you will get over it. We don’t have a vaccine yet; that development is probably a few years away.
In the meantime, I would remind you that Mom’s advice was usually sound – extra hand washing never hurt anyone!
Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.
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