So to take some of the scare…or maybe put some back in…Let’s give a quick break down on EV68 and give some information on Enteroviruses in general…as they seem to cross barriers and have similar symptoms.
Enterovirus 68 was first isolated in California in 1962 from four children. Since this time reports of EV68 isolation has become very uncommon. Between 1989 and 2003 around 12 additional EV68 clinical isolates were identified. (We’ll move into the present in just a moment)
Current enterovirus classification takes into account molecular as well as antigenic and biological properties of the viruses, resulting in five human enterovirus species: Poliovirus, Human enterovirus A (HEV-A), HEV-B, HEV-C and HEV-D.
EV68 and EV70 are the only known members of HEV-D (so far) EV70 was isolated in 1971 as one of 2 enteroviruses associated with Pandemic Acute Hemorrhagic Conjunctivitis…(AHC)
AHC is characterized by conjunctival congestion, vascular dilatation, and onset of edema. Viral infections usually elicit a mononuclear cell response. In AHC, a prominent hemorrhagic component soon appears that is characteristic of this infection.
Conjunctival: the mucous membrane that lines the eyelids and is reflected onto the eyeball
Vascular dilation: Vascular means pertaining to the blood vessels, and dilation: expansion of an organ, orifice, or vessel.
Edema: A local or generalized condition in which the body tissues contain an excessive amount of tissue fluid.
An epidemic of 200,000 people was reported in Brazil in 2006.
Unfortunately human enteroviral infection is recognized as a major cause of aseptic meningitis in children. Which is an illness characterized by serous inflammation of the lining of the brain.
Back to EV68 has not been a “big-one” 4 in California in 1962, 9 in 1970, 1 in 1987, 2 in 1994, 2 in 1997 and only 1, each year from 2000-2003. ….BUT: We must remember that antigenic typing reagents are not widely available for EV68…so it could be that they were just undiagnosed.
Also..moving forward in time, I found that in February of this year 2014, Five children in California were struck with polio-like illness: 2 of which tested positive for EV-68. It is a rare virus that has sometimes been linked to polio-like symptoms, but no cause was found in the other three. Which makes one question: do entroviruses mimic each other, and to what extent?
It should also be noted: In the past decade, newly identified strains of enterovirus have been linked to polio-like outbreaks among children in Asia and Australia. These five new cases highlight the possibility of an emerging infectious polio-like syndrome in California…MD Keith Haren.
**Despite treatment, the children’s symptoms did not improve, and they still had poor limb function after 6 months.
For more information on research see: Enterovirus 68 among children with severe acute respiratory infection, the Philippines. Emerging Infectious Diseases, 2011;17(8):1430-5.
What is an enterovirus?
Enterovirus. A group of viruses that originally included poliovirus, coxsackie virus, and ECHO virus, which infected the human gastrointestinal tract. Enteroviruses are now classified as a genus of picornaviruses (Pic-corn-a-virus).
Picornavirus: Any of a group of very small ether resistant viruses that includes enteroviruses and rhinoviruses.
Enterovirus has been around since 1960. We get 10 to 15 million cases of enterovirus per year….Which is normally in the bowl, but this is in the respiratory system.
Kids with asthma can get very sick as well as immune comprised kids.
What worries me is that: According to the CDC about 1 in 12 people have Asthma and the numbers are increasing every year. From 2001 to 2009 asthma rates rose (manly among African American children) by almost 50%.
What is also a bit concerning is that studies have found that certain enteroviruses can be persistent and have the ability to trigger dormant viruses to reactivate, such as HHV6, Epstein Barr Virus, CMV, and chickenpox: all herpes viruses.
"An enterovirus can be repeatedly recovered from the CSF (cerebrospinal fluid) over a period of months to years. Enterovirus have been recovered from many other sites in these patients, including brain, lung, liver, spleen, kidney, myocardium, pericardinal fluid, skeletal muscle, and bone marrow." -- McKinney, RE Jr., Katz, SL, Wilfert, CM. Chronic Enteroviral Meningoencephalitis in Agammaglobulinemic Patients, Rev Infect Dis 1987; 9:33-4.
Symptoms Commonly Seen for Persistent NonPolio Enteroviral Infections (By Dr. John Chia)
- • Respiratory and/or gastrointestinal symptoms or just flu-like symptoms (fevers, body ache, headache etc.). Few virus infections present with both respiratory and GI symptoms.
- • Upper respiratory tract symptoms such as runny and stuffy nose, sinus congestion and pain, sore throat, ear pain, difficulty in swallowing, loss of smell or taste.
- • Upper and lower gastrointestinal symptoms such as nausea, indigestion, reflux, abdominal bloating, upper and lower abdominal pain, cramps, constipation alternating with diarrhea.
- • Sudden weight loss due to significant stomach problem or decreased caloric intake, or weight gain due to inactivity.
- • Numbness in the limbs, muscle twitching and spasms. Some experience facial tingling and numbness.
- • Many types of headaches.
- • Bone, muscle, and/or joint pain. Foot pain is quite common.
- • Chest pain, palpitations and tightness
- • Cough, shortness of breath, wheezing
- • Low blood pressure
- • Heart arrhythmia (irregular heartbeat) or tachycardia (rapid heartbeat)
- • Intermittent low grade fever, chills and night sweats.
- • Reproductive irregularities and pain.
- • Prostate issues and pelvic pain.
- • Blurred vision.
- • Herpangina (blisters or ulcers over the roof of the mouth). Ulcers may form in the mouth, throat and for females the vaginal/cervix area.
- • Recurring yeast or bacterial infections due to a weak immune system.
- • Adrenal surge or dysfunction. High cortisol levels or low cortisol levels.
- • Psychological problems, anxiety, or depression.
- • Mental fatigue when trying to concentrate on tasks. Cognitive issues are very common as are short-term memory problems.
- • Sleep disturbance.
- • Seizures are rare but do occur.
- • Vitamin and mineral deficiencies. Many become anemic.
- • Swollen Lymph nodes in the neck and in the armpits
- • Rash
- • Organs that can be affected by enteroviruses: heart, pancreas, lungs, liver, spleen, colon, ovaries, testicles, epididymis, thyroid, muscles, skin and the central nervous system.
Okay, not scare anyone, because we cannot live in fear. This is mainly for educational purposes and so that we might watch and follow an emerging disease (Let’s hope it does not balloon out, but it did start with the start of a new school year, and schools, with their small rooms filled with little creatures that don’t follow the best hygiene rules, are kind of a breeding ground)
We know it started small over 40 years ago…and now it seems to be growing….
What I want to know is why now? What has changed?
That’s all I have for you on EV68 I will be watching this one closely as it effects children. In the meantime, do not be frightened, but be very mindful of what your child is eating, close contacts, and hygiene.
A side NOTE: Can this enteroviral infection trigger dormant viruses that were given Via Vaccine? (As in, even if I never had chickenpox, and caught an enterovirus, and was vaccinated for chickenpox…could this cause me to have chickenpox?)
A possible answer: Herpes zoster complicated by meningitis has been mainly reported in immunocompromised patients after reactivation of wild-type varicella-zoster virus. We present one of the first cases of aseptic meningitis after herpes zoster caused by reactivation of vaccine-type varicella-zoster virus in an immunocompetent child. We also highlight the increasing role of both wild-type and vaccine strains of varicella-zoster virus as a cause of viral meningoencephalitis and the use of appropriate laboratory tools to rapidly and accurately identify the virus in order to provide prompt patient care and management.
Please see: http://www.polkmoms.com/forum/topics/are-vaccines-causing-mutations-creating-a-similar-problem-as