October 10, 2014 - SACRAMENTO - The California Department of Public Health (CDPH) continues to monitor respiratory disease activity statewide. Outpatient reports of respiratory illness are low and within normal levels for this time of year. The proportion of respiratory specimens testing positive for enterovirus/rhinovirus is 20 percent, which is also a normal level for this time of year and decreased from 25-30 percent levels in recent weeks.
As of October 9, 2014, CDPH has identified enterovirus D68 (EV-D68) infection in a total of 32 patients. The positive specimens came from the following counties: Alameda (5), Contra Costa (1), Los Angeles (4), Orange (3), Riverside (2), San Diego (8), San Francisco (3), Santa Clara (1), Santa Cruz (1), Solano (1), Ventura (1), and the cities of Long Beach (1) and Berkeley (1). All 32 patients had onset of symptoms in 2014 through late September.
Testing takes 1-2 weeks, and specimens from early October are in process. Our test results suggest that EV-D68 has been circulating widely. CDPH will continue to monitor the circulation of EV-D68 and other viruses. The purpose of CDPH’s surveillance is to monitor the presence of the virus in California. This condition is not reportable in California and CDPH does not track the actual number of persons who have suspected or confirmed EV-D68 infection in California.
EV-D68 causes respiratory illness and the virus likely spreads from person to person when an infected person coughs, sneezes, or touches contaminated surfaces. Symptoms of EV-D68 include fever (although fever may not be present), runny nose, sneezing, cough, and body and muscle aches. Some children have more serious illness with breathing difficulty and wheezing, particularly children with a history of asthma. EV-D68 can rarely cause neurologic illness.
Parents should seek medical attention immediately for children who are having any breathing difficulty (wheezing, difficulty speaking or eating, belly pulling in with breaths, blueness around the lips), particularly if the child suffers from asthma. There is no specific treatment for persons with EV-D68, nor is there a vaccine to prevent it. However, everyone six months of age and older should receive influenza vaccine every year to protect themselves against that important cause of respiratory disease.
Health care providers should consider EV-D68 as a possible cause of acute, unexplained severe respiratory illness, even if the patient does not have fever, and consider laboratory testing of respiratory specimens for enteroviruses when the cause of respiratory illness in severely ill patients is unclear. In addition, health care providers should contact their local health departments to report cases of acute flaccid paralysis with spinal cord involvement and test these patients for possible enterovirus infection.
The best way to prevent transmission of enteroviruses is to:
• 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 frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
Additional information about EV-D68 can be found on the Centers for Disease Control and Prevention’s Enterovirus D68 page.
California Department of Public Health Identifies Additional Cases of Enterovirus D68 Infection Statewide