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Girl treated in Tampa is Florida's first case of enterovirus D68

 
An image of an enterovirus grouping from an electron microscope. [Centers for Disease Control and Prevention]
An image of an enterovirus grouping from an electron microscope. [Centers for Disease Control and Prevention]
Published Oct. 8, 2014

TAMPA — The Florida Department of Health confirmed Tuesday the state's first case of the contagious enterovirus D68 respiratory illness after a 10-year-old girl was treated at Tampa General Hospital last month.

"She has been treated and released here in Hills­borough, is under the care of her family physician and is doing well," said Steve Huard, spokesman for the state Health Department in Hillsborough County.

The girl was transferred to Tampa General from another hospital, which spokesman John Dunn would not name, and was a patient there six days before being released about a month ago.

Though she was treated in Tampa, she is from Polk County, Huard said. The girl's name was not released. School district spokesman Stephen Hegarty confirmed she is not a student in Hillsborough County public schools. Regardless, he said, schools here would be ready to answer questions from concerned parents about the virus and any precautions they should take.

The virus, which is transmitted in the same manner as a cold or flu, has no vaccine or antivirals, said Dr. Juan Dumois, the clinical practice director for pediatric infectious disease at All Children's Hospital Johns Hopkins Medicine. Children and teens are most susceptible to the virus, which can lead to breathing problems and possible paralysis. Symptoms include coughing, achy muscles, a runny nose and fever.

Florida becomes the 44th state to document a case of enterovirus D68, according to the Centers for Disease Control and Prevention. From mid August to Tuesday, the CDC or state public health laboratories have confirmed 628 people in 44 states and the District of Columbia with respiratory illness caused by the virus.

Almost all the confirmed cases have been among children, many of whom had asthma or a history of wheezing, the CDC reports.

A 4-year-old in New Jersey died from the virus Sept. 25. He was the country's first confirmed death linked to enterovirus D68.

But because not all cases rise to the level of hospitalization and the test for all strains of rhinovirus and enterovirus, including polio, is the same, Dumois said the number of enterovirus D68 cases is "way higher" than those that have been documented.

To confirm it is a D68 strain, hospitals have to send results of the test to the CDC in Atlanta. Because of a backlog, it takes a week or more for the hospitals to get a result, which is why many confirmations come days or weeks after a patient first contracted the disease.

"You've got hospitals from all of the states sending tests and waiting for the results, so there's a big backlog," Dumois said. "A small fraction (of children with respiratory illnesses) are going to be evaluated for enterovirus D68, so we've got to be missing a lot of them."

But that's okay, Dumois said, because doctors treat the D68 strain the same that they do other strains in the enterovirus family. It also is prevented the same way as other respiratory viruses.

Now that doctors have confirmed the Polk County girl was suffering from enterovirus D68, they can try to determine if anybody else was infected, Huard said. But, "If you're asking, 'Are we looking at an outbreak based on this one case?' at this point we're really not," he said. "It's one case. She's been treated and is doing well."

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Huard said the real message is to keep up healthy habits.

"Obviously, if you have a child that has cold symptoms and they start complaining of maybe paralysis or other associated symptoms, you want to make sure you contact your family physician and take them in immediately and have them evaluated," Huard said.

Dumois advises that people wash their hands or use alcohol-based hand sanitizers more often than they think would be necessary. He suggested people wash their hands after they touch something that somebody else might have touched and before they touch their faces. That averages to about 20 times a day, he said.

"Since we don't clean our hands routinely before touching our faces, that's how we get sick," Dumois said.

Contact Caitlin Johnston at cjohnston@tampabay.com or (813) 661-2443. Follow @cljohnst.