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DEAR MAYO CLINIC: Why is it that children are the ones most affected by the enterovirus? I have read that it starts with mild cold symptoms, so how will I know when it’s time to see a doctor? What symptoms should I look for in my children?
ANSWER: There are many forms of enteroviruses. The one making headlines now is called enterovirus D68. This virus most often affects children and teens because their bodies have not built up immunity to it yet. In most cases, enterovirus D68 causes only mild symptoms. But it can become severe in some people. If your child has severe cold symptoms, or if symptoms get progressively worse, make an appointment to see your doctor. If a child has problems breathing, seek medical care right away.
Enteroviruses can cause a wide range of infections, depending on the strain of the virus that is involved. Some can be very serious, such as the enterovirus strain that leads to viral meningitis, while others tend to be only a nuisance, such as those that cause the common cold.
Enterovirus D68 is not new. It was first identified about 50 years ago. The virus is of concern because it appears to be more aggressive than most of the other enterovirus strains that result in respiratory illness. That means people who have existing medical conditions that affect their respiratory systems, particularly asthma, are at higher risk for more severe symptoms and complications as a result of enterovirus D68.
Enteroviruses are common, so most adults have been exposed to them at some point during their lives. Because these viruses tend to be mild — some do not cause symptoms at all — many people may not realize they have been affected. But that exposure allows the body’s immune system to build up protection against the virus. When those people are exposed to it again, the virus has little or no effect.
Many children and teens have not been exposed to enterovirus D68 in the past. As a result, their bodies have not had a chance to develop the immunity necessary to protect them from the illness, and they are more prone to develop symptoms.
Symptoms of enterovirus D68 are often similar to those of the common cold: cough, runny nose, sneezing, fever and muscle aches. In many people, even children and teens who are affected for the first time, the virus does not progress beyond these symptoms. In such cases, no treatment is needed, and the virus goes away on its own within a few days.
For a minority of people who get the virus, though, symptoms can become severe, and they may develop breathing difficulty. When this happens, immediate medical attention is required. Although uncommon, some patients with severe breathing problems may need to be hospitalized.
You can take steps to help keep your children from getting enteroviruses. Encourage them to wash their hands regularly with soap and water. Teach them to cover their coughs and sneezes with the inside of an arm, rather than their hands. Clean and disinfect surfaces in your house often, especially in the kitchen and bathrooms. As much as possible, keep your children away from people who are sick. If your kids start to develop symptoms, keep them home from school or child care until they feel better.
If you have questions or concerns about a child’s symptoms, contact your health care provider. He or she can help you decide on the best plan of care. And remember, if at any point a child has difficulty breathing or develops other severe symptoms, seek medical care right away. — Pritish Tosh, M.D., Infectious Diseases, Mayo Clinic, Rochester, Minn.