In a previous post, I described the differences between flu and colds. One key difference is the pathogen: "Flu is caused by the influenza virus. Colds are caused by a different set of viruses including rhinovirus (10% to 40% of colds), coronavirus (20% of colds), and respiratory syncytial virus (10% of colds)."
Enterovirus and rhinovirus are closely related; they both belong to the picornavirus family. Rhinovirus are able to divide better at slightly lower temperatures than enterovirus. As a result, winter colds are mainly caused by rhinovirus, whereas summer colds tend to be caused by enterovirus. Another important difference is that enterovirus infections predominantly affect children and teenagers, perhaps because adults have developed immunity.
Typically one expects enterovirus infections that result in mild respiratory illness i.e. colds. This recent outbreak has been unusual because of the large number of hospitalizations. In particular kids with asthma and wheezing seem to be most susceptible to severe symptoms. Nevertheless, in general compared to flu, cold viruses tend not to be as harmful:
"Flu can lead to pneumonia and bronchitis which can cause death if severe enough and not treated properly. Colds do not have these complications. In addition, flu can aggravate an existing chronic illness (such as congestive heart failure or chronic obstructive pulmonary disease). This is why flu is much more deadly (~25,000 people die each year from flu-related causes in the U.S.) than colds which seldom lead to serious health problems."
The culprit is a particular strain of enterovirus, EV-D68, that first appeared in California in 1962. Since then, it has rarely been reported in the U.S. However last year it may have been associated with two cases of a polio-like illness in California (polio virus is also a picornavirus). In general though, the symptoms are mild and disappear after a few days. From this recent outbreak, no one has died.
What are the symptoms (CNN)?
"The virus usually starts like the common cold; symptoms include sneezing, a runny nose and a cough. This is all that happens for most people who catch an enterovirus. But some patients will get a severe cough, have difficulty breathing and/or develop a rash. EV-D68 is sometimes also accompanied by a fever or wheezing."
When should you begin worrying?
"Unfortunately in the beginning it's difficult -- if not impossible -- to tell the difference between a regular cold and this type of virus. But there are symptoms you should be on the lookout for if your child becomes sick. Go to the doctor if he or she develops a fever or a rash, or if your child has difficulty breathing. Children with asthma or a history of breathing problems are particularly susceptible for severe symptoms."
You can avoid contracting EV-D68 just like you avoid the common cold by minimizing contact with affected individuals, and by washing your hands after touching surfaces that may contain the virus i.e. regularly touched objects.
A general hospital can test for enterovirus, but the specific diagnosis of EV-D68 requires sequencing of the virus DNA which only the CDC and other specialized health labs can do.
In summary, if your child catches a cold, don't panic. The symptoms are likely to go away after a few days just like any other cold. However, if you live in an area with previous EV-D68 cases, and your child has asthma or other breathing issues, then you should be vigilant for symptoms such as a severe cough, rash, or difficulty breathing. If they arise go to the hospital immediately.
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