Respiratory illness could spike with schools re-opening

There have been three confirmed B.C. cases of enterovirus D68

As interconnected as our world is today, it’s only a matter of time before a severe respiratory illness crosses borders from the U.S. and Alberta into our province, says Dr. Lee MacKay.

The bug, known as EV-D68, is an enterovirus and often the culprit behind the usual fever, runny nose and coughing of the common cold.

It’s been popping up in various communities across North America for a few weeks, but this year, D68 effects are severe enough to warrant hospitalization, especially among children with a history of asthma.

Dr. MacKay is on the frontline of care, as a general practitioner in Nelson and chair of the Kootenay Boundary Division of Family Practise.

He says the reason the province might not have experienced an enterovirus-related spike in respiratory illness at this point, is because of the B.C. teachers’ strike.

“Interestingly, the potential reason it is not spreading aggressively in B.C. right now is that the people who have been unwell enough to need hospitalization where they get specific testing for this, have generally been children.”

The virus is most likely to cause respiratory distress in the very young, the elderly or those with compromised immune systems.

“Usually with a virus like this the kids are back in school,” said MacKay.  “There’s runny noses and poor hand washing at times,” he explained. “People are coughing on each other so it tends to spread very quickly, and those who are most susceptible will get quite unwell.”

That could change when classes potentially begin next week, but MacKay said he’s already seen two people that he suspected were infected with D68 because of the severity of illness.

Public health is trying to track whether or not the enterovirus is spreading, he noted, adding that cases are confirmed through a nasopharyngeal swab – and he had one more patient to add to that list on Tuesday.

The middle-aged person had been otherwise healthy but presented with a severity of symptoms that alerted the doctor.

“He’d been at a conference with some folks from the U.S., Russia and a few other countries,” noted MacKay. “I was just a little worried because (the patient) was much more sick than (the patient) has been in a long time.”

Since there is no treatment or vaccination to ward off the illness, MacKay maintains that the common-sense approach of hand washing, coughing into your sleeve and keeping sick children at home, is the best way to avoid catching the virus or spreading it.

“With the teachers’ strike potentially coming to an end there’s a great opportunity for it to spread,” he explained.  “Coming in with a runny nose isn’t something we can too much about, and may just add to the spread of it,” MacKay continued. “But if the child is having difficulty breathing then it’s time to go into the ER or your family doctor.”

There’s three confirmed cases of D68 in the province, Dr. Sue Pollock told the Trail Times Wednesday.

She said this particular viral strain has been known about since the early 1960s, and is the second most common cause of the garden variety cold.

“Any given season we expect enterovirus will circulate and transmit between people,” explained Pollock, a medical health officer for the Interior Health Authority (IHA). “Most individuals will present with mild symptoms,” she noted. “But what we are seeing is an increase in severity of illness, in particular, in young children with underlying respiratory conditions.”

However, Pollock warns that D68 can affect individuals of any age, but supportive care such as bed rest and fluids, is the only course of treatment because there is no anti-viral therapy available.

“One of the three confirmed cases is an adult IHA resident from the Thompson-Caribou area,” she said. “For the most part D68 seems to be affecting children, but this shows it can really affect individuals of any age. If symptoms progress and there is difficulties breathing such as wheezing, or if a child is not as alert as usual, then it is very important to seek medical care as soon as possible.”

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