Enterovirus usually circulates during the summer and fall. Thus, we are in peak enterovirus season at the writing of this article. This year, the Enterovirus D-68 strain has gained notoriety in association with increased respiratory symptoms requiring hospitalization in a subset of patients. As of mid October, there have been almost 700 confirmed cases throughout the United States and approximately 5 deaths (death rate of 0.7%). It is thought that there are many more unconfirmed cases that have not reached medical attention. This is because the vast majority of kids that get the infection exhibit symptoms consistent with a “bad cold.” There are several cases of weakness that seem to be associated with enterovirus D-68. However, it is not clear yet whether they were caused by enterovirus D-68, because not all children with weakness tested positive for the virus.
As medical director for a pediatric urgent care, I have had many parents come in concerned that their children may be infected with this virus. Thankfully, I can reassure them that the majority of children who get the virus do very well and don’t require hospitalization. Even for those that are hospitalized, the vast majority of children have had a complete recovery from the infection.
Since there are few treatments for viral infections other than supportive care, prevention is very important. Seven simple activities can help prevent you and your child from getting or spreading a viral infection:
1) Wash you hands with soap and water for at least 20 seconds. Do this frequently. Hand hygiene is one of the most important elements in infection control. If you don’t have access to water, carry hand sanitizer. Doorknobs, elevator buttons, computer keyboards, and other people’s hands can all harbor viruses. Wash your hands after touching any surface where a virus could linger.
2) Cough or sneeze into your elbow. If you sneeze into your hand, you are likely to transmit viral or bacterial particles onto a surface. Sneezing into your elbow helps prevent that. It also provides a better barrier to the rapid spread of infectious particles through the air after a sneeze or cough.
3) Avoid sugar. Sugar paralyzes your white blood cells and prevents them from fighting off bacteria. This affect can last several hours after ingestion of a sugary beverage. This may explain why I see an upsurge in viral illnesses around Halloween.
4) Get plenty of sleep. Lack of sleep has been shown to affect white blood cells in healthy volunteers. Even though it may seem difficult, getting at least 7-9 hours of sleep during cough and cold season cold potentially save lost time from work.
5) Eat lots of fruits and vegetables in as unprocessed a state as possible. Fruits and vegetables are high in antioxidants, vitamins, and minerals, and have been shown to improve immune function.
6) Drink plenty of water. When sick with cough or cold, water is more frequently lost from sneezing, coughing, and breathing faster. Drinking water will help prevent mild dehydration as well as help your body fight off the infection.
7) Maintain a positive outlook on life. Stress affects the immune system—preventing it from functioning as well. People who are stressed or depressed are much more likely to develop symptoms of infection when exposed to a virus compared to people who are happy. Many times we can’t avoid the stress in our lives, but working to maintain a happy outlook can help reduce the negative affects stress can bring.
Hopefully by taking a few simple steps you and your children can successfully navigate this enterovirus season.
References: Indian J Med Res. Nov 2011; 134(5): 611–620.  http://www.cdc.gov/flu/protect/covercough.htm  http://www.webmd.com/cold-and-flu/10-immune-system-busters-boosters  “Acute Sleep Deprivation in Healthy Young Men: Impact on Population Diversity and Function of Circulating Neutrophils.” Brain, Behavior, and Immunity 41 (October 2014): 162–72.  “Eat More Fruits and Vegetables to Improve Your Immune System. Five or More Portions of Fruits and Vegetables Daily Significantly Increase Antibody Response.” DukeMedicine Healthnews 19, no. 2 (February 2013): 5–6.  http://www.apa.org/research/action/immune.aspx