EV-D68: The Mystery Illness That’s Not Actually A Mystery

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Enterovirus D68 (EV-D68) is one of over 100 non-polio enteroviruses, according to the CDC. For most people infected, it causes flu-like symptoms, mild to severe. It spreads just like the common cold virus, through coughing, sneezing, handshakes, or touching a surface touched by someone with the infection.

Over this past summer and fall, the United States, “has experienced a nationwide outbreak of enterovirus D68,” according to the CDC. For most infected persons, it’s just another cold. But “more severe infections can lead to hypoxia, meningitis, eye problems, heart involvement, and rarely paralysis.”

This sudden surge in EV-D68 cases is perplexing to the investigative sleuths in the media. USA Today calls it “unexplained” while noting 1,116 cases in 47 states, mostly in children, with 12 deaths from the virus. Up north, the CBC calls the recent surge in infections, including at least six cases in Canada a “mystery.” My hometown newspaper the Denver Post is also stumped about this “mystery” afflicting eleven children in Colorado, one of the first states reporting cases. Meanwhile ten children have been hospitalized in Denver for unexplained paralysis.

Perhaps investigative journalism ended after the days of Woodward and Bernstein. Let’s pretend it’s still alive and well. EV-D68 cases surged this past summer. Anything else happen at the same time that might be related? How about tens of thousands of unaccompanied minors entering the U.S. from Central America. Most of the 37 thousand have been sent to live with relatives or “guardians” across the 50 states, with many languishing in temporary shelters. The administration is mum about the details of how many entered the U.S. and where they went.

A further bit of investigation leads to the Virology Journal, which published an article on human enteroviruses in Latin America. They found that these viruses, “account for a substantial proportion of respiratory viruses identified in young people influenza-like illness.” But not here as, “It has been rarely reported in the United States.”

Add to that the issue of basic hygiene among these recent immigrants including “unfamiliarity with bathroom facilities.” “Unaccompanied illegal immigrant children with communicable diseases have given or exposed federal agents to lice, scabies, tuberculosis and chicken pox” according to the Department of Homeland Security. So how much of a “mystery” is it to make the connection between this immigration surge and a new disease outbreak?

Does it really take a degree from the Columbia School of Journalism to make a connection between these facts? That a surge in children immigrating to the U.S. from a region where this virus is common might be bringing this virus to the U.S.? Look at Ebola. Canada and Australia have closed their borders to residents of affected West African countries as a means of keeping Ebola infection out. Ebola is a horrible illness with a high fatality rate, and Canada has had no fatalities from Ebola. Yet a young man from British Columbia died of EV-D68, the country’s first fatality from the disease.

What about other infectious diseases common in Central America? Dengue fever, typhoid, malaria, hepatitis A, chikungunya, and bacterial diarrhea, to name a few. That’s why the CDC provides travel health notices regarding specific destinations. Travel to and from those areas has the potential to bring these diseases into this country. Unfortunately these notices aren’t posted along the Rio Grande. Or in the White House.

More likely, making this connection is inconvenient for President Obama’s plan to provide amnesty “to as many as five million immigrants in the country illegally.” The New York Times speaks of “big, bold unapologetic administrative relief” and describes Republication opposition as “fight the president tooth and nail” but when it comes to EV-D68, everything remains “unexplained.” Acknowledging that a border open to people is also open to infectious diseases is an inconvenient truth that the media chooses to ignore or simply pass off as another great mystery.

Brian C Joondeph, MD, MPS, a Denver based physician, is an advocate of smaller, more efficient government. Twitter @retinaldoctor