Since August of this year, a respiratory virus (Enterovirus D68 or EV-68) has been identified in children in several states, primarily in the Midwest but most recently in Connecticut, New York and Pennsylvania. To date, no cases of EV-68 have yet been confirmed in Massachusetts, but suspected cases of EV-68 are currently being investigated, and it is likely that it will only be a matter of time before we see confirmed cases in Massachusetts.
As children with asthma are more vulnerable to a severe illness from EV-68, the following is a letter that we have sent to all of our pediatric patients who have asthma and have been prescribed a controller medication as part of their Asthma Action Plan.
If your child has asthma but has no active symptoms now and has not needed a controller medication within the past year, you don’t need to alter his or her asthma management at this time.
If your child has active asthma symptoms now, if you can’t find your child’s Asthma Action Plan or if you have any other questions or concerns about EV-68, please call your pediatrician’s office.
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Dear Parent or Guardian:
We are writing with an important message regarding your child’s asthma. As you may know, there has been a recent outbreak of a respiratory virus (Enterovirus D68) in the Midwest and it is only a matter of time before we expect confirmed cases in the Boston area.
What you need to know:
- Children with asthma infected with this virus have had a greater risk of hospitalization for breathing difficulties and wheezing.
- Your child has been prescribed a controller medication (ex. Flovent, Pulmicort, QVar, Singulair) to use either on a daily basis or during some times of the year.
- Your child’s asthma controller cannot prevent acquiring the infection but it may lessen the risk of a more serious asthma exacerbation in the event of illness.
What we recommend:
- On a temporary basis, restart or increase your child’s controller medication according to the yellow zone management on your asthma action plan.
- Continue this higher level of treatment until it is clear from public health officials that the infection is not spreading to Boston or has ceased to cause problems in our area. We will communicate when we feel it is appropriate to return to your green zone care.
- In the event of an illness with fever, cough, wheezing, difficulty breathing, runny nose, or nasal congestion, please contact our office so we can discuss with you whether a visit or other evaluation would be helpful.
- We continue to recommend flu vaccine for all children over 6 months of age as has been advised by the American Academy of Pediatrics and Centers for Disease Control and Prevention. Annual vaccination is especially important for children 6 months to 2 years of age and with certain chronic diseases like asthma and diabetes.
Feel free to contact your pediatrician or their staff if you have any questions about the Enterovirus illness or the flu vaccine. You may also check our website, www.harvardvanguard.org, for additional information about flu vaccination, prevention and treatment.
Sincerely,
Daniel H. Slater, MD Benjamin A. Kruskal, MD
Pediatric Director Chief of Infectious Diseases