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Recent Child Death Resulting from Staphylococcus Aureus Sepsis Associated with Enteroviral Infection (EV-D68)

Providence -- The Rhode Island Department of Health has confirmed that a Rhode Island child died last week as a result of Staphylococcus aureus sepsis associated with enteroviral infection (EV-D68). Infection by both Staphylococcus aureus sepsis and EV-D68 is a very rare combination that can cause very severe illness in children and adults.

The Centers for Disease Control and Prevention has detected EV-D68 in specimens from a few patients in a few states who had died and had samples submitted for testing. The role that EV-D68 infection played in these deaths is unclear at this time.

Only a very small portion of people who contract EV-D68 will experience problems beyond a runny nose and a low grade fever. Most viruses produce mild illnesses from which people are able to recover. After an outbreak, however, a small portion of the population may have a number of different complications. The Centers for Disease Control and Prevention continues to investigate EV-D68 and its associated illnesses, but the reason for the current EV-D68 outbreak is not completely understood.

"We are all heartbroken to hear about the death of one of Rhode Island's children," says Michael Fine, M.D., Director of the Rhode Island Department of Health. "Many of us will have EV-D68. Most of us will have very mild symptoms and all but very few will recover quickly and completely. The vast majority of children exposed to EV-D68 recover completely."

The Enterovirus D68 is a virus with flu-like symptoms that has been confirmed in 472 people, most of them children, in 41 states and the District of Columbia, according to the Centers for Disease Control and Prevention. Identified in 1962, EV-D68 was infrequently tested for and only began getting attention last month as a number of people with respiratory problems were found to have EV-D68.

The mild symptoms are similar to the common cold, but can progress to wheezing and problems breathing. Infants, children, and teens are most at risk, especially children with asthma. There is no antiviral treatment for people with EV-D68 and no vaccine to prevent it. There are 9 recent case reports about acute neurologic illness – limb weakness and MRI changes that have occurred at the same time as there has been an outbreak of EV-D68.

"While we can't prevent EV-68 with a vaccine, it's important for everyone to get the flu shot - it is as bad as or worse than EV-68. And, we do have a shot to prevent the flu. The sooner you get the flu shot, the better," says Michael Fine, M.D.

Here are recommendations from health officials for how to avoid contracting EV-D68:

* Wash your own and your child's hands often with soap and warm water 5 or 6 times a day (there is some evidence that hand washing is better than alcohol hand sanitizers at killing enteroviruses). Wash for at least 20 seconds. Children should sing their ABCs or "Happy Birthday" twice in a row while washing their hands to ensure the proper length in time.

* Avoid touching your eyes, nose, and mouth with unwashed hands, and remind children to keep their hands away from their faces. * Asthma management is particularly important at this time of year. Ensure your child is taking the appropriate medications as prescribed by your child's doctor. It is the important that parents have a current Asthma Action Plan for children with asthma.

* Clean surfaces often, including toys, doorknobs, phone receivers, and keyboards.

* Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick.

*If fever is present, stay home while sick and for at least one day after the fever is gone, without the use of fever-reducing medicines.

*Seek medical help right away for a child with asthma who is having trouble breathing or suffers worsening respiratory symptoms that do not improve as expected with their usual medicines.

*Get a flu shot today!


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