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Tuesday, September 16, 2014
So it is! from the Indiana State commissionaire
State Health Commissioner
Today at 7:58 AM
Indiana State Department of Health (ISDH) has identified four confirmed
cases of respiratory enterovirus EV-D68 among Indiana residents.
Testing was performed at
the Centers for Disease Control and Prevention (CDC). Several other
suspect cases are pending testing at the Indiana State Department of
Health Laboratory. Syndromic surveillance of hospital emergency
department chief complaints has indicated a higher than
expected level of respiratory illness statewide for this time of year.
Several other states, including Colorado, Illinois, Iowa, Kentucky,
Kansas, and Missouri, have also identified confirmed EV-D68 cases.
EV-D68 infections can be mild and self-limited, but children with asthma are at risk for
severe respiratory illness and may require hospitalization to receive intensive supportive therapy.
with asthma should carefully maintain their current medical management
and follow their asthma action plan to monitor for early signs of
exacerbation. People who smoke are
also at higher risk for severe enterovirus infections.
CDC recommends hospitals use standard, contact, and droplet precautions
when caring for patients. Alcohol-based hand sanitizers are not
effective against EV-D68.
Bleach-based disinfectants, like those used for rhinovirus and
norovirus, are effective for environmental cleaning.
are advised to suspect enterovirus infection in patients hospitalized
with asthma exacerbations or severe respiratory illness. To confirm the
EV-D68 in Indiana and further characterize this illness, the ISDH
Laboratory is temporarily requesting that clinicians send nasopharyngeal
and oropharyngeal swabs in the same transport medium or upper
must test positive for rhinovirus/enterovirus
before submission to the ISDH Laboratory. Indicate
this positive test result and the test method on the specimen
submission form. Specimen submissions lacking this information will not
·Specimens from patients who test positive for rhinovirus/enterovirus do not need prior authorization.
·Specimens do not need to be tested for influenza and respiratory syncytial virus (RSV) prior to submission.
Sequencing will be conducted to identify the specific viral strain.
Instructions for specimen submissions to ISDH for testing are located on the ISDH enterovirus page athttp://www.in.gov/isdh/26487.htmunder the laboratory specimen information section.Specimens should arrive at the ISDH Laboratory Monday-Friday excludingstate holidays within threedays of the collection date. Specimens
be submitted using LIMSNET. To sign up for a LIMSNET account, contact the ISDH LIMS HelpDesk at 317-921-5506 or 1-888-535-0011.
who identify outbreaks or unusual occurrences of respiratory illness
should contact Shawn Richards, Outbreak Supervisor,
at email@example.com or 317.233.7125 to inquire about specimen submission and further investigation to identify the cause of these outbreaks.
enterovirus infections in the U.S. occur seasonally during the summer
and fall, and enterovirus outbreaks tend to occur in several-year
cycles. Respiratory enteroviruses
include EV-D68 and rhinovirus and are transmitted through contact with
secretions from the eyes, nose, and mouth (saliva, mucus, sputum) of an
infected person; having close contact with an infected person, such as
touching or shaking hands; and touching objects
or surfaces that have been contaminated with infectious secretions.
vaccine is available to prevent infection with respiratory
enteroviruses, and no antiviral medication is available. Health care
providers should recommend the following:
·Clean: wash hands often with soap and water for 20 seconds
·Cover: cover sneezes and coughs with your sleeve or a tissue
·Contain: prevent spreading illness to others by staying home if you are sick
·Avoid close contact and sharing cups or eating utensils with those who are ill
·Disinfect frequently touched surfaces
·Avoid smoking or exposure to second-hand smoke
For questions regarding epidemiology/surveillance, please contact Shawn Richards at
firstname.lastname@example.org or 317.233.7740. For questions on specimen collection or submission please contact Stephanie Dearth at
email@example.com or 317.921.5843.
For more information on enteroviruses, please visit the following websites: