The Colorado Department of Public Health and Environment is investigating an unprecedented outbreak of rare viral infections with neurological complications among young children, state officials announced Tuesday.
State health officials, in conjunction with the experts at the Centers for Disease Control and Prevention, said they have found 41 cases of enterovirus A71 infections in children this year — a majority of them in the Denver area.
All the patients were hospitalized, officials said, and nearly all have fully recovered. There have been no deaths.
“I don’t believe a cluster this large has been identified in the U.S. previously,” said. Dr. Rachel Herlihy, a state communicable disease epidemiologist.
Health officials aren’t sure what caused the outbreak, or why it occurred in Colorado.
Enteroviruses are quite common, but usually manifest as cold-like illnesses or foot-and-mouth disease. This strain of A71 is rarely found in the U.S, according to Dr. Samuel Dominguez, who specializes in pediatric infectious diseases at Children’s Hospital in Aurora.
“It’s much more common in southeast Asia, where they have large outbreaks,” Dominguez said. “That’s where most of the data on this comes from … but this is very small compared to other parts of the world.”
These rare cases where the central nervous system is impacted include meningitis and encephalitis, as well as acute flaccid myelitis, present in 14 of the cases.
Children who have developed these infections have reported a loss of balance, unsteady walking, unusual jerking motions — especially while sleeping — and fever, Dominguez said.
A vast majority of the children have been treated at Children’s Hospital, he said. Most of them were under the age of 3, Dominguez said, and all but one were under 5 years old.
Almost all of the children have made a full recovery, but a few “have not returned to a neurological baseline,” Dominguez said. That number is small, he said, and doctors continue to follow those children.
“It’s concerning in the sense that we’ve seen lots of children with central nervous disease admitted to the hospital,” Dominguez said. “But I’m optimistic because most have done very well.”
The average stay in the hospital for these kids has been four days, Dominguez said. That’s much better than in 2014, when 11 patients were admitted for a different viral strain, he said.
Clusters of A71 cases have occurred in Colorado a few time previously — most recently in 2003 and 2005. In each of those years, eight cases were reported, Herlihy said.
State health officials have been monitoring the situation closely since May, officials said in a news release. Many of these cases came during the summer and early fall, Dominguez said, but new cases have been slowing down as of late. Normally, the prime season for these diseases ends in October or the beginning of November.
Enteroviruses can be spread much like other viruses: from hand to mouth, through saliva, nasal mucus, stool and even fluid from blisters. Some people with enteroviruses have no symptoms but still can spread the virus to others.
State health officials put out a list of symptoms associated with these diseases. Parents and guardians should contact a health care provider if they or their children have:
— Severe symptoms such as sudden weakness in arms and legs, trouble breathing, unsteady walking, severe headache, stiff neck or seizures
— Dizziness, wobbliness, or abnormal, jerking movements that are worse at night
— Fever along with any other concerning symptoms
Health officials also included a list of steps to protect yourself and others from enteroviruses:
— Wash your hands often with soap and water for at least 20 seconds
— Be especially careful to wash your hands after using the toilet and changing diapers
— Avoid close contact with people who are sick, and don’t share cups and eating utensils
— Clean and disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick
— Cover your coughs and sneezes
— Avoid touching your eyes, nose and mouth with unwashed hands
— Stay home when you’re sick, and keep children home from school or daycare for 24 hours after fever ends or if they are drooling uncontrollably and have mouth sores
