The cases of respiratory illness in Florida are at a low compared to past years, but it’s still important to screen for the Parvovirus EV-D68, which is appearing in people who have recently traveled to Southwest Asia, Central America and the Caribbean.
In spring 2014, Miami doctors were told of a flock of chickens found dead in Haiti. After testing, one of the chickens was found to have the same strain of Parvovirus as the chickens that had been shipped from the poultry plant in the Dominican Republic. A few days later, there were multiple reports of people with symptoms at the airport of Santo Domingo, where the chickens had been. Infected travelers had recently landed in Florida, and doctors diagnosed Parvovirus with 7 out of the 19 people who became ill. Parvovirus is a common cause of severe respiratory illness and dehydration in people with weak immune systems. It can also cause complications that can be lethal.
As the number of infections dropped in Miami, workers focused on identifying ways to limit the spread of the Parvovirus. Children were tested, for example, for antibodies to the virus. Some of them had never seen the virus before, but despite the lack of an apparent pattern, doctors figured out that this type of outbreak is rare. The researchers later found that the virus was also found in three Americans living in countries in Europe. But it took nearly two years for health officials to finally confirm that the EV-D68 in America was related to the avian influenza virus that also causes severe respiratory illness.
Like many infectious diseases, scientists are faced with a Catch-22 when it comes to the EV-D68. More tests for Parvovirus would likely help catch the virus, but it also takes more time. When people with severe respiratory illness arrive in the U.S., doctors typically perform tests that confirm or rule out a diagnosis, but many were testing for the virus because their patients had recently traveled and were worried about the possibility of exposure. It took 12 days for clinicians to realize that the virus was linked to the avian influenza virus.
Thankfully, doctors have begun to test people who are diagnosed with EV-D68 in Florida and the Caribbean to see if they might also have EV-D68. The Centers for Disease Control and Prevention is urging health care workers not to stop testing, because there is a strong genetic similarity between the viruses. While the U.S. is home to many imported species of birds and their progeny, so far there is no evidence of a transmittable relationship between the EV-D68 that is turning up in the Americans and the one that was found in the birds traveling from Haiti.
The problem is that there is no way to know how much additional testing would cost. There is a large database of viruses, which researchers have used to research the history of Parvovirus infections. But the type of tests recommended for EV-D68 are not included in the database, and can only be ordered with a consent from patients.
There are an estimated three million cases of infections with Parvovirus a year, according to Peter Hotez, a professor of microbiology at Baylor College of Medicine and dean of the National School of Tropical Medicine at Baylor College of Medicine. He has asked researchers to contribute to an open-access database to help in the search for new tests for EV-D68, a common respiratory illness that causes severe illness and fatalities in poor countries and where, he said, officials want to isolate any airborne transmissions that may have been present in South Florida.