Influx of patients with asthma-like symptoms strains resources in many pediatric EDs.

An outbreak of a rarely seen virus in the United States is spiking volumes at pediatric EDs across the country, with children typically presenting with asthma-like symptoms. Cases of enterovirus D68 (EV-D68) first emerged in the Midwest in early August, but the virus has since been confirmed in at least 40 states. The CDC is also investigating whether a cluster of nine pediatric cases involving young patients with muscle weakness or paralysis are related to the EV-D68 outbreak. The patients are all hospitalized in Colorado and Massachusetts. Children's Mercy Hospital in Kansas City, MO, first alerted the CDC that the ED was seeing an unusual in spike in patients coming in with asthma-like symptoms. By mid-September, the hospital had seen 500 confirmed cases of EV-D68, including 60 patients who were admitted to the pediatric intensive care unit. Patient volume in the ED at the University of Chicago Medicine Comer Children's Hospital is up by about 40 patients per day, with most reporting symptoms consistent with EV-D68. Emergency department leaders from hospitals impacted by the outbreak advise colleagues to put plans in place for an extended surge of patients because patient volumes can escalate quickly.