Federal health officials are asking physicians to watch for clusters of a rare and severe respiratory illness that is landing children in the hospital and hitting children with asthma particularly hard. The enterovirus D68, or EV-D68, has led to increases in pediatric ER visits, hospitalizations and intensive care-unit stays in Kansas City and Chicago, and clusters are being investigated in at least 12 U.S. states, the Centers for Disease Control and Prevention said Monday.

Enteroviruses are not rare; there are more than 100 types that lead to about 10 million to 15 million infections each year, according to federal health officials. However, little is known about the particular EV-D68 strain confirmed in large clusters in Illinois and Missouri, Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases, said Monday.

Unlike other enteroviruses, which are also associated with mild respiratory illness, febrile rash illness and neurologic conditions, EV-D68 primarily causes respiratory illness. The CDC said physicians and nursing staff should consider laboratory testing for enterovirus when the cause of infection in a severely ill patient is unclear. Hospitals seeing increases in the number of patients with severe respiratory conditions are encouraged to contact state health departments or the CDC to help with typing.

Coverage for the uninsured:

As the Georgetown University Center for Children and Families found that the uninsured rate for children remained at historically low levels—close to 7 percent—but did not decline further for children under age 18 between September 2013 and June 2014. However, this national snapshot does not capture all of the fluctuations in children’s coverage that may be occurring across the country in particular states; we will have to wait for data from federal sources to have a definitive assessment of how coverage is changing at the state level.

Moreover, there are reasons to believe that coverage for children will grow in future years under the ACA, particularly if current levels of Medicaid and CHIP eligibility are maintained. Because the majority of uninsured children appear to be eligible for Medicaid or CHIP coverage but are not currently enrolled, the Medicaid and CHIP programs have the potential to drive further reductions in the uninsured rate among children.

To read more about enterovirus, click here.

To read more about uninsured children and families, click here.

Jeffrey R. Ungvary President