Dan Dugan, a 13-year-old Seabrook Middle School student who loves fishing, has been hospitalized for a week with what doctors believe may be the enterovirus D68, his father says.
SEABROOK — A 13-year-old Seabrook boy has been hospitalized for roughly a week in Boston due to paralysis and other symptoms his doctors believe may be connected to enterovirus D68, severe cases of which have been reported across the country since August.
Patrick Dugan said his son Dan was brought last week to an intensive care unit at Tufts Medical Center after Dan’s legs gave out multiple times following weeks of headaches, coughing, vomiting, weakness and double vision.
Those symptoms were followed by paralysis in Dan’s lower extremities and left shoulder as well as indications of spinal cord nerve damage, according to his father. The Dugan family hasn’t left Dan’s side since his hospitalization and are trying to stay optimistic as doctors attempt to confirm whether the symptoms have in fact been caused by EV-D68.
“We’re holding up,” said Patrick Dugan, known locally as owner of Pat’s Towing Company. “Everyone is rooting for him. ... Dan’s had a really tough upbringing and he’s come a long way. He’s just an unbelievable kid. It just doesn’t make sense.”
A battery of tests have been conducted on Dan, who was transferred out of the ICU Tuesday, since he was brought to the hospital. Dugan said Tuesday was the seventh day of the roughly 10-day process to culture and confirm EV-D68 and other enteroviruses, although he said EV-D68 is still what doctors “all suspect” is the cause.
Dr. Benjamin Chan, the state’s epidemiologist, said EV-D68 is part of a group of 100 different types of viruses that cause respiratory symptoms similar to those of the common cold and influenza.
Reports of the disease first started to gain national attention in August after pediatric facilities in Illinois and Missouri began seeing sharp increases in respiratory cases, according to Chan. Since August, the Centers for Disease Control and Prevention has linked EV-D68 to respiratory illnesses in more than 500 patients across 43 states, including New Hampshire, Maine, Massachusetts and other New England states.
EV-D68, which Chan said is indistinguishable from other enteroviruses without specialized testing, is also suspected to be linked to child deaths in various portions of the country, although that as well as the virus’ connection to symptoms of paralysis aren’t yet confirmed, according to Chan.
Chan said New Hampshire has had seven confirmed cases so far this year in Rockingham, Strafford, Hillsborough and Carroll counties, although he said none of those patients are still hospitalized and all survived the illness. Data for previous years isn’t available because there has been no mandatory reporting or baseline information for EV-D68, according to Chan.
Dugan said Dan’s symptoms surfaced between three and four weeks ago when he began experiencing severe headaches while in school at Seabrook Middle School. Dugan said he brought Dan home for the day, but the family didn’t think the illness was severe because the headaches were gone when Dan awoke the next morning.
Dan awoke with what sounded “like a smoker’s cough,” though, that morning and every other morning that week, according to Dugan. Dugan's family thought it "would go away" because Dan, an avid fisherman and lover of the outdoors who had a perfect attendance record at SMS before his illness, said he felt “fine” after the cough dissipated each morning.
“He wasn’t complaining about how he felt,” said Patrick Dugan. “Dan is not one to complain.”
Then Dan started experiencing nausea and vomiting, as well as headaches that were “on and off,” said Dugan. Doctors initially thought it was the flu, but after three different falls — one while walking up a set of stairs, one in the family’s kitchen while getting a bowl of cereal, and one in the middle of the night — Dugan said his family decided it would be best to bring Dan to the hospital.
“He said, ‘I don’t know. I don’t know what’s happening,’” said Dugan, recounting the events that followed the moments where Dan’s legs just “gave out” beneath him. “He said, ‘Dad, I tried to go to the bathroom and I can’t walk. I fell and I don’t know why.’”
Dugan said he wants to tell Dan’s story in the hopes that it might help other children and parents take steps to avoid contracting enteroviruses.
“It's a nasty virus," said Dugan. "You could be carrying it and not even know it. A week after Dan got sick I was feeling sick. My dad (also) wasn’t feeling well. We all thought it was the flu.”
Barbara Hopkins, the assistant superintendent at School Administrative Unit 21, said the district has “no confirmed cases” of EV-D68. The various schools within the district have sent out alerts containing information and recommendations in response to state warnings about the virus, and Hopkins said these alerts are similar to the ones the schools distribute every flu and cold season.
"I understand the extra concern on the part of parents," said Hopkins. "Certainly, if we have a confirmed case everyone will know. We’re diligent."
Enteroviruses aren’t uncommon this time of the year and typically cause running noses and coughs, according to Chan. EV-D68 is a mainly respiratory illness and one that has been around since 1962, but Chan said it has been “rarely reported or identified” due to the fact that the strain is similar to other enteroviruses and because the “majority of the time people get the infection and get better.”
The viruses aren’t fatal, but Chan said it is possible for other complications and sometimes-deadly issues to arise as a result of the respiratory problems.
Chan said it’s unknown why more EV-D68 cases have been reported this year. He said it’s possible the CDC and doctors are just “looking for it more now” in light of the national reports.
State and national health officials say they will continue to investigate EV-D68 as well as seek out whether it is connected to reports of neurological problems and paralysis like Dan’s.
“The investigation is ongoing and I know the CDC and other public health partners looking into the possibility that EV-D68 could be contributing to this,” said Chan, who also said New Hampshire’s samples in suspected EV-D68 cases are being sent to New York for specialized testing because the CDC currently has a “backlog” of testing requests in connection to the virus. “We should have more information as the investigation into EV-D68 continues.”
There is no specific medication for enteroviruses and no vaccine, according to Chan.
Chan recommends individuals who display symptoms of any infection or respiratory illness stay home from school and work. He also said all individuals should avoid physical contact with anyone displaying symptoms, decontaminate surfaces and use proper hand-washing and coughing and sneezing protocols because the virus is spread through bodily fluids and contact with mucus membranes.
“You should call your primary care doctor or seek medical attention if (you start having breathing problems),” said Chan.
Additional information and preventive steps can be found on the New Hampshire Department of Health and Human Services’ website at dhhs.state.nh.us.
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