Patients with Respiratory Virus?

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Only referred if they have reactive airway symptoms, this symptom complex has been around for a while, the patient's that get the severe respiratory symptoms usually have a history of croup or asthma indicative of previous insult to their lungs.
We do not routinely test for EVD68. Best left for in hospital use as this test will not change the initial management of the pt. If the pt is sick enough to be tested, they are transferred to the hospital for broader workup and evaluation. Routine testing increases the cost of healthcare and has not been shown to improve pt outcomes in the outpatient environment.
While national news reports this as a predominantly childhood illness, we have seen numerous adults also affected (usually in contact with children); lobar pneumonia complicates this viral illness more than with rhinovirus.
I have seen 3 patients with no history or asthma or reactive airway problems, presenting with a 1-2 day history of fever, cough and congestion with rapid onset of wheezing and respiratory difficulty. The patients were sent to the local ED and treated from there. To my knowledge there has been no testing for a specific virus. I did review the ED documents and the patients were diagnosed with viral illnesses and treated on an individual basis. I am unsure if they were admitted or D/C for outpatient management with PCP.
Had runny nose for about a day, then severe cough and wheezing started very quickly and progressed rapidly- his O2 sats were 91% on presentation and did not respond to albuterol neb. He does not have an official diagnosis of asthma per Mom but pediatrician had given them a nebulizer last year for frequent bouts with "bronchitis".
we started seeing a "summer flu" in mid August with a few patients-young and old. this has picked up since then. Most of press has been centered on children, but we've been worried about not only the younger adults with asthma or other lung issues having more significant complications but also the elder population with copd/emphysema.
The difficult thing is that we DO see patients with cold symptoms and/or asthma. Onsite it is difficult to delineate the cause. It is just about educating the parent on what to look for. Similar with RSV. Personally I think the outbreak in Colorado and subsequent lab findings are the only reason why people are on the look out. This could have very well been misdiagnosed as Bronchitis and RSV, etc in previous years- just not as widespread.

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