DiversityNursing Blog

By Dennis Thompson

Already-strong public support for right-to-die legislation has grown even stronger in the days since the planned death of 29-year-old brain cancer patient Brittany Maynard, a new HealthDay/Harris Poll has found.

An overwhelming 74 percent of American adults now believe that terminally ill patients who are in great pain should have the right to end their lives, the poll found. Only 14 percent were opposed.

Broad majorities also favor physician-assisted suicide and physician-administered euthanasia.

Only three states -- Oregon, Washington and Vermont -- currently have right-to-die laws that allow physician-assisted suicide.

"Public opinion on these issues seems to be far ahead of political leadership and legislative actions," said Humphrey Taylor, chairman of The Harris Poll. "Only a few states have legalized physician-assisted suicide and none have legalized physician-administered euthanasia."

People responded to the poll in the weeks after Maynard took medication to end her life in early November.

Maynard moved from California to Oregon following her diagnosis with late-stage brain cancer so she could take advantage of the state's "Death With Dignity Act." Her story went viral online, with a video explaining her choice garnering nearly 11.5 million views on YouTube.

A "poster child for the movement," Maynard helped spark conversations that allowed people to put themselves in her shoes, said Frank Kavanaugh, a board member of the Final Exit Network, a right-to-die advocacy group.

"I think it is just a natural evolution over a period of time," Kavanaugh said of the HealthDay/Harris Poll results. "There was a time when people didn't talk about suicide. These days, each time conversations occur, people think it through for themselves, and more and more are saying, 'That's a reasonable thing to me.'"

The poll also found that:

• Support for a person's right to die has increased to 74 percent, up from 70 percent in 2011. Those opposed decreased to 14 percent from 17 percent during the same period.
• Physician-assisted suicide also received increased support, with 72 percent now in favor, compared with 67 percent in 2011. Opposition declined from 19 percent to 15 percent.
• Sixty-six percent of respondents said doctors should be allowed to comply with the wishes of dying patients in severe distress who ask to have their lives ended, up from 58 percent in 2011. Opposition decreased from 20 percent in 2011 to 15 percent now.

"The very large -- more than 4-to-1 and increasing -- majorities in favor of physician-assisted suicide, and the right of terminally ill patients to end their lives are consistent with other liberal social policy trends, such as support for same-sex marriage, gay rights and the decriminalization of marijuana, seen in the results of referendums and initiatives in the recent mid-term elections," Taylor said.

Support for the right-to-die movement cut across all generations and educational groups, both genders, and even political affiliation, the poll found.

Democrats tended to be more supportive of right-to-die legislation, but 56 percent of Republicans said they favor voluntary euthanasia and 63 percent favor physician-assisted suicide.

Kavanaugh was not surprised. "People think of this as a liberal issue. But I find that as I talk to [conservatives], you can appeal to them on the basis of 'get the government the hell out of my life,'" he said.

But the public is split over how such policies should be enacted, with 35 percent saying that the states should decide on their own while 33 percent believe the decision should be made by the federal government, the poll found.

"Most of the people I know in the field whose opinion I put stock in don't feel there's ever going to be federal movement on it," Kavanaugh said. "You're just going to have to suffer through a state-by-state process."

Kavanaugh does believe this overwhelming public support will result in steady adoption of right-to-die laws.

"I think this will become the ultimate human right of the 21st century, the right to die with dignity," he said. "There are good deaths and bad deaths, and it is possible to have a good death."

Despite increasing public support for assisted suicide, stiff opposition remains in some quarters.

"Assisted suicide sows confusion about the purpose of life and death. It suggests that a life can lose its purpose and that death has no meaning," Rev. Alexander Sample, archbishop of the Archdiocese of Portland in Oregon, said in a pastoral statement issued during Maynard's final days.

"Cutting life short is not the answer to death," he said. "Instead of hastening death, we encourage all to embrace the sometimes difficult but precious moments at the end of life, for it is often in these moments that we come to understand what is most important about life. Our final days help us to prepare for our eternal destiny."

Todd Cooper, a spokesman for the Portland archdiocese, said the debate over assisted suicide touches him on a very deep level because of his wife, Kathie.

About 10 years ago, she also was diagnosed with terminal brain cancer. She endured two brain surgeries, two years of chemotherapy and six weeks of radiation therapy, and remains alive to this day.

"If she'd given up the fight for life, she wouldn't be here," Cooper said. "That doesn't necessarily happen in every case, but it gives hope for those who struggle to the very end."

source: www.medicinenet.com

By Honor Whiteman

Cancer is one of the leading causes of morbidity and mortality worldwide. In 2012, there were around 14 million new cases of cancer and around 8.2 million deaths from the disease. But despite such alarming numbers, a new study by researchers from the UK finds that most people ignore cancer warning signs, attributing them instead to symptoms of less serious illnesses.

Lead study author Dr. Katriina Whitaker, senior research fellow at University College London in the UK, analyzed the responses of 1,724 people aged 50 and over to a health questionnaire that was sent to them in April 2012.

The questionnaire asked participants whether they had experienced any of 17 symptoms, 10 of which are defined as cancer "alarm" symptoms by Cancer Research UK. These symptoms include unexplained cough, changes in mole appearance, unexplained bleeding, persistent change in bowel habits, unexplained weight loss, difficulty swallowing and unexplained lumps. 

Participants were not told which symptoms are cancer warning signs.

The respondents were also asked what they thought was the cause of any symptoms they experienced, whether they deemed the symptoms to be serious and whether they visited their doctor as a result of their symptoms.

Only 2% of respondents considered warning symptoms to be cancer-related

Results of study - published in the journal PLOS ONE - revealed that 53% of participants reported that they had experienced at least one cancer warning sign over the past 3 months.

The most common cancer warning symptoms reported were persistent cough and persistent change in bowel habits, while unexplained weight loss and problems swallowing were the least common.

However, the researchers were surprised to find that of the respondents who reported cancer warning symptoms, only 2% considered cancer to be a potential cause.

What is more, Dr. Whitaker says that of participants who reported the most obvious signs of cancer - such as unexplained lumps or changes in mole appearance - most did not consider them to be cancer-related.

"Even when people thought warning symptoms might be serious, cancer didn't tend to spring to mind," adds Dr. Whitaker. "This might be because people were frightened and reluctant to mention cancer, thought cancer wouldn't happen to them or believed other causes were more likely."

On a positive note, respondents did deem the cancer warning signs to be more serious than symptoms not linked to cancer - such as shortness of breath, fatigue and sore throat- and 59% of those who experienced cancer warning signs visited their doctor.

But the researchers say their findings show that the majority of people are dismissing potential warning signs of cancer, which could be putting their health at serious risk. Dr. Whitaker says:

"Most people with potential warning symptoms don't have cancer, but some will and others may have other diseases that would benefit from early attention. That's why it's important that these symptoms are checked out, especially if they don't go away. But people could delay seeing a doctor if they don't acknowledge cancer as a possible cause."

"Most cancers are picked up through people going to their general practitioner (GP) about symptoms, and this study indicates that opportunities for early diagnosis are being missed," adds Sara Hiom, director of early diagnosis at Cancer Research UK. "Its results could help us find new ways of encouraging people with worrying symptoms to consider cancer as a possible cause and to get them checked out straight away with a GP."

Source: www.medicalnewstoday.com

That’s right—there are men in nursing, too! It’s time to rid ourselves of outdated stereotypes. We don’t live in a society where boys only like blue and girls only like pink. Where boys can only play with legos and girls can only play with dolls. There’s too much variety in this world to limit ourselves to what we think is expected of us. There are women in engineering and mathematics, and there are men in nursing and healthcare.

Population Growing for Men in Nursing

Nursing is a fantastic career. In fact, the number of men in nursing is growing, with the percentage of male nurses increasing almost every year. In addition, there are more men in nursing schools, making up 13% of nursing school students. Find out more facts about male nurses by reading the men in nursing infographic below.

Source: www.collegeamerica.edu

By  Carly Dell

In the Future of Nursing report published by the Institute of Medicine, it is recommended that health care facilities throughout the United States increase the proportion of nurses with a BSN to 80 percent and double the number of nurses with a DNP by the year 2020. Research shows that nurses who are prepared at baccalaureate and graduate degree levels are linked to lower readmission rates, shorter lengths of patient stay, and lower mortality rates in health care facilities.

What does the job market look like for RNs who are looking to advance their careers?

We tackle this question in our latest infographic, “Career Paths for RNs,” where we look in-depth at the three higher education paths RNs can choose from to advance their careers — Bachelor of Science in Nursing, Master of Science in Nursing, and Doctor of Nursing Practice.

For each career path, we outline the various in-demand specialties, salaries, and job outlook.

Source: onlinenursing.simmons.edu

In the wake of media focus on the trials and bravery of nurses in the context of the Ebola crisis, leaders in the fields of nursing and clinical ethics have released an unprecedented report on the ethical issues facing the profession, as the American Nursing Association prepares to release a revised Code of Ethics in 2015.

The report captures the discussion at the first National Nursing Ethics Summit, held at Johns Hopkins University in August. Fifty leaders in nursing and ethics gathered to discuss a broad range of timely issues and develop guidance. The report, A Blueprint for 21st Century Nursing Ethics: Report of the National Nursing Summit, is available in full online at www.bioethicsinstitute.org/nursing-ethics-summit-report. It covers issues including weighing personal risk with professional responsibilities and moral courage to expose deficiencies in care, among other topics.

An executive summary of the report is available at: http://www.bioethicsinstitute.org/wp-content/uploads/2014/09/Executive_summary.pdf

"This blueprint was in development before the Ebola epidemic really hit the media and certainly before the first U.S. infections, which have since reinforced the critical need for our nation's healthcare culture to more strongly support ethical principles that enable effective ethical nursing practice," says Cynda Hylton Rushton, PhD, RN, FAAN, the Bunting Professor of Clinical Ethics at the Johns Hopkins School of Nursing and Berman Institute of Bioethics, and lead organizer of the summit.

The report makes both overarching and specific recommendations in four key areas: Clinical Practice, Nursing Education, Nursing Research, and Nursing Policy. Among the specific recommendations are:

• Clinical Practice: Create tools and guidelines for achieving ethical work environments, evaluate their use in practice, and make the results easily accessible.
• Education: Develop recommendations for preparing faculty to teach ethics effectively
• Nursing Research: Develop metrics that enable ethics research projects to identify common outcomes, including improvements in the quality of care, clinical outcomes, costs, and impacts on staff and the work environment
• Policy: Develop measurement criteria and an evaluation component that could be used to assess workplace culture and moral distress

What does this blueprint mean for nurses on the front line?

"It's our hope this will serve as a blueprint for cultural change that will more fully support nurses in their daily practice and ultimately improve how healthcare is administered -- for patients, their families and nurses," says Rushton. "We want to start a movement within nursing and our healthcare system to address the ethical challenges embedded in all settings where nurses work."

On the report's website, nurses and the public can learn more about ethical challenges and proposed solutions, share personal stories, and endorse the vision of the report by signing a pledge.

"This is only a beginning," says Marion Broom, PhD, RN, FAAN, Dean and Vice Chancellor for Nursing Affairs at Duke University and Associate Vice President for Academic Affairs for Nursing at Duke University Health System. "The next phase is to have these national nursing organizations and partners move the conversation and recommendations forward to their respective constituencies and garner feedback and buy-in. Transformative change will come through innovative clinical practice, education, advocacy and policy."

At the time of publication, the vision statement of the report has been endorsed by the nation's largest nursing organizations, representing more than 700,000 nurses:

• American Academy of Nursing
• American Association of Critical-Care Nurses
• American Nurses Association
• American Association of Colleges of Nursing
• American Organization of Nurse Executives
• Association of Women's Health, Obstetric and Neonatal Nurses
• The Center for Practical Bioethics
• National League for Nursing
• National Student Nurses' Association
• Oncology Nursing Society
• Sigma Theta Tau International

Source: www.sciencedaily.com

Use of "antibiograms" in skilled nursing facilities could improve antibiotic effectiveness and help address problems with antibiotic resistance that are becoming a national crisis, researchers conclude in a new study.

Antibiograms are tools that aid health care practitioners in prescribing antibiotics in local populations, such as a hospital, nursing home or the community. They are based on information from microbiology laboratory tests and provide information on how likely a certain antibiotic is to effectively treat a particular infection.

The recent research, published by researchers from Oregon State University in Infection Control and Hospital Epidemiology, pointed out that 85 percent of antibiotic prescriptions in the skilled nursing facility residents who were studied were made "empirically," or without culture data to help determine what drug, if any, would be effective.

Of those prescriptions, 65 percent were found to be inappropriate, in that they were unlikely to effectively treat the target infection.

By contrast, use of antibiograms in one facility improved appropriate prescribing by 40 percent, although due to small sample sizes the improvement was not statistically significant.

"When we're only prescribing an appropriate antibiotic 35 percent of the time, that's clearly a problem," said Jon Furuno, lead author on the study and an associate professor in the Oregon State University/Oregon Health & Science University College of Pharmacy.

"Wider use of antibiograms won't solve this problem, but in combination with other approaches, such as better dose and therapy monitoring, and limiting use of certain drugs, we should be able to be more effective," Furuno said.

"And it's essential we do more to address the issues of antibiotic resistance," he said. "We're not keeping up with this problem. Pretty soon, there won't be anything left in the medical cabinet that works for certain infections."

In September, President Obama called antibiotic resistant infections "a serious threat to public health and the economy," and outlined a new national initiative to address the issue. The Centers for Disease Control and Prevention has concluded that the problem is associated with an additional 23,000 deaths and 2 million illnesses each year in the U.S., as well as up to $55 billion in direct health care costs and lost productivity.

Antibiograms may literally be pocket-sized documents that outline which antibiotics in a local setting are most likely to be effective. They are often used in hospitals but less so in other health care settings, researchers say. There are opportunities to increase their use in nursing homes but also in large medical clinics and other local health care facilities for outpatient treatment. The recent study was based on analysis of 839 resident and patient records from skilled nursing and acute care facilities.

"Antibiograms help support appropriate and prudent antibiotic use," said Jessina McGregor, also an associate professor in the OSU/OHSU College of Pharmacy, and lead author on another recent publication on evaluating antimicrobial programs.

"Improved antimicrobial prescriptions can help save lives, but they also benefit more than just an individual patient," McGregor said. "The judicious use of antibiotics helps everyone in a community by slowing the spread of drug-resistant genes. It's an issue that each person should be aware of and consider."

Multi-drug resistant organisms, such as methicillin-resistant Staphylococcus aureus, or MRSA, and other bacterial attacks that are being called "superinfections" have become a major issue.

Improved antibiotic treatment using a range of tactics, researchers say, could ultimately reduce morbidity, save money and lives, and improve patients' quality of life.

Source: www.medicalnewstoday.com

By Jamie Bond

Beginning in 1999, blogging became a route for individuals with a devotion to writing to share their talent. Blogging gives the author the ability to channel their thoughts in a manner that can be useful and enjoyable to readers.  Nurses encounter many learning situations which may be helpful to fellow nurses.  Blogs give the writer a means to share these experiences and readers a chance to learn and relate to others in a virtual setting.  In nursing, blogs serve multiple purposes including engaging fellow nurses in educational opportunities, networking, providing insight into unique avenues in nursing, and burnout prevention.

This list of top nursing blogs was compiled based on Facebook likes, frequency of postings, and number of followers. Many of the following blogs are top hits when conducting online searches and can also be followed on Twitter, Pinterest, and Google+. This list has been divided into sections for the reader’s convenience: general nursing, registered nurse, nurse practitioner, nursing student, nursing career, and women’s health.

GENERAL NURSING

1. Confident Voices – Beth Boynton is a national speaker, professional coach, facilitator, and medical improv trainer. She writes this blog founded on respectful communication for nurses, physicians, patient advocates, and support staff to encourage safe, respectful work cultures.
   
   
2. Disruptive Women in Healthcare – This blog targets challenging and inspirational concepts in the current healthcare field. There are over 100 individuals that actively contribute to this blog including elected officials, healthcare workers, patient advocates, researchers, and economists.
   
   
3. Diversity Nursing – Diversity Nursing offers a variety of articles on all topics pertinent to nursing including health and wellness and career tips. This blog also includes a job board and a forum for open discussion amongst nurses and student nurses.
   Highlight: Nurses Among Most Influential People in Healthcare
4. ER Nurses Care – Written by emergency room nurse Leslie Block, this blog uses her passion for nursing to demonstrate caring and compassion through her posts focusing on healthy living, injury prevention, and various current trending topics in healthcare.
   
   
5. Living Sublime Wellness – Elizabeth Scala MSN/MBA, RN is a motivational speaker who focuses her writing on encouraging nurses to make the necessary changes in healthcare by facilitating out-of-the box critical thinking.
   
   
6. Not Nurse Ratched – A nurse and freelance writer, Megen Duffy blogs about all things nursing while using her humor to lighten the mood as necessary. Duffy’s blog is highly followed online and on Facebook likely due to her down to earth writing style.
   
   
7. Nurse Barb’s Daily Dose – Barb Dehn, RN, MS, NP is committed to deciphering convoluted health information in order to assist individuals in achieving optimal health and wellness. Nurse Barb’s Daily Dose contains articles pertaining to women’s health, parenting, caregiving, healthy living, and medical conditions.
   
   
8. Nursetopia – Nursetopia features timely articles on all pertinent topics in healthcare. This blog inspires nurses by highlighting and displaying the positive influence nurses have on the healthcare culture.
   
   
9. rtConnections – Renee Thompson is a motivational speaker and the author of “Do No Harm” Applies to nurses too! Strategies to protect and bully-proof yourself at work. Thompson gears her presentations toward clinical competence and bullying within the workplace and works to enhance effective communication within a healthy organization.
   
   
10. The Nursing Show -The Nursing Show is not your typical blog.  It is filled with hundreds of short podcasts and easy to read articles pertaining various nursing topics geared toward nurses of all skill levels. All nurses are sure to find topics of interest in this diverse, educational blog.
    
    

REGISTERED NURSES

11. According to Nurse Kateri – Kateri, RN, BSN, started this blog while on a personal journey to discover herself and now uses it to detail her personal experiences as they pertain to health and happiness. This blog features narratives relating to her career in pediatrics and pediatric intensive care.
    
    
12. JParadisi RN’s Blog – Julianna Paradisi, RN is an accomplished artist and an oncology nurse who incorporates art into patient care. This blog focuses on the same while featuring some of her personal pieces of art as they relate to her writing.
    
    
13. Nurse Eye Roll – Nurse Eye Roll was established by a newly seasoned nurse wishing to provide encouragement, inspiration, support, and laughter to student nurses. Nursing school is tough and Nurse Eye Roll is there to offer tips and suggestions about navigating the path toward graduation and successful board examination.
    
    
14. The Nerdy Nurse – Brittany Wilson, RN, BSN is a nursing informatics nurse who prides herself by incorporating technology into healthcare in order to improve and streamline patient care. This blog is found on various lists of top nursing blogs and is highly followed on social media.  For more information, see what is nursing informatics?
    
    

NURSE PRACTITIONER

15. Barefoot Nurse – Barefoot Nurse reviews real life experiences as they occur through the eyes of an advance practice nurse. Kelly Arashin, the author behind this blog, is unique in her profession because she is a dually board certified nurse practitioner in acute and critical care and a clinical nurse specialist.
    
    
16. My Strong Medicine – Sean Dent is an acute care nurse practitioner by day and weightlifter and coach by night. This blog was originally designed to share his experiences as a nurse but now it contains more commentaries on his personal life, his love for CrossFit and weightlifting.
    
    
17. NP Business Blog – Nurse practitioners whom are in private, independent practice are breaking the mold of traditional NP employment status and are often found without the available resources to answer common questions. Barbara C. Phillips developed this blog as a means for NPs to offer support to others in all avenues of business NPs may be involved in.
    
    
18. NP Odyssey – In existence since 2009, this blog contains a wealth of valuable information and insight including what it takes to become a nurse practitioner and the challenges NPs frequently encounter. This blog also incorporates articles pertaining to recent headlines in healthcare and how they pertain to NP practice.
    
    
19. The NP Mom -Brett Badgley Snodgross is a family nurse practitioner with a passion for pain management and palliative care. She writes informative, easy to read articles related to common concerns she sees in her practice ranging from dieting to hypertension to allergies and beyond.
    
    

NURSING STUDENT

20. A Journey Through Nursing School and Beyond – This blog takes the reader through the entire process of climbing the ladder through nursing education. The author began this blog as a certified nurse assistant, became a LPN, then an RN, and is currently seeking a master’s degree in nursing education. Most entries are brief and include an update on coursework although others offer valuable tips and tricks of the nursing trade.
    
    
21. Adrienne, Student Nurse – Adrienne, RN is passionate about the way nurses and nursing students use social media in their professional lives. Adrienne, Student Nurse is written with the goal of telling the story of being a student nurse in an effort to motivate others to accept the challenge of becoming a nurse.
    
    
22. Becoming a RN – Follow Amy on her journey through nursing school through her blog where she recounts her trials, tribulations, and triumphs. This blog includes insight on navigating through the various challenges presented by nursing school and inspires nursing students to prevail.
    
    

NURSING CAREER

23. Digital Doorway – Keith Carlson, RN utilizes his blog, Digital Doorway, to coach nurses so they may feel fulfilled in their nursing careers. One of the most well known bloggers in healthcare, Carlson blogs about career opportunities, social media in healthcare, and burnout prevention.
    
    
24. Innovative Nurse – Kevin Ross, RN is the ‘Innovative Nurse’ behind this blog. Ross writes about numerous areas of career nursing such as time management, salary, mobile apps, networking, and workplace happiness in the healthcare arena.
    
    
25. International Nurse Support – International Nurse Support provides nurses with the necessary strategies to be confident in their positions while empowering them to climb the profession’s ladder as they progress in their career. This blog is owned by Joyce Fiodembo, however guest bloggers are featured frequently.
    
    
26. Off the Charts – Off the Charts is the online publication of the well renowned American Journal of Nursing. While this blog lacks the personal touch many other blogs convey, Off the Charts presents up to date research data provided in an easy to read format. Various bloggers are often featured on this blog including many other bloggers in this list.
    
    
27. The Nursing Site Blog – Kathy Quan, RN, BNS, PHN, has been a nurse for greater than 30 years and utilizes this blog as a means to share her extensive knowledge with fellow nurses. Quan is the author of five books including The Everything New Nurse Book which helps new nurses transition from nursing school to bedside nursing.
    
    
28. Your Career Nursing – Tina Lanciault, RN helps her readers find their niche in nursing by writing about alternative nursing careers. Your Nursing Career contains articles related to online learning, networking, lifestyles, product reviews, and entrepreneurship.
    
    

WOMEN’S HEALTH

29. At Your Cervix – At Your Cervix is written by a newly graduated nurse midwife and nicely portrays the trials and tribulations a new nurse midwife may encounter in practice. The blog contains educational articles that pertain to women’s health as well as commentaries based on the situations she came across over the course of the bloggers first year in practice.
    
    
30. Mimi Secor – Mimi Secor is an accomplished family nurse practitioner with over 30 years experience in women’s health. Outside of her private practice, Mimi Secor is a public speaker and nurse consultant who prides herself in promoting quality care in women’s health.
    
    

Source: Norwich University's Master of Science in Nursing online program

The UCLA Health Interpreter/Translation and Deaf Services program provides services to all UCLA Health inpatients, outpatients, and their relatives at no cost. Every attempt is made to provide services in any language. The service will be provided by an in-person interpreter, video conference or by telephone.

Source: Youtube

By MIKE STOBBE

For more than two months, health officials have been struggling to understand the size of a national wave of severe respiratory illnesses caused by an unusual virus. This week, they expect the wave to start looking a whole lot bigger.

But that's because a new test will be speeding through a backlog of cases. Starting Tuesday, the Centers for Disease Control and Prevention is using a new test to help the agency process four or five times more specimens per day that it has been.

The test is a yes/no check for enterovirus 68, which since August has been fingered as the cause of hundreds of asthma-like respiratory illnesses in children — some so severe the patients needed a breathing machine. The virus is being investigated as a cause of at least 6 deaths.

It will largely replace a test which can distinguish a number of viruses, but has a much longer turnaround.

The result? Instead of national case counts growing by around 30 a day, they're expected to jump to 90 or more.

But for at least a week or two, the anticipated flood of new numbers will reflect what was seen in the backlog of about 1,000 specimens from September. The numbers will not show what's been happening more recently, noted Mark Pallansch, director of the CDC's division of viral diseases.

Enterovirus 68 is one of a pack of viruses that spread around the country every year around the start of school, generally causing cold-like illnesses. Those viruses tend to wane after September, and some experts think that's what's been happening.

One of the places hardest hit by the enterovirus 68 wave was Children's Mercy Hospital in Kansas City, Missouri. The specialized pediatric hospital was flooded with cases of wheezing, very sick children in August, hitting a peak of nearly 300 in the last week of the month.

But that kind of patient traffic has steadily declined since mid-September, said Dr. Jason Newland, a pediatric infectious diseases physician there.

"Now it's settled down" to near-normal levels, Newland said. Given the seasonality of the virus, "it makes sense it would kind of be going away," he added.

The germ was first identified in the U.S. in 1962, and small numbers of cases have been regularly reported since 1987. Because it's not routinely tested for, it may have spread widely in previous years without being identified in people who just seemed to have a cold, health officials have said.

But some viruses seem to surge in multi-year cycles, and it's possible that enterovirus surged this year for the first time in quite a while. If that's true, it may have had an unusually harsh impact because there were a large number of children who had never been infected with it before and never acquired immunity, Newland said.

Whatever the reason, the virus gained national attention in August when hospitals in Kansas City and Chicago saw severe breathing illnesses in kids in numbers they never see at that time of year.

Health officials began finding enterovirus 68. The CDC, in Atlanta, has been receiving specimens from severely ill children all over the country and doing about 80 percent of the testing for the virus. The test has been used for disease surveillance, but not treatment. Doctors give over-the-counter medicines for milder cases, and provide oxygen or other supportive care for more severe ones.

The CDC has been diagnosing enterovirus 68 in roughly half of the specimens sent in, Pallansch said. Others have been diagnosed with an assortment of other respiratory germs.

As of Friday, lab tests by the CDC have confirmed illness caused by the germ in 691 people in 46 states and the District of Columbia. The CDC is expected to post new numbers Tuesday and Wednesday.

Aside from the CDC, labs in California, Indiana, Minnesota and New York also have been doing enterovirus testing and contributing to the national count. It hasn't been determined if or when the states will begin using the new test, which was developed by a CDC team led by Allan Nix.

Meanwhile, the virus also is being eyed as possible factor in muscle weakness and paralysis in at least 27 children and adults in a dozen states. That includes at least 10 in the Denver area, and a cluster of three seen at Children's Mercy, Newland said.

Source: http://news.yahoo.com