CDC Warns of Increasing Cases of Enterovirus D68, Virus Linked to Paralysis

The Centers for Disease Control and Prevention (CDC) is warning of an increase in a respiratory illness that is linked to paralysis in children. It’s called enterovirus D68, and the CDC says it’s currently on the rise in the US

The CDC shared the news on its Morbidity and mortality weekly reportwhich notes that enterovirus D68 cases began to increase this summer after a “prolonged period” of low case numbers during the COVID-19 pandemic.

The report details how, in August, doctors in several areas of the country notified the CDC of an increase in hospitalizations of children with “severe respiratory illness” and positive results for enterovirus D68 (EV-D68). This has put a “substantial demand on resources” in some hospitals and has also “coincided” with an increase in acute flaccid myelitis, a rare but serious neurological disease that causes the body’s muscles and reflexes to weaken.

“Continued surveillance of EV-D68 is critical,” the CDC says in the report.

The report comes just weeks after the CDC issued a health advisory, warning doctors to be on the lookout for enterovirus D68 in patients. Here’s what you need to know about enterovirus D68, plus how concerned you should be.

What is enterovirus D68?

Enterovirus D68 is a respiratory infection that is one of more than 100 diseases called non-polio enteroviruses, according to the CDC. (Polio, the infectious disease that can cause paralysis, is also an enterovirus.)

Enterovirus D68 usually causes a mild respiratory illness like a cold, but it can also cause a serious complication called acute flaccid myelitis (AFM), which can lead to paralysis, according to the CDC.

Enterovirus and enterovirus D68 usually come in waves, causing an increase in infections every two years, according to the CDC. Infections are also more likely in the summer and fall.

Symptoms of enterovirus D68

Enterovirus can cause mild symptoms, severe symptoms, or no symptoms, according to the CDC. Mild symptoms may include:

  • Nasal discharge
  • sneeze
  • couch
  • Body pains
  • Muscle pains

Serious symptoms may include:

  • Wheezing
  • Trouble breathing

If someone develops AFM from enterovirus D68, they may have the following symptoms:

  • Arm or leg weakness
  • Pain in the neck, back, arms or legs
  • Difficulty swallowing or difficulty speaking
  • Difficulty moving the eyes or droopy eyelids
  • Facial droop or weakness

How concerned should you be about enterovirus D68?

AFM is considered a rare complication of enterovirus D68, but it happens more than most people realize. In 2014, a large outbreak of enterovirus D68 caused about 10 percent of infected people to develop AFM, according to the CDC.

Increases in AFM cases have occurred in 2014, 2016 and 2018 in the US, according to the CDC, which also coincides with when there have been increases in enterovirus D68.

“AFM is a rare complication of enterovirus D68,” says Amesh A. Adalja, MD, senior investigator at the Johns Hopkins Center for Health Security. “However, it is a serious problem when it occurs.”

Enterovirus D68 AFM is more common in children than in adults, Dr. Adalja says. “Although adults can become infected with enterovirus D68, they rarely develop AFM,” he says.

“We’ve had outbreaks in the past that haven’t gotten as much attention,” Perry N. Halkitis, Ph.D., dean of the Rutgers School of Public Health, tells SELF. “Enterovirus D68 is a bigger concern right now, potentially because we’ve increased concern about the polio virus. But do I think it’s going to become a widespread problem? No.”

Worth noting: Daniel Ganjian, MD, a pediatrician at Providence Saint John’s Health Center in Santa Monica, California, said his practice is “seeing an increase in the common cold and enterovirus.” But, he adds, “we’re not seeing an increase in AFM.”

How to stay safe from enteroviruses

Enterovirus can be tricky to prevent when it’s circulating, says Dr. Adalja. “Enteroviruses are ubiquitous and very difficult to avoid,” he notes.

Still, there are some things you can do to reduce your risk. A big one is practicing good hand hygiene, says Dr. Ganjian. Other safety tips, according to the CDC:

  • Wash your hands often with soap and water for 20 seconds
  • Do not touch your eyes, nose and mouth with unwashed hands
  • Try to avoid close contact, such as kissing, hugging, and sharing cups or eating utensils with sick people.
  • Cover your coughs and sneezes with a tissue or the upper sleeve of your shirt (ie, not your hands)
  • Clean and disinfect frequently touched surfaces such as toys and doorknobs. This is especially important if someone is sick.

In general, experts say, many safety precautions that people took during the pandemic can help reduce the risk of contracting enterovirus D68. “Just keep doing what you’ve been doing,” says Dr. Ganjian.

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