Rates of enterovirus D68, a respiratory virus that can sometimes lead to a polio-like illness and paralysis in children, have risen significantly across the U.S. over the past month, based on wastewater data from the nonprofit WastewaterSCAN. The virus is now being detected at medium levels after having stayed at low levels from September 2023 to August 2024. Enterovirus D68 activity started rising this past spring in the South, and rates have started rising in all four regions the group tracks but are still highest in the South. Rising rates are concerning because enterovirus D68 can cause a rare but serious complication in kids known as acute flaccid myelitis (AFM), which can cause loss of muscle and reflexes.
Caitlin Rivers, Ph.D., an epidemiologist, stated that higher rates of enterovirus D68 usually mean higher rates of AFM. So far this year, there have been 13 confirmed AFM cases in 10 states, and since 2014, 758 people have been diagnosed with the illness. During the last rise in enterovirus cases in the U.S. in 2022, the CDC urged health professionals to be on the lookout for symptoms of severe enterovirus and AFM in kids. Enterovirus D68 usually causes respiratory illness, which can range from mild to severe. It spreads through respiratory secretions like saliva and mucus and there are no specific treatments for it.
The highest rates of enterovirus in the U.S. are currently in the South followed by the Northeast. Rates are rising nationwide and mild symptoms of enterovirus D68 include runny nose, sneezing, cough, nasal congestion, body aches, and muscle aches. Severe symptoms often include wheezing and difficulty breathing. If a child develops any limb or muscle weakness following a respiratory illness, seek medical attention immediately as it could be a sign of AFM. AFM is an uncommon but serious neurologic condition with symptoms like arm or leg weakness, loss of muscle tone, and loss of reflexes. More than 90% of AFM cases are in young children and it is most common between August and November.
Since AFM was first identified in 2014, there have been two more spikes in 2016 and 2018, all believed to be caused by enterovirus D68. The 2022 wave of enterovirus D68 didn’t lead to a rise in AFM cases, and experts are still trying to understand why. There have been 13 AFM cases in 10 states so far in 2024, including California, Florida, Illinois, Iowa, and New York, among others. Symptoms of AFM include sudden arm or leg weakness, loss of muscle tone or reflexes, difficulty moving, facial drooping, difficulty swallowing, and more. The neurologic symptoms usually appear suddenly and can progress quickly, with no specific treatment available.
It takes between one and four weeks for a case of enterovirus D68 to progress to AFM, and the outcomes can range from slight shoulder weakness to needing prolonged respiratory support. The best way to protect your family from these illnesses is to practice good hand hygiene, avoid touching your face with unwashed hands, and wear a mask in public. Enterovirus D68 spreads through respiratory secretions, and infants, children, and adolescents have the highest risk of getting ill from the virus. It’s important to seek medical attention immediately if your child develops any concerning symptoms, especially after a respiratory illness, as early intervention is crucial in the management of AFM.
