Enterovirus D68 Causing Paralyzing Illness Spiking in the U.S., Wastewater Data Reveals
Enterovirus D68, a virus known to cause a rare but severe paralyzing illness, is spiking across the United States, according to recent wastewater data. The virus primarily affects children and can lead to a condition known as acute flaccid myelitis (AFM). Health experts are closely monitoring this situation, as past outbreaks of EV-D68 have resulted in serious neurological damage, particularly in young children. Sporadic outbreaks of this virus have raised concerns about the potential for increased cases, especially in vulnerable populations.
Enterovirus D68: A Background
EV-D68 is a member of the enterovirus family, which includes other common viruses such as polio and coxsackievirus. EV-D68 typically spreads in late summer and early fall, causing mild respiratory symptoms in most people, including cough, fever, runny nose, and muscle aches. However, in rare cases, the virus can invade the central nervous system, leading to more severe complications, including paralysis.
The most feared outcome of an EV-D68 infection is acute flaccid myelitis (AFM), a condition that affects the nervous system, particularly the spinal cord, and results in muscle weakness and, in some cases, permanent paralysis. AFM has been described as “polio-like” due to its similarity in presentation to polio, though it is not caused by the poliovirus.
Wastewater Surveillance and Its Findings
In the past several years, wastewater surveillance has become an essential tool in monitoring viral outbreaks, including COVID-19 and now enteroviruses. Wastewater testing works by analyzing sewage samples for traces of viruses being shed by infected individuals, even before they show symptoms. This method allows public health authorities to track the spread of viral infections in communities and predict potential outbreaks.
Recent data from wastewater across several states in the U.S. has shown a significant increase in the levels of EV-D68. This spike is causing alarm among health officials, as it may indicate a coming rise in the number of AFM cases. While wastewater data doesn’t provide exact case numbers, it serves as an early warning system, highlighting trends and allowing for preventive action before outbreaks become widespread.
Acute Flaccid Myelitis (AFM): The Paralyzing Threat
AFM is a rare but severe neurological condition that affects the gray matter of the spinal cord, leading to muscle weakness, paralysis, and, in some cases, life-threatening complications. Symptoms typically start with sudden onset of limb weakness, often following a respiratory illness caused by EV-D68. Other symptoms can include difficulty moving the face, drooping eyelids, difficulty swallowing, and even respiratory failure in severe cases.
AFM primarily affects children, with most cases occurring in kids under the age of 18, though adults can also be affected. The illness can progress quickly, sometimes within hours or days, and while some patients recover fully, others may experience lasting paralysis or require long-term rehabilitation.
Since 2014, the U.S. has seen periodic spikes in AFM cases, typically coinciding with increases in EV-D68 infections. According to the Centers for Disease Control and Prevention (CDC), there were notable outbreaks in 2014, 2016, and 2018. In 2018, there were 238 confirmed cases of AFM in the U.S., with many patients requiring intensive care or long-term rehabilitation.
Why Is EV-D68 Spiking Now?
Several factors may be contributing to the current rise in EV-D68 cases. One possibility is that the virus, like many respiratory pathogens, follows a seasonal pattern and has re-emerged as COVID-19 restrictions, such as mask-wearing and social distancing, have been relaxed. The return of children to schools and daycares, along with increased social interaction, may also be facilitating the spread of enteroviruses.
Additionally, the COVID-19 pandemic may have indirectly influenced viral trends. Some experts speculate that the disruption to normal virus circulation during the pandemic years may have created a population that is now more susceptible to infections like EV-D68. With fewer people exposed to the virus over the past few years, immunity levels in the community could be lower, allowing the virus to spread more easily.
Preventing the Spread of EV-D68 and Protecting Against AFM
Preventing the spread of EV-D68 requires many of the same public health measures that have been emphasized during the COVID-19 pandemic, including:
- Good hand hygiene: Regular hand washing with soap and water for at least 20 seconds can help prevent the spread of enteroviruses. Alcohol-based hand sanitizers are less effective against enteroviruses.
- Avoid touching the face: The virus can enter the body through the eyes, nose, and mouth, so it is important to avoid touching the face with unwashed hands.
- Disinfect frequently touched surfaces: Regular cleaning of high-touch areas such as doorknobs, light switches, and toys can reduce the spread of the virus.
- Stay home when sick: Parents should keep children home from school or daycare if they exhibit respiratory symptoms such as coughing, sneezing, or runny nose.
- Vaccination against polio: While there is no specific vaccine for EV-D68, ensuring that children are vaccinated against polio can help reduce the risk of polio-related paralysis, which can present similarly to AFM.
What To Do If You Suspect AFM
If a child develops sudden weakness in the arms or legs, difficulty swallowing, facial drooping, or other neurological symptoms, it is critical to seek medical attention immediately. Early intervention may improve the chances of recovery. While there is no specific treatment for AFM, prompt supportive care, including physical therapy, may help reduce long-term complications.
Parents and healthcare providers should remain vigilant, especially during the late summer and fall, when EV-D68 is most likely to circulate. Public health officials continue to monitor wastewater data closely to track the virus’s spread and prepare for any potential outbreaks of AFM.
Conclusion
The recent spike in EV-D68 as shown in wastewater data serves as a warning of the potential for increased cases of acute flaccid myelitis. Public health measures, early detection, and ongoing awareness are key to mitigating the impact of this rare but serious virus. As health officials continue to monitor the situation, individuals can play their part by following preventive measures and staying informed.
