The US Centres for Disease Control and Prevention (CDC) has reported a spike in EV-D68, a contagious virus that in rare cases can lead to permanent paralysis in children, issuing a warning this month that there has been a worrying increase in the spread of the illness.
The agency said last month, hospitals and other healthcare providers had reported that “paediatric hospitalisations in patients with severe respiratory illness who also tested positive for rhinovirus (RV) and/or enterovirus (EV)” had shot up.
Rhinoviruses cause around half of all common colds
Around half of all common colds “are caused by some kind of rhinovirus” and there are more than 100 kinds each of rhinoviruses and enteroviruses that can lead to infections, one of those enteroviruses being EV-D68, which has been linked to rare cases of paralysis.
Most of those who are infected experience mild or no symptoms, but some infections can become severe, especially for children or those with impaired immune systems, reports The Independent.
The majority of people who get infected with non-polio enteroviruses don’t get sick, or they have only mild illness, like the common cold. Symptoms can include fever, runny nose, sneezing, cough, skin rash, mouth blisters, and body and muscle aches.
Children testing positive for EV-D68 higher than recent years
Healthcare providers have reported some children have also tested positive for enterovirus D68, also known as EV-D68, and the numbers of youngsters testing positive for RV or EV as well as EV-D68 is higher this year than in the previous three years, particularly over July and August.
Although it primarily causes acute respiratory illness, EV-D68 has been associated with acute flaccid myelitis (AFM), a rare but serious neurologic complication involving limb weakness. AFM can sometimes lead to permanent paralysis.
‘Increases in EV-D68 respiratory illnesses have typically preceded cases of AFM’
The CDC said it “had not received increased reports of AFM cases with onset in 2022” as of 30 August of this year, adding that “increases in EV-D68 respiratory illnesses have typically preceded cases of AFM.
RVs are usually linked to acute respiratory illness, such as asthma. While EVs can also lead to acute respiratory illness, it’s connected to other issues, such as febrile rash, neurologic illness, aseptic meningitis, AFM and encephalitis. The respiratory symptoms are similar for those infected with RVs and EV-D68.
Common symptoms
Common symptoms among hospitalised children with EV-D68 include cough, shortness of breath and wheezing, while fever is reported in half of the cases. Rarely, EV-D68 may cause AFM, an uncommon but serious neurologic condition primarily affecting children and typically presenting with sudden limb weakness.
There are no available vaccines or specific treatments for RV or EV, including EV-D68.
RVs and EVs have similarities making them “indistinguishable from one another” in complex tests used in clinical settings. To differentiate them, more detailed measures are required.
Spread of EV-D68 peaks in certain seasons
The CDC warned that RVs circulate at all times but tend to peak in the spring and autumn. The EV season is the same, as is that of EV-D68.
“The relatively lower circulation in 2020 may reflect the use of pandemic infection mitigation measures, which are known to have interrupted the circulation of other respiratory viruses,” the CDC said, adding that AFM cases also spiked in autumn 2014, 2016, and 2018.
The median age of children seeking emergency or inpatient care in 2018 for respiratory illness associated with EV-D68 was three years old, but all ages can be affected.
Children with a history of asthma or reactive airway disease might be more likely to require medical care, though those without a known history of asthma can also become severely ill. Among adults, the EV-D68 is less understood but it’s thought to be more commonly detected in patients with underlying conditions.
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