Enterovirus D68 is a respiratory virus that can cause acute flaccid myelitis, presenting symptoms similar to polio.
On September 27, the Centers for Disease Control and Prevention (CDC) in the United States reported a significant increase in cases of enterovirus D68 among children. From March 1 to September 20, the CDC recorded 260 infections—higher than the total for the previous three years combined. The agency identified 6 cases in 2019 and 30 cases in 2020.
Children infected with enterovirus are typically under three years old. The infections were detected at pediatric medical centers associated with the CDC’s Vaccine Surveillance Network.
What is Enterovirus D68?
Scientists first identified enterovirus D68 in 1962. At that time, the virus was not widely circulating, and patients exhibited mild symptoms. Enterovirus D68 is one of over 100 types of viruses that do not belong to the poliovirus group.
Symptoms of Enterovirus D68 Infection
Individuals infected with enterovirus D68 may experience respiratory symptoms ranging from mild to severe, or may show no symptoms at all. Mild symptoms include a runny nose, sneezing, coughing, body aches, and muscle pain. Severe symptoms include difficulty breathing.
Enterovirus can sometimes lead to acute flaccid myelitis, characterized by inflammation in the neck or spinal cord. Those affected may have difficulty moving their arms, while others may experience weakness in all four limbs.
During an outbreak in the U.S. in 2014, approximately 10% of those diagnosed with enterovirus went on to develop acute flaccid myelitis. Most patients do not fully recover after this illness. They may improve to some extent, but the recovery process is challenging and often requires rehabilitation.
Children with acute flaccid myelitis often require hospitalization. The high-risk group includes children with asthma, although the reasons for this are not yet clear.
Medical experts advise parents to seek immediate medical attention if their child shows signs of weakness in the arms or legs, neck pain, back pain, difficulty swallowing, slurred speech, or inability to control eye movements.
According to the CDC, it is challenging to differentiate enterovirus symptoms from other respiratory symptoms. Acute flaccid myelitis is also easily confused with severe polio.
Computer-generated image of enterovirus D68. (Photo: Med Page Today)
How is the Virus Transmitted?
Enterovirus can be found in bodily fluids (such as feces and urine) or respiratory secretions (saliva, nasal mucus, phlegm) of infected individuals. The virus spreads from person to person when an infected person coughs, sneezes, and does not cover their mouth.
Why is There an Increase in Enterovirus Cases?
In the past, the CDC has noted spikes in enterovirus infections in certain years, specifically in 2014, 2016, and 2018. Dr. Benjamin Greenberg, a neurologist at the O’Donnell Brain Institute, stated that the increase in patients is due to the COVID-19 lockdowns over the past two years. Children were not exposed to pathogens, leading to a decrease in immunity. Consequently, enterovirus has had the opportunity to resurge this year.
Dr. Sarah Hopkins, a neurologist at the Children’s Hospital of Philadelphia, speculated that the virus would increase in 2020, following the previous two-year pattern. However, mask mandates and social distancing measures limited the activity of respiratory viruses.
