CDC Warns About Child Respiratory Disease Cases Due to Virus Linked to Child Paralysis Cases

Previous outbreaks of child paralysis cases have surged in late summer and early fall.

Government health officials are warning doctors and parents about an increasing number of cases involving a serious respiratory disease among children, which has been linked to childhood paralysis and limb weakness.

The U.S. Centers for Disease Control and Prevention (CDC) issued the report on September 9, indicating several regions across the country saw a rising number of pediatric hospitalizations with severe respiratory illness in August involving a polio-like disease among children, with many experiencing a rare, but severe limb weakness.

The CDC reports an increasing number of pediatric patients tested positive for rhinovirus (RV) and enterovirus (EV), including many which also tested positive specifically for enterovirus D68 (EV-D68); an enterovirus linked to neurologic complications and limb weakness.

The number of children who tested positive for EV-D68 this year is greater than the number of children who tested positive from 2019 to 2021 combined, the CDC warns

Surveillance sites are reporting a higher proportion of EV-D68 among children who are also RV/EV positive. However, RVs and EVs can have clinically similar presentations and are indistinguishable from one another on standard testing used in a clinical setting.

Childhood Paralysis Concerns

EV-D68 primarily causes acute respiratory illness, such as cough, shortness of breath and wheezing. Some children also experience fevers. However, it is also linked to acute flaccid myelitis (AFM), a rare but serious neurologic complication that affects the nervous system, especially the spinal cord, and leads to limb weakness and sometimes paralysis.

Health officials are urging doctors to consider testing for EV-D68 when treating children with acute respiratory symptoms,  as well as testing them for RV or EV in general.

The CDC has not received any case reports of the polio-like condition AFM in these latest reports, but cases of AFM are typically preceded by an increase in cases of EV-D68. Furthermore, cases may increase in the coming weeks, as most cases tend to be reported in late summer and fall.

Previous AFM Outbreaks

Outbreaks of EV-D68 occurred in 2014, 2016, 2018 and to a lesser degree in 2020. The outbreaks were followed by an increase in cases of AFM in the fall.

After cases of EV-D68 spiked in 2018, cases of AFM impacted more than 300 children and led the CDC to establish an active prospective EV-D68 surveillance program among pediatric patients in seven US hospitals using the New Vaccine Surveillance Network.

Early on, officials struggled to determine the cause of AFM before eventually concluding EV-D68 was the most probable cause of the illness that was causing children to have weakened limbs and sudden paralysis, which is why many called it “polio-like” even though it is not linked to the polio virus.

The CDC recommends parents focus on good hygiene among families, including washing hands with soap and water, and avoiding touching the eyes, nose and mouth with unwashed hands. The agency also recommends:

• Avoid close contact such as kissing, hugging and sharing cups and eating utensils with people who are sick.
• Always cover a cough or sneeze with a tissue or shirt sleeve, not hands.
• Clean and disinfect high-touch surfaces and stay home when sick.

There are currently no available vaccines or specific treatments for RV or EV, including EV-D68.