Enterovirus D68 Infections May Be Linked to 4 Deaths, 10 Paralysis Cases

At least four children have died, and nearly a dozen others have suffered paralysis that may be linked illnesses involving a strain of enterovirus that continues to spread across the country, reportedly sickening more than 500 nationwide. 

In an alert issued late last week, the U.S. Centers for Disease Control and Prevention (CDC) warned state and local health departments that at least 10 children in the state of Colorado alone have been hospitalized with illnesses involving the brain and spinal cord, with about half of the childrent having enterovirus D68 in their nose secretions.

To date, 538 people across 43 states, mostly children, have become ill with enterovirus D68, which is primarily characterized by respiratory symptoms including asthma and wheezing.

Four children who tested positive for enterovirus D68 have died, although officials are unclear the role the virus played in their deaths. One young patient from Rhode Island also tested positive for a staph infection, a bacteria resistant to many antibiotics.

The children in Colorado have reportedly experienced weakness and paralysis in their arms and legs, after initially experiencing respiratory symptoms commonly associated with enterovirus D68.

Health officials are unsure whether the effects of the polio-like illness will be permanent. Most of the children affected by paralysis symptoms had a problem with their spinal cord that could be seen on magnetic resonance imaging (MRI), which can often identify problems with the nervous system.

All the patients experienced fever and respiratory symptoms, like wheezing, one week before the onset of muscle weakness.

The CDC is continuing to work with health officials in Colorado and elsewhere to determine what may have caused the children hospitalized to become sick, indicating that they do not yet know whether the respiratory infection is in fact linked to the reported muscle weakness.

Enterovirus Continues to Spread

In rare cases, people testing positive for enterovirus D68 may display symptoms which mimic infection with polio virus. As cases of D68 continue to mount across the country, it is even more likely for patients to experience those symptoms.

Initial reports of enterovirus D68 revealed dozens of children becoming sick in Illinois and Missouri in early August. It is not an uncommon illness, especially during this time of year. Symptoms are typically are no more harmful than the common cold.

Of the patients tested so far, half have tested positive for D68. One-third have tested for some type of enterovirus or rhinovirus other than D68. Enterovirus D68 is one of more than 100 non-polio enteroviruses which cause 10 to 15 million infections in the U.S. annually.

The CDC is currently in the process of developing and validating a diagnostic test to detect D68 in specimens. The agency is also exploring options to provide test kits to state public health laboratories.

In the meantime, health officials indicate that the best defense for children is good hygiene.