Enterovirus D68 Problems May Include Risk of Paralysis, Muscle Weakness: Reports

Amid continuing concerns about the spread of enterovirus D68 among children throughout the U.S., health officials are reviewing several reported cases of paralysis and severe muscle weakness linked to the illnesses.

Since early August, at least 277 children in 40 different states and the District of Columbia have been infected with enterovirus D68, according to the latest update provided by the U.S. Centers for Disease Control and Prevention (CDC).

Federal health officials indicate that at least nine children in Colorado have experienced limb weakness, and in some cases, paralysis. The children developed the respiratory illness and later developed neurological illness as well.

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Health officials are currently investigating whether enterovirus D68 was the cause of the neurological symptoms. So far, eight of the nine children tested positive for enteroviruses or rhinoviruses. Four of the six tested positive for D68 and the final two children are awaiting results.

Officials indicate that samples of spinal fluid of the infected children has indicated an infection, but no specific evidence of what virus. Tests evaluating for polio and West Nile virus tested negative, however.

In rare cases, people testing positive for enterovirus D68 may display features that mimic infection with the polio virus. However, with so many cases of D68 occurring across the country, it is more likely to see the polio-like effects occur.

None of the four children who tested positive for D68 and have paralysis symptoms have a weakened immune system or other conditions which may predispose them to a severe illness. Eight of the nine children experiencing limb weakness symptoms were up to date on their polio vaccinations.

Doctors are uncertain whether the limb weakness or paralysis will be temporary or permanent after recovery from the enterovirus D68 problems.

Virus spreads across the country

Earlier this year, Stanford University researchers identified a polio-like illness in 20 California children. Two tested positive for enterovirus D68. Two cases of paralysis of patients who tested positive for the D68 virus in their spinal fluid were published in the past. One reported a 5 year old in 2008 and another was may years earlier.

All laboratory confirmed cases of enterovirus D68 have been found among children, except for one adult. Most children infected by enterovirus experienced severe respiratory symptoms, but already had a history of asthma or wheezing.

Enterovirus D68 illnesses were first reported in children in Kansas City and Chicago in August. Initial the outbreak affected dozens of young children, many who suffered from asthma. The majority of the children required hospitalization and respiratory intervention to help with recovery.

Later, cases of enterovirus D68 progressed across more than half the nation by late September, with more than 200 children has been sickened by late September.

The CDC is prioritizing the testing of samples from children who already suffer with respiratory illness. Of all the specimens tested by the CDC, half tested positive for D68 and one-third tested positive for various enteroviruses other than D68 or rhinoviruses.

Infected children receive supportive care, oxygen, medicine to control fever, steroids and breathing treatments to aid with recovery. No deaths have been reported.


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