The United States is currently facing a significant uptick in cases of Enterovirus D68 (EV-D68), a respiratory virus that has the potential to paralyse children in rare cases. Hospitals across the country have reported an alarming increase in paediatric patients showing symptoms of severe respiratory illness, raising concerns among healthcare providers and parents alike. According to the U.S. Centres for Disease Control and Prevention (CDC), this outbreak could lead to a rise in acute flaccid myelitis (AFM), a rare neurological condition linked to EV-D68 that can cause permanent paralysis.

Surge in respiratory illnesses

Since the summer, several hospitals have observed a noticeable increase in children admitted with severe respiratory conditions, which have been traced back to enteroviruses, including EV-D68. Wastewater testing in different regions of the U.S. has confirmed the presence of the virus, with many areas seeing a higher-than-usual rate of infections.

EV-D68, a member of the enterovirus family, primarily affects children, particularly those with compromised immune systems. While many cases present with mild symptoms similar to a cold, including coughing, sneezing, and shortness of breath, the virus can sometimes progress to more severe forms of respiratory illness. More concerning, however, is its association with AFM, a condition that has left children paralysed in past outbreaks.

No vaccine or cure

The lack of a vaccine or specific treatment for EV-D68 has made managing the virus challenging. Medical experts stress that prevention, including good hygiene practices and avoiding close contact with infected individuals, is currently the best line of defence. The virus tends to spread more during late summer and early autumn, which aligns with the current surge in cases. Healthcare professionals are also warning that the spread of EV-D68 is expected to continue into the autumn months, posing a continued threat to children nationwide.

The EV-D68 virus has a history of resurging every few years. EV-D68 spikes in 2014, 2016, and 2018 were linked to sharp increases in AFM cases, and current trends indicate a similar pattern might emerge. Schools and public spaces could become hotspots for the virus as children congregate in larger numbers, making vigilance critical in the coming weeks.

Increased vigilance needed for AFM

AFM typically follows respiratory outbreaks involving EV-D68, and although the CDC has not yet reported a spike in AFM cases, the number of severe respiratory illnesses is being closely monitored. The CDC has urged healthcare providers to be on high alert for any signs of limb weakness or paralysis in children following respiratory symptoms. Timely diagnosis and treatment are essential for managing AFM, though recovery from paralysis remains difficult, and some children may suffer permanent damage.

While AFM cases remain rare, the neurological symptoms can appear suddenly, typically within a few days of the initial respiratory illness. The risk of paralysis has added a layer of concern, particularly because AFM primarily affects children under the age of five, a demographic already vulnerable to respiratory infections.

Expert advice on prevention

Experts recommend that parents take proactive steps to protect their children from EV-D68. This includes encouraging frequent handwashing, keeping children home from school if they show any symptoms of respiratory illness, and ensuring that shared surfaces are cleaned regularly. Doctors also stress the importance of seeking immediate medical attention if a child shows signs of difficulty breathing, persistent coughing, or sudden limb weakness, as early intervention can make a significant difference in the outcome of AFM.

Healthcare providers are also preparing for a potential strain on hospital resources, given the growing number of cases requiring intensive care. Paediatric wards in some regions have already reported an increase in admissions, with children requiring ventilatory support due to the severity of their symptoms.

  acute flaccid myelitis, AFM, CDC, Enterovirus D68, EV-D68, James Lawler, paediatric healthcare, U.S. Centres for Disease Control and Prevention