A respiratory virus that in rare cases can cause polio-like paralysis in children is on the rise in California and across the country, according to wastewater analyses.
Enterovirus D68 was detected in 207 of 268 samples taken from wastewater sites nationwide in the past 10 days, the nonprofit WastewaterSCAN says.
During the same period, EV-D68 was detected at medium levels in 17 California wastewater sites, including facilities in Los Angeles, San Diego, San Francisco, Sacramento and San Jose. Because humans shed viruses in waste, wastewater sampling is used to measure the prevalence of infection in a community.
According to the Centers for Disease Control and Prevention, most people who contract EV-D68 will experience mild or no respiratory symptoms. However, its spread is concerning because the virus can cause a rare and debilitating neurological disease called acute flaccid myelitis, or AFM.
AFM attacks motor neurons in the gray matter of the spinal cord, which controls movement. This causes muscles and reflexes to weaken and, in severe cases, can lead to paralysis and death, according to the CDC.
About 90% of cases occur in children and there is no known treatment.
Dr. Robert Kim-Farley, an epidemiologist and infectious disease expert at the UCLA Fielding School of Public Health, told The Times that the best way to avoid contracting EV-D68 is to practice common respiratory hygiene.
“That's covering your mouth when you cough and sneeze, that's washing your hands,” she said, “if you've been around someone who's coughing and sneezing… make sure you haven't touched any contaminated surfaces that they've been touching or shared glasses or utensils.”
This year, the CDC has confirmed 13 cases of AFM, including one in California, as of Sept. 3.
The largest known outbreak of the disease occurred in 2018, when 238 cases were confirmed across the country. Cases also increased in 2014 and 2016.
Most cases of EV-D68 will be mild and feel like a common cold. However, children with asthma are at higher risk for more severe symptoms, according to the CDC.
Below are some common symptoms of EV-D68:
- Rhinorrhea
- Sneezing
- Cough
- Body aches
- Wheezing and shortness of breath
If the virus progresses and causes AFM, symptoms include:
- Weakness in arms or legs
- Difficulty swallowing or difficulty speaking
- Difficulty moving the eyes and drooping of the eyelids and face.
Kim-Farley recommends that people seek medical attention if they develop any evidence of paralysis or weakness in limbs or muscles after having a respiratory or febrile illness one to two weeks previously.
The paralysis caused by AFM is very similar to that caused by polio, which, like EV-D68, is also an enterovirus.
According to the CDC, polio was eradicated in the United States in 1979 thanks to a widespread vaccination campaign. Unfortunately, there is no vaccine against EV-D68.
“Although [EV-D68] “While paralysis is not vaccine-preventable, it is always a good opportunity to realize that there are other diseases that cause paralysis, such as polio, that are vaccine-preventable” and that children can be vaccinated against, Kim-Farley said.
He also recommended getting the latest COVID-19 vaccine.
