A respiratory virus that in rare cases can cause polio-like paralysis in children is on the rise in California and across the nation, according to wastewater analyses.
Enterovirus D68 was detected in 207 out of 268 samples taken from wastewater sites across the nation in the last 10 days, says the nonprofit WastewaterSCAN.
In the same time period, EV-D68 was detected at a medium level at 17 wastewater sites in California, 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.
Most people who contract EV-D68 will experience slight respiratory symptoms or none at all, according to the Centers for Disease Control and Prevention. Nevertheless, its spread is troubling because the virus can lead to a rare and debilitating neurological condition called acute flaccid myelitis, or AFM.
AFM attacks motor neurons in the spinal cord’s gray matter, which controls movement. This causes muscles and reflexes to weaken and, in severe cases, can lead to paralysis and death, according to the CDC.
Around 90% of cases occur in children, and there is no known treatment.
Dr. Robert Kim-Farley, an epidemiologist and infectious diseases expert with 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.
“This is covering your coughs and sneezes, it’s washing hands,” he said, “If you’ve been around someone who’s coughing and sneezing … make sure that you haven’t touched contaminated surfaces that they’ve been touching or shared cups 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 illness took place in 2018, when 238 cases were confirmed across the country. Cases also spiked 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 of experiencing more severe symptoms, according to the CDC.
Here are some common symptoms of EV-D68:
- Runny nose
- Sneezing
- Cough
- Body aches
- Wheezing and difficulty breathing
If the virus progresses to cause AFM, symptoms include:
- Arm or leg weakness
- Difficulty swallowing or slurred speech
- Difficulty moving the eyes and drooping in the eyelids and face
Kim-Farley recommends people seek medical care if they develop any evidence of paralysis or weakness in the limbs or muscles after having had a respiratory or fever-inducing illness one to two weeks prior.
The paralysis caused by AFM is very similar to that caused by polio — which, like EV-D68, is also an enterovirus.
Polio was eradicated in the Unites States in 1979, thanks to a widespread vaccination campaign, according to the CDC. Unfortunately, there is no vaccine for EV-D68.
“Even though [EV-D68] is not vaccine-preventable, it’s always a good opportunity to realize there are other diseases that cause paralysis, like polio, that are vaccine-preventable” and against which children can be inoculated, Kim-Farley said.
He also recommended getting the latest COVID-19 vaccine.
