A virus that, in some cases, can cause polio-like symptoms in children is on the rise in the United States, according to wastewater data.
Enterovirus D68 (EV-D68) usually causes mild cold like symptoms, such as a runny nose, sneezing, or coughing, but may also be linked to a polio-like condition, according to Stanford and Emory University researchers who run WastewaterSCAN, a national program monitoring wastewater samples and testing.
According to the researchers, EV-D68 may be linked to the rare neurological condition known as acute flaccid myelitis (AFM), which can cause muscle and reflex weaknesses leading to trouble swallowing, drooping eyelids, slurred speech, arm and leg weakness, or facial droop.
Since August, there has been a sharp spike in the DNA of EV-D68 in wastewater—by about four fold—which could be of concern for children, infants, and teenagers who are most susceptible to developing severe symptoms, according to recent data published on the program’s website. Minors with asthma are considered at higher risk of developing symptoms.
The virus is spread through saliva, coughs, sneezes, or contaminated surfaces, with infections peaking during the summer and fall. Unlike polio, which has a vaccine, there is no vaccine for EV-D68 infections but supportive therapy is available to help relieve symptoms, according to the program’s website.
According to the Centers for Disease Control and Prevention (CDC), most healthcare providers cannot test for EV-D69, which must be diagnosed through lab tests using blood or throat and nose fluid samples.
EV-D68 is one of more than 100 non-polio enteroviruses. Most enteroviruses don’t result in cold symptoms, but children or people with weakened immune systems are more susceptible to infections, the CDC says.
Although uncommon, serious infections can lead to myocarditis (inflammation of the heart), viral encephalitis (inflammation of the brain), viral meningitis (inflammation of the spinal cord and/or brain covering), or blisters from hand, foot, and mouth disease, among others, according to the CDC.
In a recent study published in the medical research journal Frontiers in Virology, researchers said that EV-D68 has re-emerged as a “major public health concern” in recent years after the virus was first discovered in 1962 in children with pneumonia. Since discovery, small outbreaks have occurred on and off, with the last major outbreak in 2014.
From 2014 to 2018, major outbreaks have occurred bi-annually and mostly among children, of whom 90 percent were under the age of 16. The virus also spiked, along with several other respiratory viruses, since the emergence of SARS-CoV-2 during the COVID-19 pandemic, according to the study published in February.
The study involved researchers from The Henry M. Jackson Foundation for Military Medicine at the Uniformed Services University in Bethesda, Maryland, and the Children’s Hospital Colorado and University of Colorado School of Medicine in Aurora, Colorado.
They said in the study’s conclusion that researchers have yet to determine the cause for the uptick in infections, or why children under 16 are more susceptible. A reason why the infection can result in spinal cord gray matter destruction, which can cause paralysis, is also unknown but further study into immune responses to the virus could help researchers learn more.