CDC Warns of Virus That Causes Polio-like Symptoms in Kids

With children back in school and masks optional, viruses are circulating. Families are not only still dealing with COVID-19, but also other typical childhood illnesses. On September 9, 2022, the Centers for Disease Control and Prevention (CDC) issued an emergency warning about an increase in kids being hospitalized with a respiratory illness known as enterovirus D68 (EV-D68).

For the most part, EV-D68 is an acute respiratory illness that kids will recover from with time and rest. In rare cases, it can cause serious neurological complications. While that could be alarming for parents and caregivers, the CDC says it put out the health alert so healthcare workers are aware the virus is spreading. That way they can test those with respiratory symptoms for EV-D68 and watch out for any of its more dangerous symptoms.

What Causes Enterovirus D68?

EV-D68 is one of over a hundred enteroviruses. Polio is an enterovirus, but EV-D68 does not cause polio. Coxsackie is another type of enterovirus you may have heard of. Enterovirus infections are most common in the summer and fall. The CDC says various enteroviruses circulate each year. Different types can also be more common in different years.

"EV-D68 is known to be common and usually causes mild illness," says Shruti K. Gohil, MD, MPH, a board-certified UCI Health specialist in infectious diseases who serves as associate medical director for UCI Health Epidemiology and Infection Prevention.

What Are the Symptoms of Enterovirus D68?

EV-D68 usually presents with mild, flu-like symptoms. You might notice your child has body aches, a cough, fever, runny nose, or sneezing.

More severe symptoms include difficulty breathing and wheezing. "These severe symptoms may be especially seen in children with asthma," says Pierrette Mimi Poinsett, MD, a pediatrician and consultant for Mom Loves Best.

Because EV-D68's symptoms are often the same as those of the flu or common cold, it can be easy to overlook the fact that your child might be infected. In some cases, your child may not have any symptoms at all. In other rare cases, symptoms could be more severe.

Does Enterovirus D68 Cause Paralysis?

EV-D68 can cause more serious symptoms, such as acute flaccid myelitis (AFM). AFM is a neurologic condition associated with weakness in the arms and legs. While AFM has some similarities to polio, they are not the same. Those similarities include lesions in the grey matter of the spinal cord and limb weakness.

"This is a rare complication but it is serious if it occurs," says Gohil. "Parents should look out for arm or leg weakness, pain in the neck, back, arms, or legs, difficulty swallowing or speaking (slurring), difficulty moving eyes, eyelids or parts of the face."

It is crucial to seek out emergency medical attention if a child presents with any of these symptoms.

Why Are Enterovirus D68 Cases On The Rise In Children?

According to the CDC, the number of EV-D68 cases between July and August 2022 was greater than the same period in 2019, 2020, and 2021. As of August 30th, the CDC hadn't gotten any reports of AFM cases. But, they say, EV-D68 comes before AFM so if a child was sick, parents should keep a close eye on them.

"Outbreaks have been known to occur in the past," notes Gohil. "For example, a large outbreak occurred in 2014 nationally with almost 1400 cases across 49 states."

It's not clear why the numbers are up this year. It could be that children are catching EV-D68 more because they are more likely to be in close contact with others, such as in school. In the previous two school years, mask-wearing was more common as well. Children may also be more likely to put their hands into their mouths or nose before washing them.

Treatment for Enterovirus D68

Like most viral infections, doctors focus on symptom relief while letting the immune system fight off the virus. It's important for the child to rest and stay hydrated during recovery.

"Children with wheezing or difficulty breathing may need asthma treatments," says Dr. Poinsett. "For children with acute flaccid myelitis, physical therapy may be indicated."

How Do I Prevent My Child From Getting Enterovirus D68?

Preventing EV-D68 calls for basically the same protocols as preventing any other viral infection. Wash your hands frequently and before eating, and avoid touching the mouth or eyes with unclean hands. Cover coughs and sneezes and avoid sharing drinking cups or utensils.

EV-D68 can be passed on surfaces, so regularly cleaning high touch areas such as counters or door knobs will help too. "Fortunately, a lot of the things we have learned during this COVID-19 pandemic apply to prevention of all viruses, including EV D68," notes Gohil.