- The CDC has issued an alert to health care providers about the rise in respiratory illness in children.
- One such virus, called enterovirus D68, has been associated with acute flaccid myelitis, or AFM.
- AFM can cause symptoms of paralysis in children.
The Centers for Disease Control and Prevention (CDC) recently released a file health alert To doctors regarding common respiratory illnesses, including one that can cause an uncommon type of paralysis in children called acute flaccid myelitis (AFM.)
In July and August, there was an increase in cases of rhinovirus and enterovirus – two types of viruses that cause common upper respiratory infections in children. This increase in cases follows the last wave of these viruses in the summer and fall of 2018, before the onset of the COVID-19 pandemic.
Rhinovirus is usually associated with upper respiratory infections, and although this virus tends to spread throughout the year, there are usually peaks in the spring and fall of each year. Enterovirus can closely resemble the symptoms of rhinovirus, but it can also lead to fever, rash, and neurological disease. A type of enterovirus called enterovirus D-68 has in rare cases led to AFM.
Dr.. Lydia MarcusEnterovirus D68 is one of several non-polio enteroviruses and typically causes respiratory and gastrointestinal symptoms, explained Assistant Professor of Pediatric Neurology at UAB Marnix E. Heersink School of Medicine and Children in Alabama.
“Symptoms are often mild but sometimes can be more severe, and can include difficulty breathing, coughing, congestion, body aches, fever, and diarrhea or vomiting,” Marcus explained.
Although enterovirus is present year-round, it peaks during late summer and early fall.
Most children infected with these viruses only have symptoms of the common cold, such as a runny nose, body and muscle aches, sneezing, and some fever. However, with the recent increase in hospital admissions due to these viruses, doctors are beginning to see an increase in cases of acute flaccid myelitis. [AFM] Which could lead to paralysis.
“Symptoms of acute flaccid myelitis can include neck, back, arm or leg pain, weakness in the neck, arms or legs, difficulty swallowing, slurred speech, facial weakness or double vision,” Marcus told Healthline.
These symptoms come after the typical upper respiratory symptoms that children have with enteroviruses.
“In rare cases, EV-D68 can cause a paralytic disease similar to polio,” Dr. William Schaffneran infectious disease expert at Vanderbilt University Medical Center in Tennessee.
“Paralysis occurs on average 5 days after the onset of respiratory illness and is rapid onset — hours to days — often asymmetric and may involve any group of extremities, usually including the arms,” Schaffner explained to Healthline.
Because many of the symptoms between rhinoviruses and enteroviruses are similar, it is sometimes difficult to determine which virus a patient has without specialized testing. Because of the similarities, conventional tests make these two viruses indistinguishable, however, by specialized PCR analysis, doctors were able to determine that enterovirus D68 is the likely cause of acute flaccid myelitis.
Many children outgrow enterovirus through over-the-counter medications and do not need hospitalization or invasive treatment, however, a small percentage of children may develop paralysis from this virus.
“Infants, children, and young adults are more susceptible to enterovirus infection and disease than adults because children’s immune systems are still developing immunity to these very common viruses,” Marcus says.
Since August 2014, the CDC
Schaffner explains that the biennial pattern “has been interrupted by social distancing and virtual education during the COVID pandemic and now that normal behavior has been relatively restored, this could have allowed the transmission of D68 again.”
As of mid-September, there are only 14 confirmed cases of acute flaccid myelitis, but experts warn that as enterovirus cases increase, so will the number of cases of myelitis.
Although the neurological complications of this virus have since been documented
Health experts say parents should not be overly concerned about the rare results of enterovirus D68.
Marcus reminds parents that “AFM is a very rare neurological disorder while enterovirus and other viral infections are very common, so being aware of any worrisome symptoms and not ignoring them is the most important thing.”
Like any other illness, it’s important to keep an eye on your children and their illnesses, including the common cold, but with acute flaccid myelitis rare, over-the-counter medications and a vigilant eye are important to successful treatment in most children.
Experts stress that prevention is key. They advise that washing hands with soap and warm water for at least 20 seconds, avoiding touching the eyes, nose and mouth with unwashed hands, avoiding close contact with sick people, and cleaning and sanitizing frequently are all steps people can take in order to help prevent the spread of not only this virus.
If your child begins to have symptoms that seem more severe than an upper respiratory infection, early diagnosis and detection are important. You can follow up with a primary care physician, pediatrician, local health department, or emergency room physician who can make an early diagnosis.
Dr. Rajiv Bahl is an emergency medicine physician, board member of the Florida College of Emergency Physicians, and health writer. You can find it in RajivBahlMD.com.
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