CDC Warns of Virus Strain Linked to Polio-like Condition

By Lucy Hicks
Sept. 13, 2022

A recent uptick in severe respiratory illness in children may be tied to a strain of a virus that can cause a rare polio-like condition, according to a CDC advisory issued last week.

In August, health care providers and hospitals notified the CDC of an increase in severe respiratory illness in children who also tested positive for rhinovirus or enterovirus. Additional testing found that some children were positive for a straight of the enterovirus known as EV-D68. It primarily causes acute respiratory illness. However, the virus has been associated with acute flaccid myelitis or AFM, a rare condition involving muscle weakness.

Also, in July and August 2022, surveillance networks showed an increase in EV-D68 compared with the same months in 2019, 2020, and 2021, the CDC said. As of Aug. 30, the CDC has not received any reports of AFM beginning this year; however, spikes in EV-D68 typically come before first.

"Something we are always on the lookout for in the late summer and fall is AFM cases," says Rick Malley, MD, of the division of infectious disease at Boston Children's Hospital. "Unfortunately, we kind of expect them during enterovirus season," he said. That season is thought to peak in the late summer and early fall.

Since the CDC began tracking AFM in August 2014, there have been 692 confirmed cases in the United States. Cases spiked in 2014, 2016, and 2018, mostly in young children. In 2021, there were 28 confirmed cases across 15 states. The CDC did not specify the age of those cases, but in 2018 — when EV-D68 most recently circulated at high levels —children who visited the emergency department or were hospitalized for EV-D68–associated respiratory illness were mostly around 3 years old.

"[AFM] can be very severe and it can be very scary for the parents of children who have it," Malley says, "but given the prevalence of enteroviruses in the community, you have to include it's a relatively rare event in susceptible individuals. Why some get it and others don't is unfortunately unclear at this moment."

The CDC recommends that health care providers consider EV-D68 as a possible cause for severe respiratory illness in children. If the cause of a respiratory illness in a severely ill patient is not clear, health professionals should test for rhinoviruses and enteroviruses. There are no vaccines or specific treatments for either virus.

The advisory also urged providers to strongly consider AFM in patients with limb weakness, especially after respiratory illness or fever between of August and November.

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Reviewed on 9/13/2022
References
SOURCE:

WebMD, Sept. 13, 2022.

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