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New respiratory illness may cause paralysis in children

I would have known that school was back in session even without looking at the calendar. I could hear the coughing and sniffling behind me. I could hear the throat clearing.

Where there are children, there is an illness. They are always touching everything, sneezing and coughing, and keeping on with their play even if they did just sneeze all over their hands before touching the monkey bars, the swings, and everything else on the playground!

I am glad that children keep playing. If they stop, then we have greater problems on our hands than a cold or even COVID.

About three weeks ago, the Centers for Disease Control and Prevention (CDC) issued a new warning about a contagious new respiratory virus that can cause paralysis--even permanent paralysis--in children.

In an article written by Gustaf Kilander for The Independent, the CDC stated that “pediatric hospitalizations in patients with severe respiratory illness who also tested positive for rhinovirus (RV) and/or enterovirus (EV)” had increased.

According to the CDC, most of the people who are infected will experience mild symptoms or none at all. However, some of the infections can become severe like in children with impaired immune systems.

The number of children testing positive for RV or EV is higher this year than in previous years, according to the CDC. "The number of detections in July-August of 2022 was greater than in the same period over the previous three years," the CDC stated.

“Although it primarily causes acute respiratory illness, EV-D68 has been associated with acute flaccid myelitis (AFM), a rare but serious neurologic complication involving limb weakness,” the CDC said.

What is enterovirus D68 or EV-D68?

According to the CDC, the virus was first identified in California in 1962 and is one of more than 100 non-polio enteroviruses. EV-D68 typically causes respiratory illness, which can be mild (like a common cold) or more severe.

EV-D68 and AFM

Acute flaccid myelitis (AFM) is an uncommon but serious neurological condition, mostly in young children. It affects the nervous system, specifically the area of the spinal cord called gray matter, which causes the muscles and reflexes in the body to become weak. Viruses, including EV-D68, likely play a role in causing AFM.

What are the symptoms of EV-D68 infection?

Note: The following is from the CDC website.

EV-D68 can cause mild to severe respiratory illness, or no symptoms at all.

  • Mild symptoms may include a runny nose, sneezing, cough, body aches, and muscle aches.

  • Severe symptoms may include wheezing and difficulty breathing.

Anyone with respiratory illness should contact their doctor if they are having difficulty breathing or if their symptoms are getting worse.

EV-D68 can also cause acute flaccid myelitis (AFM), an uncommon but serious neurologic condition that mostly affects children and causes the muscles and reflexes in the body to become weak.

Seek immediate medical attention if you or your child develops any of these AFM symptoms, especially following a respiratory illness:

  • arm or leg weakness

  • pain in the neck, back, arms, or legs

  • difficulty swallowing or slurred speech

  • difficulty moving the eyes or drooping eyelids

  • facial droop or weakness

AFM has been known to lead to permanent paralysis, according to the CDC.

While the CDC says it has not received increased reports of AFM, it did say that “increases in EV-D68 respiratory illnesses have typically preceded cases of AFM, indicating that increased vigilance for AFM in the coming weeks will be essential."

Kilander stated that "RVs are usually linked to acute respiratory illness, such as asthma. While EVs can also lead to acute respiratory illness, it’s connected to other issues, such as febrile rash, neurologic illness, aseptic meningitis, AFM, and encephalitis." “On rare occasions, EV-D68 may cause AFM. This rare but serious neurologic condition primarily affects children and typically presents with sudden limb weakness,” according to the CDC. “There are no available vaccines or specific treatments for RV or EV, including EV-D68, and clinical care is supportive.”

The peak of EV season is late summer and early fall, the same is true for EV-D68. “The relatively lower circulation in 2020 may reflect the use of COVID-19 pandemic infection mitigation measures, which are known to have interrupted the circulation of other respiratory viruses,” the CDC said.

Children of all ages including adolescents can be affected, although the median age of those hospitalized is three years old. “Children with a history of asthma or reactive airway disease may be more likely to require medical care, though children without a known history of asthma can also present with severe illness,” according to the CDC.

Among adults, the CDC said that EV-D68 is “less understood” but that it’s “thought to be more commonly detected in patients with underlying conditions”.

Ways to Slow the Spread

As usual, the CDC has some basic tips for slowing the spread of this disease among many others. Here is a list of the top ways to reduce the spread of RVs or EVs.

  • Wash your hands often with soap and water for at least 20 seconds (frequently)

  • Avoid touching your eyes, nose, mouth or face.

  • Avoid close contact with sick people.

  • Cover your coughs and sneezes with a tissue or your shirt sleeve, not with your hands.

  • Clean and disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.

  • Stay home if you are ill.

The CDC also recommends contacting a healthcare provider immediately if you or your child has trouble breathing or has a sudden onset of limb weakness.

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