CALIFORNIA STATE — A respiratory virus that can cause a rare but serious neurological illness in children is showing up at high levels in parts of the Bay Area, giving parents another health concern to watch this fall.
The virus is enterovirus D68, often shortened to EV-D68. It can cause cold-like symptoms, but it can also cause acute flaccid myelitis, or AFM, a condition that affects the spinal cord and can lead to lasting paralysis.
SFGATE reported October 5 that WastewaterSCAN data showed high and rising concentrations in Palo Alto, Napa and southeast San Francisco, with high levels also detected in San Rafael.
The local findings come amid a sharp national increase. In its October 2 update, WastewaterSCAN said EV-D68 was detected in approximately 72% of samples collected across its network in September, compared with approximately 20% in August.
Those percentages describe wastewater samples — not the percentage of people infected. The program classified national wastewater levels as high.
Wastewater monitoring can help identify viruses circulating in a community, including infections that never lead to a doctor’s visit. But it cannot reliably tell parents how many children are sick, and a wastewater increase alone does not establish an increase in AFM cases.
What parents should know
CDC guidance says EV-D68 can cause a runny nose, sneezing, coughing and muscle aches. More serious respiratory illness can include wheezing, difficulty breathing or pneumonia.
Infants, children and teenagers are more likely than adults to become infected and ill because they have less immunity from previous exposure. Children with asthma may face a higher risk of severe respiratory symptoms.
The rare complication drawing particular concern is AFM. It affects the spinal cord’s gray matter and weakens muscles and reflexes. More than 90% of reported AFM cases have been in young children, according to the CDC.
AFM is sometimes described as a polio-like illness because it can cause paralysis. EV-D68 is a non-polio enterovirus.
The symptoms that need immediate attention
AFM symptoms can begin several weeks after an EV-D68 infection.
The CDC’s warning signs include sudden arm or leg weakness, loss of muscle tone or reflexes, facial weakness, drooping eyelids, trouble swallowing and slurred speech.
A child may also have pain in the neck, back, arms or legs. In severe cases, weakness can affect the muscles used for breathing.
The CDC advises seeking medical care right away if these symptoms develop. Difficulty breathing or worsening respiratory symptoms also require prompt medical attention.
How families can reduce their risk
There is no vaccine specifically against EV-D68 and no specific antiviral treatment for the respiratory illness it causes. Severe cases may require hospital care.
The CDC recommends washing hands with soap and water for at least 20 seconds, disinfecting frequently touched surfaces and shared items, and avoiding close contact with infected people.
For children with asthma, families should follow their asthma action plan, continue prescribed medications and make sure caregivers and teachers know how to help. New or worsening symptoms should be addressed according to that plan, with a call to the doctor if symptoms do not improve.
