The CDC is currently evaluating whether limb weakness, and in some cases paralysis, may be associated with the recent enterovirus D68 outbreak sweeping across the U.S.
According to data released by the CDC, nine children in Colorado who developed a respiratory virus subsequently developed limb weakness, and in some cases, varying degrees of paralysis.
According to recent reports out of Denver, six of the eight children tested positive for enteroviruses or rhinoviruses (cold viruses), with four of the six testing positive for enterovirus D68. The two remaining cases are still awaiting final test results.
At this time, the CDC is investigating whether the enterovirus D68 was the actual cause of the neurologic symptoms. Recent reports have indicated infection within spinal fluid samples, but no evidence of any specific virus within the fluid itself. Tests to evaluate for polio or west nile virus have also been negative thus far. And in rare cases, it is possible that enteroviruses may display infectious features that can mimic infection with polio viruses.
While infection with enterovirus D68 in this current outbreak has led to predominately respiratory systems—notably worse in patients with asthma— infection with enteroviruses in general can lead to neurologic manifestations, including paralysis in some cases. In rare cases, infection with enterovirus D68 has been reported to lead to limb weakness and paralysis.
Recent data from the CDC indicates that the virus has been confirmed in 277 patients in 40 states. However, many more cases are likely, due to lack of widespread ability to test for the virus.
Symptoms are typically mild, leading to fever, cough runny nose and congestion, muscle aches and a mild rash. Patients with asthma are at risk for a more severe course with potential development of respiratory failure leading to the need for mechanical ventilation.
Patients from 6 months up to age 18 have developed infection with the virus, with those ages 3-5 most commonly affected. No deaths have been reported so far, with supportive care including oxygen, medicine to control fever, steroids, and breathing treatments helping most patients to recover uneventfully.
Attention to careful hand washing and practicing good hygiene and disinfection techniques are vital to limiting spread of the virus, since it can spread person to person via respiratory secretions (coughing and sneezing) and can live on surfaces for up to one day.
