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What is enterovirus D68? -

Enterovirus D68 is a virus that causes respiratory infections. It's more common in children and teenagers, but adults can get it too.

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What is acute flaccid myelitis? (AFM) -

Some people with EV-D68 develop a nervous system disorder called acute flaccid myelitis. AFM causes sudden, extreme muscle weakness and paralysis.

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Enterovirus D68 in 2014 - The D68 enterovirus strain started causing concern in 2014 in the US when the country saw a spike in pediatric AFM for the first time. That year, 120 children were diagnosed. 

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Enterovirus D68 and AFM pattern -

Since 2014, larger waves of AFM have followed an every-other-year pattern, with spikes in 2016 (153 cases) and 2018 (238 cases).

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COVID-19 pandemic -

The pattern stopped in 2020 when the US went into lockdown because of the COVID-19 pandemic. This dramatically reduced viral spread and that year, just 32 cases of AFM were logged. 

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Post-lockdown -

In 2022, the spread of D68 increased again as lockdowns were lifted. However, a rise in AFM cases didn't follow. Experts say this could be due to the way the virus itself has changed or that more people in the US have been exposed and now have a level of immunity to D68.

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How common is enterovirus D68? -

According to scientists, enterovirus D68 is very common in the US, and most people over the age of five show evidence of a previous infection. Fortunately, neurological complications are relatively rare. 

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Other enteroviruses -

Other enteroviruses include poliovirus and enterovirus 71 (which causes some cases of hand, foot, and mouth disease) can also result in AFM. 

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Wastewater -

According to data from the nonprofit WastewaterSCAN, enterovirus D68 was detected in 207 out of 268 samples taken from wastewater sites across the country. 

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Wastewater sites in California -

EV-D68 was detected at a medium level at 17 wastewater sites in California, including facilities in Los Angeles, San Diego, San Francisco, Sacramento, and San Jose. 

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What are the symptoms of enterovirus D68? -

Symptoms of enterovirus D68 are typically mild. They include a stuffy or runny nose, cough, fever, muscle pain, and a sore throat. You may also experience shortness of breath and wheezing. 

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What are the symptoms of enterovirus D68? -

Within a few days to two weeks after initial EV-D68 symptoms, some people develop symptoms of AFM. These include weakness, slurred speech, difficulty swallowing, drooping eyelids, and back, neck, or arm pain.

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What causes an enterovirus D68 infection? -

EV-D68 is a viral infection that is specifically a non-polio enterovirus. The infection is caused by the virus entering the body through respiratory droplets.

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Spinal cord infection -

Most people with EV-D68 have symptoms like a runny nose or cough, but it can also infect the spinal cord, similar to the virus that causes polio. This can damage the nerves, causing temporary or permanent paralysis. 

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Is enterovirus D68 contagious? -

EV-D68 is a contagious virus that spreads through sneezing, coughing, sharing eating utensils, touching contaminated surfaces, or contact with infected feces (such as not washing hands thoroughly after using the bathroom or changing a diaper).

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What are the complications of enterovirus D68? -

In addition to AFM, EV-D68 can also lead to pneumonia, encephalitis, and meningitis. People with asthma or a compromised immune system are more likely to experience severe respiratory symptoms.

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What are the complications of acute flaccid myelitis? -

AFM can affect the muscles used to breathe, which can result in respiratory failure. Approximately one-third of people with AFM require intubation and ventilation. 

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Neurological complications -

AFM can also cause serious neurological complications, including body temperature changes, unstable blood pressure, and irregular heart rate, which can be life-threatening. 

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How is enterovirus D68 diagnosed? -

If you have mild, cold-like symptoms, your healthcare provider is unlikely to test for EV-D68. If you have more severe symptoms, and you test negative for common viruses like the flu and COVID-19, they may suspect EV-D68 if it's spreading in your area.

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How is enterovirus D68 diagnosed? -

To confirm a diagnosis, your healthcare provider may perform a blood test or lumbar puncture to test your cerebrospinal fluid, particularly if you have nervous system symptoms. An MRI (magnetic resonance imaging) may also be used to diagnose and rule out other causes of weakness and paralysis.

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How is enterovirus D68 treated? -

There isn't a specific antiviral treatment for EV-D68. Mild symptoms usually improve in a week or two with at-home care. Severe cases need to be treated in a hospital, where a doctor may administer an intravenous antibody treatment that can help you fight off infections.

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How can I prevent an enterovirus D68 infection? -

Practicing good hygiene is key to reducing your risk of contracting EV-D68 and spreading it to others. You should aim to sneeze or cough into the crook of your elbow, disinfect high-touch surfaces, wash your hands with soap and water, and keep your kids home from school when they’re sick.

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How long does it take to recover from enterovirus D68? -

Mild symptoms of EV-D68 are likely to ease after a week or two. However, if your child develops AFM, it can take them over a year to recover. Their healthcare provider might recommend physical or occupational therapy.

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How long does it take to recover from enterovirus D68? -

While most children with AFM regain some muscle strength and function, some never fully recover. According to research, less than 10% of individuals with AFM achieve a complete recovery.

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How can I take care of myself or child at home? -

You can ease mild symptoms by drinking lots of fluids and getting plenty of rest, taking a hot shower to loosen congestion, and taking over-the-counter medication for fever and pain.

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When is it necessary to go to the ER? -

Go to the emergency room immediately if you or your child develops severe symptoms such as difficulty breathing, blue skin, lips, or nails, or any symptoms of AFM like slurred speech, weakness, or paralysis.

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Antiviral medicine? -

Experts have begun conducting safety studies on a monoclonal antibody designed to stop D68. In studies involving mice, it successfully prevented infections that could lead to AFM. However, the research is expected to take years before the treatment is deemed safe and effective.

Sources: (CNN) (NBC News) (LA Times) (Cleveland Clinic)

See also: The Nipah virus outbreak: should you be worried? 

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