The CDC in a Sept. 9 advisory alerted providers of the potential for a rise in acute flaccid myelitis among children. AFM is a rare, polio-like complication of infection with an enterovirus.
In August, the agency said healthcare providers and hospitals in several regions reported increases in the number of children hospitalized with severe respiratory illness. The patients tested positive for rhinovirus or enterovirus, which are related viruses that primarily cause acute respiratory symptoms. Some of the patients tested positive for enterovirus D68.
"Common symptoms among hospitalized children with EV-D68 include cough, shortness of breath, and wheezing; fever is reported in approximately half of known cases. On rare occasions, EV-D68 may cause AFM. This rare but serious neurologic condition primarily affects children and typically presents with sudden limb weakness," the CDC's alert said.
The CDC said providers should consider EV-D68 as a possible cause of severe respiratory illness in children with or without a fever.
The U.S. saw EV-D68 cases peak in the fall of 2014, 2016 and 2018. In 2020, there appeared to be "relatively lower circulation," likely due to COVID-19 mitigation measures. The number of EV-D68 detections between July and August was higher than in the same period of the previous three years, the CDC said. So far, there has not been an increase in reported cases of AFM this year, though a rise in EV-D68 cases usually precede AFM reports, "indicating that increased vigilance for AFM in the coming weeks will be essential."
Click here to view the CDC's full alert and provider recommendations.