Sewage samples in the US are showing an alarming rise in a respiratory virus that has been linked to polio-like symptoms.
An enterovirus variant, EV-D68, can lead to acute debilitating myelitis, which can cause weakness or paralysis, usually in children.
“We’re detecting EV-D68 nucleic acids in wastewater all over the country right now, and the levels are rising,” Alexandria Boehm, program director of WastewaterScan, a nonprofit monitoring network and a professor of civil and environmental engineering at the Stanford University. This week’s news.
EV-D68 is quite common, with most people over the age of 5 showing evidence of previous infection. The virus is transmitted through respiratory secretions such as saliva or nasal mucus or by touching a contaminated surface and then the mouth or nose.
Infections peak in summer and autumn – babies, children and teenagers, especially those with asthma, are most vulnerable.
Symptoms of EV-D68 are usually mild and include runny nose, sneezing, coughing, nausea and body aches. In severe cases, wheezing and difficulty breathing have been reported.
Most worryingly, EV-D68 is believed to play a role in the development of acute flaccid myelitis.
A rare but serious neurological condition, symptoms of AFM include muscle weakness, slurred speech, difficulty swallowing, facial droop and, in some cases, paralysis. In these cases, AFM begins with cold-like symptoms and progresses to paralysis within a week.
While intensive physical therapy can be helpful, there is no specific treatment or cure, and many patients are left with serious, life-changing disabilities.
Similar to polio, AFM causes paralysis in only a few people.
While these neurological complications are rare, outbreaks of severe EV-D68 and AFM follow a distinct pattern.
Since the Centers for Disease Control and Prevention began monitoring the condition in 2014, AFM has been on a wave, increasing in an annual pattern — infecting far more people in 2016 and 2018 than in 2015 and 2017.
The annual model was halted in 2020 thanks to the COVID-19 shutdowns. EV-D68 resumed its increase in 2022 after the blockages were lifted, but surprisingly, this increase was not accompanied by an increase in AFM cases.
Dr. Kevin Messacar, an infectious disease specialist at Children’s Hospital Colorado, told NBC News, “We saw the virus that was previously driving the AFM cases, but we didn’t see the AFM cases associated with it.”
The CDC has confirmed 13 AFM cases so far this year.
Viruses are notoriously difficult to predict, and experts believe EV-D68 may have evolved or mutated, or more people were exposed to it and developed immunity.
There is no vaccine for EV-D68 – medical professionals recommend protecting yourself by washing your hands thoroughly, avoiding close contact with people who are sick, cleaning and disinfecting surfaces, and managing asthma if you have it.
Meanwhile, Dr. Buddy Creech, a pediatric infectious disease physician at Vanderbilt University Medical Center in Nashville, is studying a monoclonal antibody that he hopes can stop EV-D68 before it becomes AFM.
“In mouse studies, it prevented the infection that would lead to AFM,” Creech told NBC News. However, it may take years before treatment becomes available.
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