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Home SCIENCE A common virus is emerging that can cause polio-like illness in children

A common virus is emerging that can cause polio-like illness in children

Enlarge / Students listen to their teacher during their first day of transitional kindergarten at Tustin Ranch Elementary School in Tustin, Calif., on Wednesday, August 11, 2021.

The Centers for Disease Control and Prevention is warning that a respiratory virus common in children is on the rise in several regions of the US, raising concerns that an unusually large and alarming increase in a polio-like condition could soon follow.

The virus, a non-polio enterovirus called EV-D68, typically causes a mild respiratory illness, much like a cold, and is often an indistinguishable trickle in the steady stream of runny childhood illnesses. But in recent years, experts have linked EV-D68 to a rare but serious polio-like neurological condition called acute flaccid myelitis (AFM). In a small number of children (median age 5 years), the condition follows EV-D68 disease by about a week, causing muscle and limb weakness that can lead to long-term or even permanent paralysis.

In 2014, a spike in EV-D68 cases raised the profile of the virus despite being identified in 1962. Since then, the CDC has recorded closely linked spikes in EV-D68 and AFM cases that follow a pattern of two years, landing in late summer and case. Why every two years? While EV-D68 circulates continuously at low levels, epidemiological models suggest that two years is the time it takes for a large enough group of susceptible children to accumulate and for transmission of EV-D68 to take off (adults are generally undeterred). by the virus, following wave after wave of exposure to non-polio enteroviruses during childhood).

After paired spikes in 2014 and 2016, the largest increase occurred in 2018, when annual AFM reached a record 238 documented cases nationwide following a spike in EV-D68 activity. Experts had braced for another bad year in 2020. But then the COVID-19 pandemic hit.

unconventional shoots

In March 2020, long before the expected heyday of EV-D68, day care centers closed, schools went virtual, and social gatherings were canceled. People put on masks, improved ventilation and impulsively sanitized their hands. The deadly pandemic has upended the lives of people around the world and knocked a host of other infectious diseases out of whack.

Most notably, seasonal flu was almost non-existent in the fall of 2020. He probably returned in the fall of 2021 but he had a unusual and unconventional rise in the spring of 2022. Experts fear that it may come roaring back this fall And they’re pushing flu shots. Meanwhile, the rate of another common childhood respiratory infection, respiratory syncytial virus (RSV), has unexpectedly swung; the CDC issued an alert in June 2021 that the cold season virus thrived in the summer.

Then there is the EV-D68. The CDC tracks EV-D68 activity through a documented acute respiratory illness (ARI) surveillance system at seven sentinel healthcare sites across the country. Between July and November 2017, a year out of EV-D68, about 0.08 percent of documented ARIs were linked to EV-D68. In 2018, a peak year, the percentage rose to 11 percent, then fell to 0.2 percent in 2019. Epidemiologists expected another high year in 2020, but amid the pandemic, EV-D68 ARIs that year rose to just 1.4 percent. And 2021 was also low, at 0.3 percent. That’s according to unpublished data presented by CDC epidemiologist Claire Midgley at the CDC’s International Conference on Emerging Infectious Diseases (ICEID) in early August.

AFM cases per year.
Enlarge / AFM cases per year.

Viral wobble is of particular concern for EV-D68 and AFM. Since its two-year cycle is thought to depend on amassing enough susceptible children, a four-year gap suggests the virus could multiply. At last month’s meeting, Midgley presented the first data pointing to such a scenario. In “very, very preliminary data,” Midgley said the CDC saw 71 EV-D68 detections among approximately 3,500 ARIs in its surveillance network as of July 2022. “That’s more than we saw in total during 2019 and 2021.” , said. “So this is something we’re keeping an eye on. There’s potential for more circulation this year.” The CDC has yet to see a corresponding increase in confirmed AFM cases, he added last month, but it is “something we are monitoring and preparing for in the coming months.”



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