Rates of enterovirus D68, a respiratory virus that can sometimes lead to a polio-like illness and paralysis in children, have risen significantly across the U.S. in recent months. Wastewater data from the nonprofit WastewaterSCAN shows that the virus is now being detected at medium levels nationally, after having stayed at low levels from September 2023 to August 2024. Enterovirus D68 activity started rising in the South during the spring, and has since been increasing in all four regions the group tracks, but is still highest in the South.

While enterovirus D68 usually causes mild, cold-like symptoms, the rising rates are concerning as it can lead to a rare but serious complication in children known as acute flaccid myelitis (AFM), a neurologic condition that can cause muscle and reflex loss. Higher rates of enterovirus D68 usually lead to higher rates of AFM, making the current situation worrisome. So far this year, there have been 13 confirmed cases of AFM in 10 states, according to CDC data. Since 2014, when AFM was first identified, 758 people have been diagnosed with the illness.

Enterovirus D68, which is believed to be common, typically causes respiratory illness ranging from mild to severe. The virus spreads through respiratory secretions such as saliva and mucus, especially when an infected person sneezes or coughs. There are no specific treatments for enterovirus D68, so it is important to practice good hand hygiene, avoid close contact with others when sick, and disinfect high-touch surfaces to prevent infection. Infants, children, and adolescents are at the highest risk of getting ill from the virus.

The highest rates of enterovirus D68 in the U.S. are currently in the South, followed by the Northeast, based on WastewaterSCAN data. Symptoms of the virus include runny nose, sneezing, cough, body aches, and muscle aches. Severe symptoms can include wheezing and difficulty breathing, especially shortness of breath or rapid breathing. If a child develops any limb or muscle weakness following a respiratory illness, it is important to seek medical attention immediately as it could be a sign of AFM.

AFM is a serious neurologic condition characterized by sudden arm or leg weakness, loss of muscle tone, and loss of reflexes. It is most common between August and November, when enteroviruses are also prevalent. More than 90% of AFM cases occur in young children, and the condition can progress rapidly, with symptoms peaking in just a few hours. There is no specific treatment for AFM, so the key to protecting your family is to practice good hand hygiene and wear a mask in public.

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