A nonprofit wastewater monitoring network has found that enterovirus D68, a respiratory virus that can cause paralysis in children, is spreading across the United States. In rare cases, D68 has been linked to acute flaccid myelitis (AFM) , a polio-like illness causing severe weakness in the arms and legs. Historically, September is the typical month for seeing AFM cases, an epidemiologist at Johns Hopkins told NBC News. While enterovirus is common, the D68 strain first spread in 2014, resulting in 120 children diagnosed with AFM. This year so far, only 13 AFM cases have been confirmed by the Centers for Disease Control and Prevention. The highest prevalence of AFM occurred in 2018 (with 238 cases) and 2016 (with 153 cases).
Virologic mystery: There is no treatment approved for AFM, and many patients will have lifelong disabilities. Symptoms can initially be subtle and often mimic other neurologic diseases. CDC offers a few tools and resources for clinicians here.