CDC to Physicians: Watch for Severe Respiratory, Polio-Like Illness in Children

Providers should be aware of enterovirus D68 (EV-D68) causing severe respiratory illness and acute flaccid myelitis (AFM) in children and adolescents, the CDC said this week, saying that infections are rising across the country.

EV-D68 is one of more than 100 non-polio enteroviruses; it often arrives as summer turns to fall and can causes respiratory illness similar to a mild cold, or it may become more severe. It causes about 15 million infections a year in the United States.

It can also lead to AFM, with weakness and paralysis of the arms and legs. Past outbreaks of EV-D68 and AFM were seen in 2014, 2016, and 2018.

However, disease activity was low during the COVID-19 pandemic in 2020 and 2021. Over the past few weeks, news reports began popping up of children heading to the emergency department (ED) or being hospitalized with acute respiratory illness and asthma/reactive airway disease.

Surveillance data released Tuesday bore those reports out. The data shows that positive test results for rhinovirus/enterovirus “appears to be increasing at a rate comparable to that in past EV-D68 outbreak years,” doubling in a period of a few weeks through early September, the CDC said.

“Clinicians are advised to consider EV-D68 as a possible cause of severe respiratory illness in children and adolescents, particularly those with wheezing or who require respiratory support,” the CDC said.

In addition to testing for AFM, health care providers are urged to test for poliovirus, which has been found in New York wastewater.