The Return of a Paralyzing Virus: Enterovirus D68 and the Threat of AFM
A silent threat is brewing in the United States. Enterovirus D68 (EV-D68), a common respiratory virus that typically causes mild symptoms, is once again on the rise. Wastewater data collected across the country indicates a substantial increase in EV-D68 presence, mirroring the pattern observed in recent years. This, however, raises a chilling concern: the potential return of acute flaccid myelitis (AFM), a rare but devastating neurological condition that can cause paralysis in children.
AFM is a polio-like illness that affects the spinal cord, leading to sudden weakness and paralysis in limbs, facial muscles, and even respiratory systems. The condition is particularly worrying due to its potential for permanent neurological damage and even death.
While EV-D68 usually causes mild illnesses, such as runny nose, fever, and cough, a small but significant percentage of infected individuals, mainly children, develop AFM.
The link between EV-D68 and AFM was first established in 2012. Since then, the U.S. has experienced recurring outbreaks of AFM, often coinciding with surges in EV-D68 infections. Scientists have identified specific strains of EV-D68 with mutations that make them more likely to cause AFM, adding to the urgency of the situation.
Wastewater monitoring systems, like WastewaterSCAN run by researchers at Stanford and Emory University, provide crucial early warning signals for infectious disease outbreaks. The recent spike in EV-D68 levels in wastewater across the country, coupled with the historical correlation between EV-D68 and AFM outbreaks, has triggered alarm bells. While AFM cases remain lower than in previous years, the risk is far from negligible.
"We are detecting EV-D68 nucleic acids in wastewater across the country now, and the levels are increasing," said Alexandria Boehm, program director of WastewaterSCAN and a professor at Stanford University, in an interview with NBC News.
The COVID-19 pandemic has thrown a wrench into the usual cadence of EV-D68 and AFM outbreaks. While the virus was suppressed initially due to heightened social distancing, its resurgence in 2022 was only followed by a mild rise in AFM cases. Scientists are still unclear if this signifies a change in the virus itself or is simply a temporary blip.
"It’s possible that EV-D68 has changed once again to become less likely to cause AFM," said Dr. [Expert’s name], a leading virologist, "but it’s probably still too early to know for sure. We need continued surveillance and research to understand the evolving nature of this virus."
In the face of this evolving threat, scientists are working tirelessly. The National Institutes of Health (NIH) has launched a clinical trial investigating a lab-developed antibody designed to neutralize EV-D68 before it can cause AFM. This potential preventative treatment holds significant promise for the future, but it is still in its early stages of development and may take years to reach the public.
While the current situation remains fluid, the increasing presence of EV-D68 in wastewater is a cause for concern, particularly for parents and caregivers. Vigilance and early detection are crucial in recognizing and managing potential AFM cases. Here are some key steps to take:
- Know the symptoms: Be alert for signs of AFM, such as sudden weakness or paralysis in arms or legs, facial weakness, slurred speech, and neck pain.
- Seek immediate medical attention: If you observe any of these symptoms, immediately contact your child’s healthcare provider or seek emergency care. Early diagnosis and treatment are crucial for optimal outcomes.
- Practice good hygiene: Promote proper handwashing practices, especially before eating and after using the bathroom.
- Stay informed: Follow public health updates and recommendations from reliable sources, such as the Centers for Disease Control and Prevention (CDC).
The return of EV-D68 and the potential for AFM outbreaks underscore the importance of continued research, vigilant surveillance, and effective public health measures. As scientists continue to monitor the situation and develop new treatments, staying informed and taking necessary precautions are crucial in protecting children from this potentially devastating illness.
