The link between EV-D68 and acute flaccid myelitis has been hard to prove conclusively because the symptoms of AFM often show up after the virus has cleared the child's body.
“But the fact that outbreaks of EV-D68 and AFM come together — there were spikes in the number of cases in 2014, 2016 and 2018 — and the fact that EV-D68 shows up in respiratory specimens of roughly half of AFM patients certainly adds support to the fact that it’s likely to be the leading causative agent,” said Elrick.Experts suspect that in many of the children infected with EV-D68, symptoms are limited to the respiratory tract.
“There’s probably a very small percentage of kids who get an infection and develop AFM as a result,” Elrick said. “Most commonly they are asymptomatic or have a mild cold.” Scientists are still learning how AFM is similar to polio. While both viruses can cause paralysis, they affect different parts of the body. AFM is very rare, but that could change, Elrick said. Polio didn’t immediately become a widespread problem and EV-D68 is in the same family of viruses, he added.
Some experts have suggested that the enterovirus could mutate to become more infectious. As yet, “there is no evidence to suggest that changes in the virus are associated with transmission or infectiousness,” said Dr. Susan Gerber, a CDC researcher in the division of viral diseases at the National Center for Immunization and Respiratory Diseases, told NBC News in an email.In 2017, CDC received information for 35 confirmed cases of AFM in 16 states.
Elrick said he found the number of children diagnosed with AFM in 2018 to be concerning, since it falls in line with the trend of increasing cases shown in previous years.Linda Carroll is a regular health contributor to NBC News and Reuters Health. She is coauthor of"The Concussion Crisis: Anatomy of a Silent Epidemic" and"Out of the Clouds: The Unlikely Horseman and the Unwanted Colt Who Conquered the Sport of Kings.
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