A frightening virus has swept across the nation, leaving scientists scrambling to analyze it and find a cure. This is not a new infection, but rather an evolved strain that was first observed around four years ago, with an alarming similarity to polio and other nerve-damaging viruses. Doctors and researchers across the country are currently working on one of the biggest medical puzzles in recent years.
115 children in 34 states have been infected, over 100 of which had developed paralysis. The original virus is called Enterovirus D68, quite rare but with a sudden prevalence in the 21st century. It was discovered in 1962 and first isolated in California. However, there have been cases as far as the Philippines, Japan, and the Netherlands. The Bottom Line covered the story last year as awareness of the disease began to spread.
Enterovirus D68 affects children, particularly those under five years old. It primarily causes respiratory illness with initial symptoms that are easy to mistake for a cold. Experts’ biggest concern is the resulting muscle weakness and paralysis that has resulted from the virus. Viruses can mutate and adapt to survive in new environments the way humans do, and this one has presented a great challenge to scientists in terms of both diagnoses and treatment. A recent study revealed that the mutated strain resembles polio more than it has in years past. The children were tested to see if another pathogen may be causing symptoms, but so far studies have been inconclusive since no other virus, bacteria, fungi, or parasites were found. A defining aspect is the variability in responses—in an infected sibling pair, for example, one girl developed paralysis in both arms and torso while her brother had no lasting effects from the exact same virus.
“This suggests that it’s not only the virus, but also patients’ individual biology that determines what disease they may present with” said Charles Chiu, who worked on the study at University of California, San Francisco.
Doctors around the U.S. had already noticed an upswing in respiratory illness when there were accumulating reports of children with mysterious weakness in their limbs—some had symptoms so severe they had no voluntary muscle movement. A group led by scientists at UCSF pinpointed the genetic code of EV-D68 in half of the children in California and Colorado who displayed sudden and unexplained muscle weakness and paralysis, known as acute flaccid myelitis. One obstacle to diagnosis and treatment is the fact that Enterovirus D68 presents a wide range of symptoms—if any emerge at all—from flu-like symptoms to severe respiratory illness and paralysis requiring a ventilator. Interestingly, experts estimate that the majority of the population has already been exposed to the enterovirus, but healthy adults do not show symptoms. This has been one of the biggest questions scientists ask themselves, along with the fact that those who are ill have had minimal to no improvement, according to one study.
An enterovirus enters through the gastrointestinal tract, and grows in the body before eventually attacking the nervous system. It is known that the most common time of infection is during the summer and fall, and it is unknown how this will affect the new evolved strain of EV-D68. As of now, there is no vaccine available for the enteroviruses besides the one for polio. Ultimately, the illness must run its course and doctors may attempt to treat symptoms. So far, none of the infected have regained full mobility.
The virus is spread through saliva, phlegm, and stool. The Center for Disease Control and Prevention has recommended general cleanliness, avoiding those infected and keeping surfaces clean. New research centers and trials in hospitals have opened up around the country. The often-cited Lancet study has authors in Aurora, Colo., San Francisco, Palo Alto, and Los Angeles working to analyze and fight the debilitating illness. The added complications of enterovirus season and a novel strain have made the efforts all the more crucial.