CDC Issues Emergency Alert for Rare Pediatric Neurological Condition

Last week, healthcare providers and hospitals received an official health advisory from the CDC warning them about an influx of severe pediatric respiratory illnesses leading to hospitalization. The alert shared that a higher-than-average proportion of patients have tested positive for enterovirus D68 (EV-D68) which primarily causes acute repository illness but can lead to acute flaccid myelitis (AFM), a serious neurologic condition.  

Officials were first notified of the rise in severe respiratory illness in August, after surveillance found rates of acute respiratory illness that were higher than in the past three years. The CDC recommends that providers and laboratories be aware of the increase in EV-D68 cases and watch for symptoms, including limb weakness, neck or back pain, facial drooping, and difficulty speaking or swallowing, that are indicative of AFM. 

Rhinoviruses and enteroviruses are both parts of the enterovirus genus and are indistinguishable from each other on respiratory assays that would be used at a physician’s office. There is no vaccine or treatment for either infection, and clinical care is only supportive. The enterovirus that sometimes leads to AFM — EV-D68 — peaks in the late summer and early fall, while rhinoviruses peak in the spring and fall.  

As of September 2, the CDC has recorded 13 confirmed cases of EV-D68-caused AFM in nine states. The rate of EV-D68 The most recent outbreak occurred in 2018 when 238 children fell ill with AFM Infections. The median age of children affected in that outbreak was three years old. Before that, a large unspecified number of children contracted AFM in 2014, leading to the CDC’s more intense surveillance of EV-D68 and AFM.   

Infections were down the past three years due to COVID-19 precautions taken by health authorities across the country. But now, communicable infections seem to be rising again as children return to school and encounter illnesses.  

The high rate of acute respiratory illness spells trouble for children with asthma, who may experience exacerbated symptoms and require medical care if infected. According to CDC data, Black children are 50% more likely to suffer from asthma than White children, and their parents should prepare an asthma action plan in case of a respiratory infection.  

Climate and environmental factors, such as indoor or outdoor air pollutants, can contribute to the prevalence of asthma in a community and consequently lead to more severe respiratory illness for that area’s pediatric population. Asthma is currently the leading chronic illness for people under 18, affecting nearly 6 million children in the US.