Virus causing paralyzing disease surges in US – NBC10 Philadelphia

A respiratory virus that sometimes paralyzes children is spreading across the United States, raising concerns about a possible increase in cases of a polio-like disease.

Sewage samples have found a significant increase in an enterovirus called D68, which has been linked in rare cases to acute flaccid myelitis, or AFM. The disease attacks the nervous system and causes severe weakness in the arms and legs. It is most common in young children.

“We’re now detecting EV-D68 nucleic acids in wastewater across the country, and the levels are increasing,” said Alexandria Boehm, program director of WastewaterSCAN, a nonprofit monitoring network, and a professor of civil and environmental engineering at Stanford University.

It’s the first indication that the country could see a surge in AFM cases this year, said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security and author of “Crisis Averted: The Hidden Science of Fighting Outbreaks.”

“The second clue,” she said, “is that it’s the right time of year.”

Historically, September is the month with the highest number of AFM cases.

Anyone who’s ever had a cold has probably had an enterovirus; they’re so common. In most cases, the viruses cause mild symptoms, like a runny nose, cough, headache, and a general feeling of “meh.”

The D68 strain of enterovirus began causing more serious problems in 2014, when the U.S. saw its first surge in AFM cases in children. That year, 120 children were diagnosed.

There is no cure or specific treatment for paralysis. Even after years of intensive physical therapy, many are left with life-altering disabilities.

Viral puzzle

Although several dozen cases have been reported each year since then, larger waves of AFM have occurred every two years, peaking in 2016 (153 cases) and 2018 (238 cases).

That pattern stopped in 2020 when the country went into lockdown due to the Covid pandemic, drastically reducing the spread of the virus. Just 32 cases have been recorded this year. The spread of D68 has picked up again in 2022 as lockdowns have been lifted.

Interestingly, no increase in AFM incidence was observed.

“We’ve seen the virus that caused cases of AFM before, but we haven’t seen cases of AFM associated with it,” said Dr. Kevin Messacar, an infectious disease specialist at Children’s Hospital Colorado, who treated some of the earliest cases of AFM in 2014.

It’s a puzzle any virologist would appreciate. While experts try to predict how viruses will behave, worms always try to stay a few steps ahead of them.

It may be that the virus itself has changed, or that more people in the U.S. have been exposed and now have some level of immunity to D68. “We’re still trying to figure that out,” Messacar said.

So far in 2024, there have been 13 confirmed cases of AFM, according to the Centers for Disease Control and Prevention. There have been 758 cases since 2014.

This suggests hundreds of families and their children have suffered long-term, life-changing paralysis due to the virus.

Some improvement after years of physiotherapy

The Kagolanu family from Los Altos, California, were playing Monopoly on a Friday night in November 2014 when 7-year-old Vishnu’s head began to tilt, inexplicably, to one side. Vishnu admits that although he was losing the game, it wasn’t an attention-seeking behavior.

“My dad said, ‘Hey, what are you doing? Tilt your head back straight,'” said Vishnu, now 17. “I thought, ‘I can’t do that.'”

Within an hour, Vishnu had lost all movement in his arms and legs. “I couldn’t get up off the floor,” he said.

Vishnu was one of the first to be diagnosed with AFM in 2014. At that time, no one connected the dots between D68 and the “mystery disease.”

“We didn’t understand what was happening. Even the doctors couldn’t figure out what was happening,” said Saila Kagolanu, Vishnu’s mother. “It was the worst experience of my life.”

Doctors warned Vishnu’s family that he might never regain the use of his arms and legs. The poor prognosis devastated Vishnu. He had always flourished as the “king of the playground” when it came to sports and other physical activities.

“Seeing my legs getting smaller and smaller every day” was devastating, he said. “I couldn’t move.”

Vishnu spent years in physiotherapy to regain the ability to walk. It worked. Otherwise, there is little the doctors can do. His right arm remains limping.

Testing possible treatments

“We all get really frustrated every time we get to this point and we don’t have readily available antivirals,” said Dr. Buddy Creech, a pediatric infectious disease physician at Vanderbilt University Medical Center in Nashville. “We don’t have much to offer these kids.”

Creech and his colleagues are working on a solution. They have begun safety testing of a monoclonal antibody that would ideally stop D68 in its tracks.

“In mouse studies, it prevented infections that could lead to AFM,” Creech said. The study is expected to take years before the treatment is deemed safe and effective.

Meanwhile, young people like Vishnu Kagolanu are trying to move forward and even inspire others in AFM. In recent years, he founded a nonprofit called Neurostronger, which works to raise funds and awareness for children with neurological diseases.

“Growing up with AFM is tough,” Kagolanu said. “But at the same time, there are ways to get around some of those obstacles. There are ways to find joy.”

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