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A virus that could lead to paralysis in kids is on the rise. How worried should parents be?

By Faye Chiu, CNN

(CNN) — Rates of enterovirus D68 infections are on the rise across the United States, according to the nonprofit WastewaterSCAN network. This common virus can lead to a rare but serious polio-like complication known as acute flaccid myelitis.

Symptoms of acute flaccid myelitis include limb weakness and paralysis. Children are among those most affected by this condition.

What is enterovirus D68, and how is it spread? What are its symptoms? How likely is it that this infection will result in acute flaccid myelitis? How worried should parents be? And what steps can families take to reduce their chance of contracting this virus?

To help us with these questions, I spoke with CNN wellness medical expert Dr. Leana Wen. Wen is an emergency physician and clinical associate professor at George Washington University. She previously was Baltimore’s health commissioner and is the mother of two school-age children.

CNN: What is enterovirus D68? How common is it, and how do we know that the numbers are increasing?

Dr. Leana Wen: Enterovirus D68 is part of a group of more than 100 non-polio enteroviruses. These enteroviruses are very common. Many people who contract them have no symptoms at all or have mild coldlike symptoms. Most are probably unaware that what they have is an enterovirus.

This is why wastewater testing is useful. Testing sewage for viruses gives an early indicator of virus activity in a specific area. It is especially useful for diseases that are often asymptomatic or those that often are not tested. Recent data shows that enterovirus activity is now registering in the “medium” level and has been especially escalating since July.

CNN: How is enterovirus D68 spread, and who is most likely to contract it?

Wen: Enterovirus D68 is a respiratory virus that is spread when someone with the infection sneezes or coughs, and these droplets land on someone’s nose, mouth or eyes. The droplets can also land on surfaces or objects, and then when someone else touches those areas and then touches their nose, mouth or eyes, they could contract the virus.

Children are more likely to get infected and develop symptoms. This is for several reasons. First, children are in close contact with one another at school and day care. They also may not observe the best hygiene practices.

In addition, it is true that prior infections convey some protection against repeat infection and severe disease. According to the US Centers for Disease Control and Prevention, adults can also get these infections, but they are less likely to have symptoms, and if infected, they may have milder symptoms compared with children.

CNN: What are symptoms of enterovirus D68 infection?

Wen: Many people will have mild coldlike symptoms, like runny nose, sneezing, fever and a cough. Some may have more severe symptoms, such as difficulty breathing, fatigue and body aches. Less commonly, enteroviruses can cause inflammation of the brain and heart. Asymptomatic infection is possible as well, making this virus even harder to contain.

CNN: What can you tell us about acute flaccid myelitis, the rare but dangerous complication that can result from enterovirus D68 infection?

Wen: Acute flaccid myelitis is a condition that has only recently been named, in 2014. This condition has some similarities with polio. Individuals first have a viral infection and then, a few weeks later, develop sudden onset of arm or leg weakness. Other symptoms include loss of muscle tone and loss of reflexes, facial droop and slurred speech.

The condition can be life-threatening when respiratory muscles are involved; patients may need machines to help them breathe. It could also cause problems with regulating blood pressure, body temperature and heart rate.

There is no specific treatment for acute flaccid myelitis. Patients receive supportive care, including hospital admission, fluids, anti-inflammatory medications, breathing support if needed, and physical and occupational therapy.

While some can recover completely, the majority have lasting symptoms and disability as a result of this disease.

CNN: How likely is it that enterovirus D68 infection will result in acute flaccid myelitis? Should parents be worried?

Wen: It’s unlikely. Enterovirus infections are very common. The vast majority of cases are never diagnosed, and virtually everyone is exposed to many enteroviruses during their lifetimes.

Since acute flaccid myelitis was first named in 2014, there have been 758 confirmed cases in the US. This year (as of September 3), according to the CDC, there have been 13 confirmed cases in 10 states.

Though the total number of affected individuals is low, I understand why parents are concerned about acute flaccid myelitis, given its severity and the lack of a cure.

CNN: Are there steps families can take to reduce their chance of contracting this virus?

Wen: Everyone should wash their hands regularly and well with soap and water. Kids should be sure to wash their hands when they come back from school and from playing with their friends. While at school, they should wash regularly, ideally with soap and water. If this is not available, they should regularly use hand sanitizer.

It might be hard to instruct kids in day care and other young kids to avoid chewing objects that other kids have put into their mouths, but older kids can be taught to avoid touching their faces with unwashed hands, to cover their coughs and sneezes, and to use hand sanitizer or wash their hands after touching high-touch surfaces like doorknobs.

Parents should also look out for concerning symptoms that could indicate acute flaccid myelitis. In addition to sudden weakness in the arms or legs and slurred speech, symptoms of this condition include drooping eyelids, difficulty swallowing and new pain in the neck, arms and back. Any of these symptoms should prompt urgent medical attention.

Finally, while there is no vaccine for this enterovirus, there are vaccines that protect against many other illnesses. Parents and caregivers should make sure that their children are up to date on their childhood immunizations and that they themselves receive the recommended vaccines.

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