Patch Alert by Michelle Rotund-Johnson: Virus Causing Polio-Like Paralysis On The Rise In NJ, Wastewater Shows

NEW JERSEY — Wastewater data shows the rate of enterovirus D68, a respiratory illness that causes polio-like symptoms, is spiking in parts of New Jersey and in several other states.

The data, from the nonprofit WastewaterSCAN, shows the D68 virus is now being detected at medium levels in 323 of 429 samples nationwide over the last 10 days. Because the viruses are shed in waste, sewage analysis can detect viral activity in communities.

Wastewater samples taken in New Jersey show medium rates of D68 at testing sites in Newark, Hazlet, Oakhurst, Bridgewater, Belmar, and Bridgeton.

Symptoms of the virus are normally mild and may appear to be nothing more than a case of the sniffles, but can cause a serious complication in children known as acute flaccid myelitis, or AFM, a neurological condition that can cause muscles and reflexes to become suddenly weak and can leave some patients unable to move their face, neck, back, arms or legs.

Typically, AFM cases trend upward in September, Caitlin Rivers, an epidemiologist at Johns Hopkins Center for Health Security, told NBC News. So far this year, there have been 13 confirmed cases of AFM among 22 under investigation, according to CDC data.

The highest rates of D68 are in the South and Northeast, according to the data. There have been no cases confirmed in New Jersey, but there are some in neighboring states. States reporting confirmed cases are California, Florida, Illinois, Iowa, Louisiana, New Mexico, New York, Oregon, Pennsylvania and Texas.

AFM remains somewhat of a mystery. Health officials have ruled out the enterovirus that causes polio as a cause of AFM, but it can be just as devastating as the illness that once struck tens of thousands of U.S. children a year, resulting in lasting paralysis in some children. Polio was nearly eradicated following the introduction of a polio vaccine in the 1950s.

Since the CDC began tracking AFM in August 2014, there have been 758 confirmed cases. Last year, there were 18 confirmed cases. Since the spike a decade ago, there have been two other AFM surges — in 2016 and 2018, and all are believed to be caused by enterovirus D68. Health experts expected a wave of D68 infections in 2022 to lead to a similar rise in AFM cases. They’re not sure why that didn’t happen, but it could be due to changes in the virus, or higher levels of immunity.

“We’re still trying to figure it out,” Dr. Kevin Messacar, an infectious disease specialist at Children’s Hospital Colorado, who treated some of the earliest AFM cases in 2014, told NBC News.

D68 is highly contagious and is spread primarily through saliva, mucus, and other respiratory secretions; by touching or shaking hands with an infected person; or by touching contaminated surfaces, such as toys, doorknobs, and counter spaces. It can also be spread by failing to properly wash hands after using the restroom or changing a diaper.

There is no vaccine for D68. To prevent its spread, the CDC recommends thoroughly washing hands with soap and hot water for at least 20 seconds, disinfecting frequently touched surfaces, and teaching kids to cough and sneeze safely.

Patients usually recover from the respiratory symptoms of D68 before it progresses to AFM. Symptoms to be aware of include:

Enterovirus D68 Symptoms

• Stuffy or runny nose
• Cough
• Fever
• Muscle pain or body aches
• Sore throat
• Wheezing
• Shortness of breath
• Diarrhea

AFM Symptoms

• Weakness
• Slurred speech
• Difficulty swallowing (dysphagia)
• Drooping eyelids
• Difficulty moving your eyes
• Facial paralysis
• Back, neck, arm, or leg pain