Virus that can cause rare polio-like illness rising in Northern California

Rates of enterovirus D68, a respiratory virus that usually causes mild cold-like symptoms in adults but can lead to a rare polio-like illness in small children, are rising in multiple parts of the Bay Area, recent data from municipal wastewater shows. 

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According to WastewaterSCAN, which monitors traces of multiple viruses throughout the entire country, concentrations of EV-D68 are high and rising in Palo Alto, Napa and southeast San Francisco. Just across the bridge, San Rafael also shows high levels of the virus.

Cold and flu season has arrived early in San Francisco, with the city’s Department of Public Health announcing the first flu-related death last week.

One of more than 100 non-polio enteroviruses, EV-D68 typically emerges in summer and fall, often causing mild respiratory illness that resembles the common cold. Symptoms usually include runny nose, sneezing and muscle aches but can lead to more serious symptoms like difficulty breathing and pneumonia in vulnerable populations. Rarely, it can also cause acute flaccid myelitis, or AFM, a dangerous neurological condition that can develop in small children weeks after infection with EV-D68 and lead to lifelong complications. 

First identified in California in 1962, the virus used to appear in small clusters, but in 2014, rates of the illness surged in the U.S., leading to over 1,000 infections in virtually the entire country. Just last year, EV-D68 — along with multiple other respiratory diseases — was in high circulation in the Bay Area, SFGATE previously reported. 

“It’s the infants we get really worried about,” Dr. Monica Gandhi, an infectious diseases specialist at UCSF, told SFGATE Monday, referring to AFM. 

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The rare condition, which can be caused by different viruses such as West Nile and herpesviruses, attacks the spinal cord, leading to sudden muscle weakness and loss of reflexes among children, the U.S. Centers for Disease Control and Prevention says. Slurred speech, difficulty moving the eyes and drooping facial features are also symptomatic of the neurological condition. Because the disease can develop within just a few hours or days, the CDC advises parents to immediately bring children to the hospital if they present these concerning symptoms.  

Older adults, along with small children and those who are immunocompromised, are most at risk of developing severe illness if they contract EV-D68, Gandhi said. While “the majority of respiratory illnesses are mild for healthy individuals,” she continued, it “still can be severe for certain risk groups.”

Though there’s no vaccine for EV-D68, individuals can take steps to protect themselves by frequently washing their hands and avoiding close contact with those who are sick. In the meantime, Bay Area residents are encouraged to receive updated flu and COVID-19 vaccines to prevent serious illness. “This sad news reminds us that respiratory viruses such as flu and COVID should be taken very seriously, especially for people who are at higher risk of getting sick,” San Francisco Health Officer Dr. Susan Philip said in the health department’s Oct. 1 announcement. “With fall festivities approaching, we want people to stay healthy and do all the fun and joyful things they want to do. Vaccines help make this happen.”