EV-D68 Enterovirus: Recurring Outbreaks, History, and What to Expect
Outbreaks of the paralyzing enterovirus EV-D68 occur roughly every two years in the United States, and experts anticipate a potential rise in 2024. This understanding comes from ARS Technical reports that monitor public health trends and virology developments.
Nearly a decade ago, hundreds of otherwise healthy children in the United States experienced sudden leg weakness. A significant portion required intensive care, and some needed mechanical ventilation. In certain cases, paralysis persisted. Investigations linked these alarming events to EV-D68, a member of the enterovirus family that shares ancestry with the polio virus, a pathogen historically responsible for paralysis and respiratory failure in children many decades ago, though EV-D68 itself is a distinct virus.
In 2014, about 120 EV-D68 infections were documented. Two years later, 153 cases were reported, followed by 238 cases in 2018. The pandemic year of 2020 saw no upsurge, likely reflecting widespread measures to curb viral spread such as quarantine, mask use, enhanced hygiene, and remote work arrangements, all of which reduced transmission of many respiratory viruses.
Although researchers anticipated a stronger resurgence, the burden of EV-D68 infections dropped to 47 cases in 2022. The reasons for this decline remain uncertain; possible explanations include changes in the virus through mutations or higher immunity levels among children. Public health surveillance continues to track this pattern and assess the impact of any emerging variants.
Current modeling suggests a renewed wave could occur in 2024. Projections indicate that the upcoming season may be smaller in scope than the 2022 surge, though vigilance remains essential for early detection and response by health systems.
Historically, scientists have explored how immune responses develop and adapt to viral exposures. Early speculative ideas about immune cells gaining training in a dream-like sense reflect imaginative attempts to understand how the body learns to recognize and respond to pathogens. Modern research emphasizes concrete mechanisms—such as innate and adaptive immunity, antibody production, and memory T and B cell responses—that guide protection and recovery after EV-D68 exposure.