Surge In Viruses Putting NJ Kids In Hospital, State Monitors Polio-Like Illness

NEW JERSEY — Hospital emergency rooms around New Jersey experienced a surge in pediatric patients with viral infections. Some of the children have been admitted for severe respiratory illness.

The New Jersey Department of Health communicated with care providers last week about staying aware of rhinovirus and enterovirus. But the agency also told providers to look out for a rare but serious polio-like condition: acute flaccid myelitis.

New Jersey has no known cases of AFM as of Thursday afternoon, and health officials have only tallied three cases in the state since the beginning of 2019. The last outbreak to hit the state occurred in 2018, causing 11 infections. Out of the 238 confirmed cases around the nation that year, 98 percent of patients were hospitalized and 54 percent were admitted to the intensive care unit, according to the CDC. Ninety-four percent of cases were in children.

Federal officials began noticings a rise in pediatric hospitalizations for respiratory viruses in August. New Jersey children also recently began their first school year of the pandemic that doesn't have major COVID-19 protocols, leaving the greater possibility for the spread of different illnesses.

Health care providers and hospitals in several regions of the United States notified the CDC in August about increases in pediatric hospitalizations for severe respiratory illness. Patients tested positive for rhinovirus and/or enterovirus. Both viruses can have clinically similar presentations that can make them indistinguishable in certain medical settings.

Some of the specimens turned up positive for enterovirus D68 (EV-D68), which is associated with AFM. Surveillance sites for pediatric respiratory illnesses have also reported a higher proportion of EV-D68 positivity in children, compared to past years.

State officials did not immediately have data on how many children were getting hospitalized during the wave of respiratory illnesses. But the state health department planned a call with hospitals to assess their pediatric capacities, according to an agency spokesperson.

The CDC has confirmed 15 AFM cases in 10 states as of Wednesday, with 45 reports of patients under investigation.

The federal agency began tracking AFM in August 2014, noting increases in infections that year (120 confirmed cases), in 2016 (153) and 2018 (238). The CDC anticipated another peak year in 2020. But amid significant COVID protocols, the agency only confirmed 33 cases that year.

AFM affects the nervous system — specifically the spinal cord — which can cause muscles and the nervous system to stop functioning normally. Anyone can get the illness, but most cases occur in children, according to the New Jersey Department of Health.

Most AFM patients will experience a sudden onset of weakness or paralysis of one or more limbs, along with the loss of muscle tone or reflexes. Some patients also experience:

• facial droop/weakness
• difficulty moving the eyes
• drooping eyelids
• difficulty with swallowing or slurred speech
• difficulty swallowing or slurred speech

The CDC recommended the following actions from the public:

• Help protect yourself from getting and spreading respiratory viruses, like rhinoviruses or EV-D68 through the following steps:
  • Wash your hands often with soap and water for 20 seconds.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Avoid close contact such as kissing, hugging and sharing cups or eating utensils with people who are sick, and when you are sick.
  • Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands.
  • Clean and disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
  • Stay home when you are sick.
• Consider wearing a mask around other people if you have respiratory symptoms.
• Contact a health care provider immediately if you or your child has trouble breathing or has a sudden onset of limb weakness.
• Ensure you or your child are following an up-to-date asthma action plan if you or your child have asthma.
• Stay up-to-date with all recommended vaccines.

The state health department recommended to care providers that they adhere to testing and appropriate isolation, and to report suspected outbreaks of rhinovirus and enterovirus to local health departments. Find more info about AFM from the state health department.