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EV-D68 and EV-A71 are enteroviruses and belong to the same family of viruses as polio. Poliomyelitis is notoriously a cause of neurological complications, including almost complete paralysis but also limb weakness. Polio has caused regular epidemics until vaccination has wiped out most countries.
Other viruses such as EV-D68 and EV-A71 cause a much less serious disease or no symptoms. But in very rare cases, they can damage the nerves.
"We know that enteroviruses, especially EV-A71, have been associated with flaccid acute myelitis," Herlihy told NBC News.
EV-A71 is a common cause of foot-and-mouth disease, an uncomfortable and highly contagious childhood disease characterized by vesicles or spots on the palms, soles, mouth and elsewhere.
In Colorado, EV-A71 has caused neurological disease in at least 38 very young children, the health department said.
"This includes cases of meningitis, encephalitis and acute flaccid myelitis (AFM) as well as children with myoclonus (abnormal muscle saccades) and ataxia (loss of balance). Cases are all under the age of 3 with no underlying medical condition, "said the state in a medical alert to doctors last June.
"The parents described their children as stunned, shaking and jerking," said Herlihy. Most of the children have recovered, she added.
Minnesota officials have not yet identified any particular virus in the six cases mentioned. "All recent cases in Minnesota involve children under 10 and have all been hospitalized. Cases have been reported in the twin cities, in central Minnesota and in northeastern Minnesota, "said the state health department in a statement.
Symptoms of acute flaccid myelitis include the sudden onset of weakness of the arms or legs, as well as drooping facial muscles, including eyelids, and difficulty in moving the eyes. Most patients must be hospitalized.
"We do not have an effective treatment for the virus or the disease yet," said Messacar.
"But we know that over time, with rehabilitation therapies, many children can return to work."
The affected muscles may remain weak, but it is possible to strengthen the surrounding muscles to allow the children to resume their movements, explained Messacar. But some still have partial paralysis and, depending on the affected muscles, children may need ventilators to help them breathe and may need to use a wheelchair.
A victim, Carter Roberts, a 5-year-old from Chesterfield, Va., Died last month after developing the AFM in 2016. He never fully recovered.
Messacar said it's important that parents immediately consult a doctor if their child has symptoms of weakness in the muscles of the face or throat. Acute flaccid myelitis is tricky to diagnose and may require cerebrospinal fluid testing, as well as magnetic resonance imaging (MRI).
But parents can not do anything else to protect their children. There is no vaccine against EV-D68 or EV-A71, so the same precautions apply as for any other infectious disease: people should wash their hands frequently, stay home when they are sick, get coughs and sneezes and stay away from people who cough and sneezing.
Almost all viral infections can cause neurological symptoms, although they are extremely unusual. The CDC states that it is also important to be fully aware of vaccinations.
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