WEDNESDAY, Oct. 1, 2014 (HealthDay News) -- Forty-two states and the District of Columbia now have a total of 500 confirmed cases of Enterovirus D68, the severe respiratory illness that has been infecting children since the summer, U.S. health officials reported Wednesday.
Four people infected with the virus have died in recent weeks, but it's not clear what role -- if any -- the virus played in those deaths, officials said.
Health officials are also trying to determine if the virus is associated with cases of muscle weakness and even paralysis that have struck 10 children in the Denver area. Other cases of muscle weakness or paralysis have been reported in Massachusetts, Michigan and Missouri, according to The New York Times.
Doctors don't know if the limb weakness or paralysis is temporary or will be long-lasting -- or whether it has anything to do with Enterovirus D68.
Among the dead children was a 10-year-old Rhode Island girl who died last week after she became infected with the virus and bacteria, Rhode Island and federal health officials said Wednesday.
Her death was caused by a bacterial infection, Staphylococcus aureus, that hit her at the same time as the virus, the Associated Press reported, quoting Rhode Island officials. They called it "a very rare combination," and stressed that most people infected with Enterovirus D68 typically suffer little more than a runny nose and a low-grade fever.
"We're saying we're sure that the child died of staph aureus sepsis, which is an overwhelming bacterial infection. We're sure of that," state Health Director Dr. Michael Fine said Wednesday, the Providence Journal reported.
"The virus was present in the child's body. We're not sure how much the presence of the virus contributed -- or didn't contribute -- to the child's death," he added.
The virus is behind a spike in harsh respiratory illnesses in children that started in early August.
According to the U.S. Centers for Disease Control and Prevention, the 42 states with confirmed cases of Enterovirus D68 are: Alabama, Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
So far, almost all of the cases have involved children, the CDC said.
Enterovirus D68 is part of the family of viruses that includes the common cold. It can sometimes require hospitalization, especially for children with asthma.
The CDC said it expects more cases to be confirmed in the coming weeks because the testing for Enterovirus D68 is complex and can only be done by the CDC and a small number of state-run laboratories.
The first cases of Enterovirus D68 were diagnosed in August in Midwestern and Western states.
Enteroviruses are common in September as kids head back to school, with an estimated 10 million to 15 million people infected each year. But doctors believe this particular type of enterovirus is causing more severe cases than in the past.
The virus is also hard to track because it causes symptoms similar to many other infections, including the common cold, according to health experts.
Illness associated with the Enterovirus D68 infection typically lasts about a week. Children will appear to have a severe cold, with runny nose, sneezing and cough. But the illness can escalate quickly in some cases, and the child may start to have trouble breathing. It's typically transmitted through close contact with an infected person, or by touching objects or surfaces contaminated with the virus and then touching the mouth, nose or eyes, according to health officials.
Antibiotics won't work against a virus, and there is no antiviral treatment available for Enterovirus D68, health officials said.
The CDC is asking doctors and public health officials to consider Enterovirus D68 as a potential suspect if widespread respiratory illnesses start occurring in their communities.
Health experts say good hygiene is the best defense against the virus.
Children and adults should wash their hands with soap and water for at least 20 seconds on a regular basis. They also should avoid contact with people who are sick, and stay home if they themselves fall ill. Kids with asthma need to stay on top of their symptoms and take their medication, health officials said.
Enteroviruses are very common, according to the CDC. There are more than 100 types of enteroviruses. People who come down with a bad summer cold often have been laid low by an enterovirus, the agency said.
To learn more about enteroviruses, visit the U.S. Centers for Disease Control and Prevention.