A respiratory virus that sometimes paralyzes children is spreading across the U.S., raising concerns about another possible rise in polio-like illnesses.

Wastewater samples have detected a significant escalation in an enterovirus called D68, which, in rare cases, has been linked to acute flaccid myelitis, or AFM. The illness affects the nervous system and causes severe weakness in the arms and legs. This most often occurs in young children.

“We are detecting EV-D68 nucleic acids in wastewater across the country now, and the levels are increasing,” said Alexandria Boehm, program director of WastewaterSCAN, a nonprofit monitoring network and a professor of civil and environmental engineering at Stanford University.

The D68 enterovirus strain started causing more serious problems in 2014, when the U.S. saw, for the first time, a spike in pediatric AFM. That year, 120 kids were diagnosed.

There’s no cure or specific treatment for the paralysis. Even with years of intensive physical therapy, many are left with life-altering disabilities.

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