(HealthDay News) — Forty states and the District of Columbia now have a total of 277 confirmed cases of Enterovirus D68, the severe respiratory illness that typically targets children, U.S. health officials are reporting.

Officials said the 40 states are Alabama, Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, 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, all the cases have involved children, except for one adult, according to the federal Centers for Disease Control and Prevention.

Meanwhile, health officials are investigating whether Enterovirus D68 might be the possible cause of muscle weakness or paralysis that has occurred among nine children in Colorado within the last two months. Tests detected the virus in four of eight of the children. The status of the ninth child is not clear. All the children are being treated at Children’s Hospital Colorado in Aurora, the Associated Press reported.

While Enterovirus 68 can cause paralysis, doctors haven’t pinpointed the actual culprit in these nine cases. And doctors don’t know if the limb weakness or paralysis is temporary or will be long-lasting, the AP reported. 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.

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