"There are now two possible cases reported in 2018 that are under investigation", said the Maryland health department's Brittany Fowler.
The Washington Department of Heath says all the children are 6 or younger.
There's word that a tenth child in IL is being treated for symptoms of the paralyzing polio-like disease known as AFM.
The children live in King, Pierce, Lewis, Snohomish and Skagit counties.
It's not a new condition, but the Centers for Disease Control and Prevention says the increase is not normal. The CDC reported 120 cases of AFM in 2014, 22 cases in 2015, 149 cases in 2016 and 33 cases in 2017.
Symptoms include a sudden onset of limb weakness, loss of muscle tone and reflexes, facial droop, difficulty moving eyes, drooping eyelids, difficulty swallowing, and slurred speech. AFM has been compared to polio because the condition can lead to paralysis.
"All suspected cases are sent to the CDC for review by their neurologists", said Lara Anton of the Texas Department of State Health Services. Were working closely with medical providers and public health agencies. "If this pattern continues, we should expect to see an increase in AFM cases in 2018". Children with asthma may have a higher risk for severe respiratory illness caused by EV-D68 infection. Another preventative measure is protecting oneself from mosquito bites, which can carry West Nile virus, by using repellent, reducing outdoor time at dusk and dawn and removing areas of standing or stagnant water.
The New York State Department of Health is advising parents/guardians, other caregivers and health care providers to be aware of the signs and symptoms of enterovirus EV-D68, which has now been confirmed in39 children in New York State.
"We do not yet know the long-term effects of AFM", a CDC report said.
In general, infants, children and teenagers are most likely to get infected with EV-D68 and become ill because they do not yet have immunity from previous exposures to enteroviruses.