California has reported 32 cases of the respiratory illness enterovirus D-68, the California Department of Public Health (CDPH) said on Friday.

According to the Los Angeles Times, the number of patients with the illness has more than doubled in just one week; on October 3rd, the CDPH reported just 14 cases of the illness statewide. 

All of the patients being treated for EV-D68 in California are reportedly between the ages of one week and 15 years old.

“There have been concerns about EV-D68 because of the large outbreaks it sparked in other parts of the country,” CDPH epidemiologist Dr. Gil Chavez told the Times.

Still, he maintained, with regard to the number of cases in California, “activity remains within normal levels.”

According to the Times, four cases have been reported in Los Angeles County, while three cases have been reported in Orange County. 

Health Care Agency spokeswoman Nicole Stanfield told the Orange County Register the patients in Orange County ranged in age from newborn to teenage. While the Agency would not disclose the patients’ symptoms, Stanfield said that each had already been treated at area hospitals and released.

“We’ve seen it throughout the country for the past few months,” Stanfield told the Register. “We were not surprised because of increased surveillance that we found it in Orange County.”

On August 19th, Children’s Mercy Hospital in Kansas City alerted the Centers for Disease Control and Prevention (CDC) that it was seeing an increase in patients with severe respiratory illness, including some who were taken into pediatric intensive care. Four days later, a Chicago hospital also alerted the CDC to increased cases of patients with severe respiratory illness. A CDC investigation found EV-D68 in 19 of 22 patients at the Kansas City hospital, and 11 of 14 patients at the Chicago hospital.

Since then, from mid-August to October 10 of this year, 691 cases of enterovirus D-68 have been reported in 46 states, according to the CDC. The CDC notes that almost all reported cases of EV-D68 have affected children, many of whom had asthma or a pre-existing respiratory condition.

Symptoms of EV-D68 can range from mild cough, fever, and runny nose, to more severe respiratory illness, and, in at least two cases, partial paralysis.

According to the Los Angeles Times, one child is currently being treated for partial paralysis caused by EV-D68 at Children’s Hospital Los Angeles, while Mail Online reported that a 5-year old Hamilton, Alabama girl with the illness is currently paralyzed from her arms to her legs and is being treated at Children’s of Alabama, where she remains on a ventilator.

No vaccine currently exists for enterovirus D-68.