As public health officials struggle to track and contain a respiratory virus that has hospitalized hundreds of children across the U.S., there are now concerns that the illness may also cause paralysis in some cases.

In Missouri, doctors are investigating whether Enterovirus D68 caused three children to develop paralysis in their limbs this month, Mary Anne Jackson, director of the division of infectious disease at Children's Mercy Kansas City, said in a telephone interview. In Colorado, officials are examining nine similar cases of severe muscle weakness and limb paralysis, according to the Centers for Disease Control and Prevention.

While the virus has been confirmed in all but 10 states, with 277 cases, the actual number is likely much higher, health authorities said. Testing facilities have been overwhelmed with samples and only the sickest are being tested.