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CDC: Link between EV-D68, neurologic illness unverified
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Although the relationship between enterovirus D68 and acute flaccid myelitis has yet to be confirmed, the CDC suggests being up-to-date with all recommended vaccinations to prevent severe illness.
In September 2014, the CDC received reports of a cluster of cases of acute limb weakness among children by physicians at Children’s Hospital Colorado. Most patients reported respiratory or febrile illness before onset of neurologic symptoms. These cases coincided with a national outbreak of severe respiratory disease caused by EV-D68.
As of Nov. 13, 2014, 88 cases — defined as acute onset of focal limb weakness occurring on or after Aug. 1, 2014 and an MRI-confirmed spinal cord lesion restricted to gray matter — among patients aged younger than 21 years, have been verified by the CDC. The median age of these patients was 7.6 years, and incidence occurred across 32 states.
Eighty-one percent of patients reported respiratory illness, and 68% reported febrile illness that occurred before neurologic symptoms appeared. Seventy-one patients underwent cerebrospinal fluid testing. No enteroviruses or other pathogens have been confirmed, according to the CDC.
Of the 41 patients with upper respiratory tract samples available for CDC testing, 20% tested positive for EV-D68, and 22% tested positive for other enterovirus/rhinovirus types.
“Although the specific causes [of acute flaccid myelitis] are still under investigation, and causal relationship to EV-D68 has not yet been substantiated, being up to date on all recommended vaccinations is essential to prevent a number of severe diseases,” the researchers from the CDC wrote. “Prevention of viral infections includes general hygienic measures, such as frequent hand washing with soap and water, avoiding close contact with sick persons, and disinfecting frequently touched surfaces.”
The CDC, which will continue to investigate reported cases and possible etiologies of acute flaccid myelitis, recommends children who experience sudden onset of weakness in the arms or legs should be taken to a health care provider and assessed for potential neurologic illness.
Disclosure: The researchers report no relevant financial disclosures.
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