Cluster of acute flaccid paralysis in Colorado children

[MeSci]

Following on from the California outbreak, here is a paper on one in Colorado.

A cluster of acute flaccid paralysis and cranial nerve dysfunction temporally associated with an outbreak of enterovirus D68 in children in Colorado, USA

There is an interesting associated Physician's First Watch article

Enterovirus D68 May Have Caused Colorado's Cluster of Muscular Weakness

By Joe Elia
Edited by
- Susan Sadoughi, MD, and
- Richard Saitz, MD, MPH, FACP, FASAM

The circumstances surrounding a case cluster of acute flaccid paralysis or cranial nerve dysfunction point to, but do not definitively link it with, enterovirus D68, according to a study in The Lancet.

The cluster comprised 12 Colorado children stricken between August and October 2014. All had gray-matter or brainstem lesions on imaging, and most were febrile at the onset of neurologic symptoms. However, all cerebrospinal fluid specimens were negative for enterovirus. Treatment with antivirals and other agents brought no improvement, and all children with limb weakness showed residual deficits.

What's suggestive is that the cases all occurred during a community-wide outbreak of D68 respiratory illness and that all cases in the cluster had a preceding febrile illness.

A commentary points out that the inability to find D68 in cerebrospinal fluid doesn't necessarily absolve the virus, since similar-acting viruses are more often recovered from stool or throat swabs.

Link(s):
Lancet article (Free abstract) http://click.jwatch.org/cts/click?q=227;68132557;8zhhx2LKxTPJdZdefVYij2W7OkCfBf4O+PkTxgBLDz4=
Background: Physician's First Watch coverage of EV-D68 (Free) http://click.jwatch.org/cts/click?q=227;68132557;8zhhx2LKxTPJdZdefVYij4DoeAz8aEjg+PkTxgBLDz4=

 

[Iquitos]

It's not just in Colorado. The CDC has reported this enterovirus D68 being reported from many locations of the US, with only children being infected and affected, as far as I know. Symptoms are similar to polio, which is also an enterovirus.

Wouldn't it be interesting to follow this outbreak and see how these children are affected from now on.

 

[Sidereal]

A commentary points out that the inability to find D68 in cerebrospinal fluid doesn't necessarily absolve the virus, since similar-acting viruses are more often recovered from stool or throat swabs.

Just shows you how hard it is to detect these viruses. I think it's possible that ME is due to chronic enteroviral infection.

 

[SDSue]

My first thought, aside from how horrific this is for the children and their families, is that perhaps this will lead to discoveries that could help us, too.

Of all the things ME/CFS has made me, self-centered is the one I didn't expect. Unfortunately, this illness has forced me into extreme self-preservation which, to the untrained eye, looks a lot like selfishness. And so it goes.

 

[Iquitos]

Yes, SDSue , I had similar thoughts. At least the CDC is calling it an outbreak and not demonizing the patients and their physicians like they have done to us and the few researchers who take us seriously.

 

[Sidereal]

My horrible thought was that due to its being an outbreak affecting children they are less likely to call it hysteria and more likely to properly investigate it.

 

[halcyon]

My horrible thought was that due to its being an outbreak affecting children they are less likely to call it hysteria and more likely to properly investigate it.

Not nice to think about indeed, but it worked for polio.

 

[Pyrrhus]

Related discussion:

The return of Polio to the USA? Is paralysis being mis-diagnosed as FND?
https://forums.phoenixrising.me/thr...s-paralysis-being-mis-diagnosed-as-fnd.79074/