US doctors have reported 12 cases of muscle weakness or paralysis among children in Colorado that may be linked to a nationwide outbreak of an usually rare respiratory virus called EV-D68.
EV-D68 is a so-called non-polio enterovirus. Some viruses in this group have been found to cause meningitis, encephalitis or paralysis, as well as infection of the heart muscle or the sac surrounding it, in a small number of people. EV-D68 has previously caused localized outbreaks of respiratory illness in Asia, Europe and the United States from 2008 to 2010. According to the latest figures on the US Centers for Disease Control and Prevention (CDC) website, it returned last August in a US-wide outbreak, which as of January 15 had caused 1,153 mild to severe respiratory illness cases.
Physicians at the Children's Hospital Colorado examined 12 cases of sick youngsters who had been admitted over a three-month period. These children reportedly had varying degrees of muscle weakness in the arms and legs as well as facial paralysis or problems swallowing, Roughly a week after falling ill with a fever and breathing difficulties. 8 of the 12 tested positive for enteroviruses or rhinoviruses, of which five were identified as EV-D68. Scans showed that 10 children had spinal cord lesions and brain-stem lesions were seen in 9. Despite having received treatment, all 10 with limb weakness still have problems.
Microbial epidemiologist Samuel Dominguez said, "Over the past four years, our hospital has seen a maximum of four similar cases in any three-month period where children lose the use of one or both arms or legs. These 12 cases are three times that. The extent to which this new distinctive neurological disease has spread is unknown, but it does not appear to be isolated to Colorado or the USA. Since the reporting of this cluster, 107 similar cases have been reported across the USA and one in France. If the link is confirmed EV-D68 will be added to the list of non-polio virus enteroviruses capable of causing severe, potentially irreversible neurologic damage, and finding effective antiviral therapies and vaccines will be a priority."
Exposure to EV-D68 comes from close contact with an infected person, through sneezes, coughing and shaking hands with them or touching surfaces that have the virus on it. There is currently no vaccine or targeted treatment for the disease.
The report appears online in UK medical journal The Lancet.