Friday 30 January 2015

Little Improvement in Children Paralyzed After Viral Infection, Study Finds

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Cluster of Colorado cases may be tied to 2014 outbreak of enterovirus D68, experts say


WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

THURSDAY, Jan. 29, 2015 (HealthDay News) -- A cluster of 12 Colorado children are suffering muscle weakness and paralysis similar to that caused by polio, and doctors are concerned these cases could be linked to a nationwide outbreak of what's usually a rare respiratory virus.

Despite treatment, 10 of the children first diagnosed late last summer still have ongoing problems, the authors noted, and it's not known if their limb weakness and paralysis will be permanent.

The viral culprit tied to at least some of the cases, enterovirus D68 or EV-D68, belongs to the same family as the polio virus.

"The pattern of symptoms the children are presenting with and the pattern of imaging we are seeing is similar to other enteroviruses, with polio being one of those," said lead author Dr. Kevin Messacar, a pediatric infectious diseases physician at Children's Hospital Colorado in Aurora.

Dr. Amesh Adalja is a senior associate at the Center for Health Security at University of Pittsburgh Medical Center, and a spokesman for the Infectious Diseases Society of America. He stressed that it's "important to keep in context that this is a rare complication that doesn't reflect what enterovirus D68 normally does in a person.

"There's no avoiding comparisons to polio because it's in the same family of virus, but I don't think we're going to see wide outbreaks of associated paralysis the way we did with polio," Adalja added. "For whatever reason, we're seeing a smaller proportion of paralytic cases."

In 2014, the United States experienced a nationwide outbreak of EV-D68, according to the U.S. Centers for Disease Control and Prevention (CDC). From mid-August to mid-January 2015, public health officials confirmed more than 1,100 cases in all but one state. The virus was detected in 14 patients who died of illness, the CDC reported.

In most cases EV-D68 resembles a common cold, according to the CDC. Mild symptoms include fever, runny nose, sneezing and cough. People with more severe cases may suffer from wheezing or difficulty breathing.

Colorado was hit hard by EV-D68, the report authors say in background notes. In August and September, Children's Hospital Colorado experienced a 36 percent increase in ER visits involving respiratory symptoms and a 77 percent increase in admissions for respiratory illness, compared to 2012 and 2013.



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