Acute Flaccid Myelitis Associated with Enterovirus D68 in Children, Argentina, 2016

Carballo, Carolina; Erro, Marcela García; Sordelli, Nora; Vázquez, Gabriel; Mistchenko, Alicia; Cejas, Claudia; Rodriguez, Manlio; Cisterna, Daniel; Freire, María Cecilia; Contrini, María Marta; López, Eduardo

doi:10.3201/eid2503.170897

Cited by 27 publications

(21 citation statements)

References 13 publications

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“…Since the EV-D68 outbreak reported by the United States Centers for Disease Control and Prevention (CDC) in 2014, EV-D68 has been increasingly associated with acute flaccid myelitis in other researches [5][6][7][8][9][10][11][12][13]. Previous studies in 2014 showed that the odds of EV-D68 infection were 10.3 times higher for children with AFM than for respiratory pathogen panel (RPP)-tested controls [14].…”

Section: Discussionmentioning

confidence: 99%

Enterovirus D68 in a 6-year-old acute flaccid myelitis case in China, 2018: a case report

Wang

Zhang

et al. 2020

BMC Infect Dis

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Background: Acute flaccid myelitis (AFM) are reported to be associated with enterovirus D68 infection. Though an increasing number of AFM cases were reported with EV-D68 infection in the US, few such cases have been found in China. Case presentation: A 6-year-old boy presented with acute flaccid myelitis (AFM) involving left arm after fever and respiratory symptoms for 6 days. Computed Tomography (CT) revealed inflammation in both lungs and magnetic resonance imaging (MRI) of the brain and spine showed swelling in the left frontal lobe and brain stem. The patient was diagnosed with meningomyelitis. EV-D68 was detected from pharyngeal samples 36 days after the onset of the disease. Conclusion: We report the first EV-D68 infection in case of AFM in mainland China. AFM surveillance systems is recommended to be established in China to guide diagnosis, case reporting, and specimen collection and testing for better understanding its etiologies.

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Section: Discussionmentioning

confidence: 99%

Enterovirus D68 in a 6-year-old acute flaccid myelitis case in China, 2018: a case report

Wang

Zhang

et al. 2020

BMC Infect Dis

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“…Geographic involvement in the USA has varied each year. Cases have also been seen in other parts of the world, including Europe, Canada, Asia and South America 4 5 10 11. There is a slight male predominance in AFM cases1 8 with a recent, although small case series of 28 patients with AFM suggesting a predisposition in patients with a history of asthma, atopic dermatitis or head trauma 12.…”

Section: Epidemiology and Reporting Of Afmmentioning

confidence: 99%

Update on acute flaccid myelitis: recognition, reporting, aetiology and outcomes

Hardy

Hopkins

2020

Arch Dis Child

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Acute flaccid myelitis, defined by acute flaccid limb weakness in the setting of grey matter lesions of the spinal cord, became increasingly recognised in 2014 following outbreaks in Colorado and California, temporally associated with an outbreak of enterovirus D68 respiratory disease. Since then, there have been biennial increases in late summer/early fall. A viral infectious aetiology, most likely enteroviral, is strongly suspected, but a definitive connection has yet to be established. Patients typically present with asymmetric weakness, maximal proximally, in the setting of a febrile illness. MRI demonstrates T2/FLAIR abnormalities in the central grey matter of the spinal cord, and cerebrospinal fluid typically shows a lymphocytic pleocytosis with variable elevation in protein. The weakness may be progressive over several days and involve respiratory muscles, making early recognition and close monitoring essential. Other complications in the acute period may include autonomic instability and bowel/bladder involvement. There is no clear recommended treatment at this time, although intravenous immunoglobulin, steroids and plasma exchange have been used. Intensive therapies and rehab services have shown benefit in maximising function, and surgical interventions may be considered in cases without optimal response to therapies. Close attention should also be paid to psychosocial factors. Prognosis is generally guarded, and additional factors that predict final outcome, including host factors and treatment effects, have yet to be elucidated. Multicentre collaborative efforts will be required to provide answers about this rare but serious disorder.

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“…13 Enterovirus-D68 circulation has likewise correlated with AFM outbreaks in Asia, 14 Europe, 15,16 and South America. 17 The epidemiological signal of AFM outbreak periods in the summer to fall of every other year since 2014 in the United States contrasts starkly with the background noise of sporadic cases during the intervening years (Fig 1). It is already evident in the Ayers et al 1 study and among US AFM cases overall from 2014 to 2018 that enterovirus-D68 has been the predominant pathogen detected.…”

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confidence: 94%

Acute Flaccid Myelitis Surveillance: A Signal Through the Noise

2019

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Acute Flaccid Myelitis Associated with Enterovirus D68 in Children, Argentina, 2016

Cited by 27 publications

References 13 publications

Enterovirus D68 in a 6-year-old acute flaccid myelitis case in China, 2018: a case report

Enterovirus D68 in a 6-year-old acute flaccid myelitis case in China, 2018: a case report

Update on acute flaccid myelitis: recognition, reporting, aetiology and outcomes

Acute Flaccid Myelitis Surveillance: A Signal Through the Noise

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