An increase in reports of acute flaccid paralysis (AFP) in the United Kingdom, 1 January 2018–21 January 2019: early findings

Ramsay, Mary; Dunning, Jake; Foulkes, Sarah; LÓpez, J.J. Ochoa; Bukasa, Antoaneta; Iyanger, Nalini; Zambon, Maria; Brown, Kevin E.; Bradshaw, D.; Ladhani, Shamez; MacGregor,; Pebody, Richard; Donati, Matthew; Stowe, Julia; Williams, C.; Devine, Michelle; Reynolds, Audrey H.; Marques, Diogo F P; McMenamin, Jim; Templeton, Kate; Lim, Ming

doi:10.2807/1560-7917.es.2019.24.6.1900093

Cited by 36 publications

(25 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…EV-D68 was also detected among two of the other nine confirmed acute flaccid myelitis patients during this surveillance period. 33…”

Section: Epidemiologymentioning

confidence: 99%

Current status of enterovirus D68 worldwide and in Taiwan

Chang

2020

Pediatrics & Neonatology

View full text Add to dashboard Cite

Enterovirus D68 was first identified in 1962 and caused a worldwide outbreak starting from the North America in 2014. Enterovirus D68 has been in continuous circulation among many countries recently, including Taiwan. Reports also reveal high seroprevalence, which indicates that the disease burden of enterovirus D68 may be underestimated via viral culture or polymerase chain reaction results. Although most infected cases have mild respiratory illness, severe complications including acute flaccid myelitis and acute respiratory distress syndrome have also been reported. In the position of an emerging pathogen, enterovirus D68 poses a threat to public health and may cause devastating diseases. Diverse severity of neurological sequelae remains inevitable among acute flaccid myelitis patients, but no curable treatment is available currently. According to the management suggestions of the American Centers of Disease Control, uses of corticosteroids and plasmapheresis are either preferred or avoided and intravenous immunoglobulin also has no clear indication in the treatment for acute flaccid myelitis. In this review article, we provide information about the epidemiology, clinical recognition and treatment strategy of enterovirus D68. Better understanding of this disease is the foothold for advanced investigation and monitoring in the future.

show abstract

“…EV-D68 was also detected among two of the other nine confirmed acute flaccid myelitis patients during this surveillance period. 33…”

Section: Epidemiologymentioning

confidence: 99%

Current status of enterovirus D68 worldwide and in Taiwan

Chang

2020

Pediatrics & Neonatology

View full text Add to dashboard Cite

show abstract

“…4 Now, with recognition of biannual peaks in AFM cases in the USA and documentation of an outbreak of AFM in the United Kingdom (UK) in 2018, there is a growing need to characterise the epidemiology of AFM, not only an emerging disease among children, but one with global significance particularly in countries where polio has been eradicated. 5,12,13 The relationship between AFM and enteroviruses has been the subject of several reviews since the 2014 US AFM outbreak, which coincided with a peak in EV-D68 infection causing asthma and other respiratory illnesses. 4,6 EV-D68…”

Section: Discussionmentioning

confidence: 99%

“…However, PCR testing for EV-D68 is rarely positive on CSF samples in AFM cases and is less frequently detected in stool than respiratory samples. 4,5 USA and UK AFM surveillance emphasises the importance of respiratory sampling for detecting EV-D68. In Australia, collection of stools and sub-type testing of all enteroviruses by the reference laboratory at VIDRL is recommended for all AFP cases, in accordance with WHO requirements.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the importance of continued AFP surveillance in high-income countries has been highlighted by epidemics of a newly-recognised syndrome, acute flaccid myelitis (AFM) in the United States of America (USA) and Europe since 2014. [3][4][5] AFM is a form of AFP characterised by a 'polio-like' pattern of spinal cord inflammation primarily affecting the central grey matter and anterior horns of the spinal cord. 4 While cases that fit this pattern of disease have been described prior to 2014, AFM has only been recognised in the literature as an unique syndrome since the first clusters of disease in California, USA that year.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acute flaccid myelitis – has it gone unrecognised in Australian children?

et al. 2020

View full text Add to dashboard Cite

We have identified a previously unrecognised cluster of a newly recognised condition – acute flaccid myelitis (AFM) – among acute flaccid paralysis (AFP) cases identified by the Australian Paediatric Active Enhanced Disease Surveillance Network (PAEDS) 2007–2017. In the 12 months before and after detection of enterovirus D68 (EV-D68) from a single AFP case in April 2016, 24 of 97 notified cases of AFP were found to be clinically compatible with AFM; of these 24 cases, ten, clustered in early 2016, met magnetic resonance imaging (MRI) criteria for AFM. Detection of emerging enteroviruses requires collection of respiratory, cerebrospinal fluid and stool specimens, and should be routine practice for all AFP cases.

show abstract

“…38 This definition has been deployed across the USA and also adopted by UK and European surveillance organisations. 39,40 Recently, US case definitions have been further updated to improve specificity, including removal of CSF criteria; the current AFM surveillance definition is summarised in Box 4. 38 EV-D68 was first detected in an Australian case of AFP by VIDRL in 2010 in Australia, with no outbreaks of associated disease reported.…”

Section: New Enemies: Enterovirus Species a Serotype 71 (Ev-a71)mentioning

confidence: 99%

Polio – The old foe and new challenges: An update for clinicians

Bao

Thorley

Isaacs

et al. 2020

J Paediatrics Child Health

View full text Add to dashboard Cite

The Global Polio Eradication Initiative since 1988 has seen the impact of poliovirus decline from frequent global epidemics in the early 1900s to being now only endemic in two countries today. Global vaccination programmes and surveillance for the disease have resulted in the landmark eradication of two of the three poliovirus strains in the last 5 years. Australia continues to contribute to global surveillance efforts for the disease via the Australian Paediatric Surveillance Unit and the Paediatric Active Enhanced Disease Surveillance Network, which aim to detect cases of acute flaccid paralysis in children, the key clinical feature of poliomyelitis. Today, in the era of the polio 'endgame', there is growing recognition of non-polio enteroviruses causing paralytic diseases that are polio-like, particularly in children, with an increased need for awareness and vigilance by paediatric clinicians.

show abstract

An increase in reports of acute flaccid paralysis (AFP) in the United Kingdom, 1 January 2018–21 January 2019: early findings

Abstract: This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.

Cited by 36 publications

References 15 publications

Current status of enterovirus D68 worldwide and in Taiwan

Current status of enterovirus D68 worldwide and in Taiwan

Acute flaccid myelitis – has it gone unrecognised in Australian children?

Polio – The old foe and new challenges: An update for clinicians

Contact Info

Product

Resources

About