- Copyright © 2014, The American Academy of Pediatrics
The Centers for Disease Control and Prevention (CDC) continues to investigate possible infectious and non-infectious causes of the unexplained muscle weakness or paralysis after the reports of 10 cases in Colorado and other reports around the country.
Management and treatment guidelines for clinicians are expected to be issued by the CDC within the next week or so, according to a CDC conference call for clinicians held Oct. 3.
Despite the recently reported cluster of pediatric patients in the Denver area, and isolated reports elsewhere around the country, it still is not clear how many U.S. children have the neurologic condition characterized by limb weakness and/or cranial dysfunction. The reports coincide with an increase in enterovirus D68 (EV-D68) in many parts of the United States, now up to 538 confirmed cases in 43 states.
While the strains of EV-D68 circulating this year are not new, according to the CDC, it is common for multiple strains of the same enterovirus type to be co-circulating in the same year.
The CDC also has worked with the California Department of Health to look further into the cause of cases of acute flaccid paralysis with anterior myelitis reported to that department earlier this year. However, notable differences exist between the California and Colorado cases, including age distribution of patients, timing of cases and incidence.
Clinicians are urged to report to their local and state health departments, and the CDC, details on cases with the following criteria:
Patients ages 21 years of age or younger with acute onset of focal limb weakness occurring on or after Aug. 1; and
Those with magnetic resonance imaging showing a spinal cord lesion largely restricted to gray matter.
The goal is to have clinicians and the public health community work together to be able to describe the epidemiology of the neurologic syndrome and help define the risk factors.
Read the early release article “Acute Neurologic Illness of Unknown Etiology in Children — Colorado, August-September 2014” in the Oct. 3 Morbidity and Mortality Weekly Report at http://1.usa.gov/1uHBxRc
Link to CDC page on EV-68 www.cdc.gov/non-polio-enterovirus/outbreaks/EV-D68-outbreaks.html
EV-68 for health care professionals, www.cdc.gov/non-polio-enterovirus/hcp/EV-D68-hcp.html
AAP enterovirus resource page, http://bit.ly/1oH8MNF
Unexplained Paralysis Hospitalizes Children, parent page, www.cdc.gov/features/unexplainedparalysis/index.html