Background:

• Polio is a crippling and potentially fatal infectious disease
  • Can cause temporary or permanent acute flaccid paralysis
  • Fecal-oral or oral transmission
  • The majority of cases of polio infection are asymptomatic
  • The public/global health significance of polio has been discussed in previous UMEM Educational Pearls (See: 5/7/2014 and 12/18/2013).
• Caused by small, single-strand, positive-sense RNA virus of the genus Enterovirus

 

Enterovirus D68

• Recent widespread nationwide outbreak of this non-polio enterovirus
  • From mid-August 2014 to January 15, 2015, federal and state public health laboratories confirmed 1,153 people with infections
  • Usually seen in children
  • Usually causes mild to severe respiratory illness.
• Concurrent with the national outbreak of Enterovirus D68, there was a concurrent increase in children with acute flaccid myelitis

 

Is there a relationship between Enterovirus D68 and the outbreak of acute flaccid myelitis?

• Recent NIH funded research published in Lancet Infectious Disease analyzed the genomes of 48 patients with enterovirus infections
  • Phylogenetic analysis showed that all enterovirus D68 sequences associated with acute flaccid myelitis were part of the same clade B1 strain .
• These findings strengthen the possible relationship between enterovirus D68 and acute flaccid myelitis

 

Bottom Line

• Acute flaccid myelitis may rarely occur after Enterovirus D68 in susceptible hosts

References

http://www.cdc.gov/polio/

http://www.cdc.gov/non-polio-enterovirus/about/ev-d68.html

http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2815%2970093-9/abstract