enterovirus-D68 infection
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Epidemiology
- 20-25 cases of polio-like syndrome reported in Califormia 2014
- 2 of 5 initial cases tested positive for enterovirus-68
- cases confirmed in 472 people across 41 states & Washington, D.C. (Sepember 30, 2014)[7]
- at least 4 deaths (Oct 2, 2014)[8]
- children diagnosed with enterovirus D68 in late 2014 were not at greater risk for death or critical care admission, relative to children with other respiratory viruses[13]
- outbreak in children in Colorado, Sept-Oct 2014[10]
- pediatric cases of enterovirus D68 spiked in 2018, mirroring cases of acute flaccid myelitis[14]
Pathology
- cause of lower respiratory tract infection
- severity variable, mild to fatal
- associated with polio-like symptoms[2]
- may be cause of acute neurologic illness with focal limb weakness & spinal cord gray matter abnormalities on MRI[6]
- may be a cause of acute neurologic illness with limb paralysis (acute flaccid myelitis)
- may be especially risky to those with asthma[3]
Genetics
- paralysis associated with B1 strain of enterovirus-D68[12]
- not all children with enterovirus-D68 B1 strain infection develop paralysis[12]
Clinical manifestations
- limb weakness or paralysis may occur
- most patients have very mild symptoms
- all but a very few recover quickly & completely[7]
Laboratory
- enterovirus D68 RNA by rt-PCR[10]
- laboratories now able to process 140 specimens/day
Radiology
- magnetic resonance imaging of spinal cord
- spinal cord gray matter abnormalities on MRI[6]
Complications
Differential diagnosis
More general terms
Additional terms
References
- ↑ Centers for Disease Control and Prevention Clusters of Acute Respiratory Illness Associated with Human Enterovirus 68 --- Asia, Europe, and United States, 2008--2010 MMWR September 30, 2011 / 60(38);1301-1304 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6038a1.htm
- ↑ 2.0 2.1 Physician's First Watch, Feb 24, 2014 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
Seroka R, Uher M A Polio-like Syndrome in California: Clinical, Radiologic, and Serologic Evaluation of Five Children Identified by a Statewide Laboratory over a Twelve-month Period. American Academy of Neurology 66th Annual Meeting https://www.aan.com/PressRoom/Home/GetDigitalAsset/11171
American Academy of Neurology. News Release. Feb 23, 2014 Mysterious Polio-Like Illness Found in Five California Children. https://www.aan.com/PressRoom/Home/PressRelease/1246 - ↑ 3.0 3.1 Orciari Herman A, Sadoughi S, Sofair A Enterovirus-68-like Respiratory Virus Sickening Children Across the U.S. Physician's First Watch, Sept 8, 2014 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
Missouri Department of Health & Senior Services. Health Alert. August 29, 2014 FROM: GAIL VASTERLING DITECTOR SUBJECT: Respiratory Illnesses D ue to Enterovirus D68 (EVD68) in Missouri http://health.mo.gov/emergencies/ert/alertsadvisories/pdf/HA82914.pdf - ↑ 4.0 4.1 Midgley CM et al Severe Respiratory Illness Associated with Enterovirus D68 - Missouri and Illinois, 2014 MMWR. September 8, 2014 / 63(Early Release);1-2 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e0908a1.htm
- ↑ Centers for Disease Control and Prevention (CDC) States with Lab-confirmed Enterovirus D68. September 2014. http://www.cdc.gov/non-polio-enterovirus/about/EV-D68-states.html
- ↑ 6.0 6.1 6.2 CDC HEALTH ADVISORY. September 26, 2014, Acute Neurologic Illness with Focal Limb Weakness of Unknown Etiology in Children. http://emergency.cdc.gov/han/han00370.asp
- ↑ 7.0 7.1 7.2 Orciari Herman A, Sadoughi S, Saitz R Child Dies from Enterovirus D68 Complications; Neurologic Symptoms Increasingly Reported Physician's First Watch, Oct 2, 2014 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
Press Releases. Oct 1,2014 Recent Child Death Resulting from Staphylococcus Aureus Sepsis Associated with Enteroviral Infection (EV-D68). http://www.ri.gov/press/view/23044 - ↑ 8.0 8.1 NEJM Journal Watch Editors Health Departments Investigating 4 Deaths Linked to Enterovirus D68 Physician's First Watch, Oct 3, 2014 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
- ↑ Pastula DM et al Acute Neurologic Illness of Unknown Etiology in Children - Colorado, August-September 2014 MMWR. October 3, 2014 / 63(Early Release);1-2 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e1003a1.htm
Ayscue P et al Acute Flaccid Paralysis with Anterior Myelitis - California, June 2012-June 2014 MMWR. October 3, 2014 / 63(Early Release);1-4 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e1003a2.htm - ↑ 10.0 10.1 10.2 10.3 10.4 Messacar K et al A cluster of acute flaccid paralysis and cranial nerve dysfunction temporally associated with an outbreak of enterovirus D68 in children in Colorado, USA. Lancet. Jan 28, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25638662 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2962457-0/abstract
- ↑ Centers for Disease Control and Prevention (CDC). Press Release. October 14, 2014 CDC Develops a New, Faster Lab Test for Enterovirus D68 http://www.cdc.gov/media/releases/2014/p1014-test-enterovirus-D68.html
- ↑ 12.0 12.1 12.2 Greninger AL et al A novel outbreak enterovirus D68 strain associated with acute flaccid myelitis cases in the USA (2012-14): a retrospective cohort study. The Lancet Infectious Diseases. Published Online: 30 March 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25837569 <Internet> http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2815%2970093-9/fulltext
Norder H, Magnius L Can sequence data predict enterovirus D68 infection outcome? The Lancet Infectious Diseases. Published Online: 30 March 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25837570 <Internet> http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2815%2970107-6/abstract - ↑ 13.0 13.1 Young K, Fairchild DG, Di Francesco L Enterovirus D68 Not Tied to Elevated Risk for Death in Kids During 2014 Outbreak Physician's First Watch, Oct 14, 2015 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org http://www.cmaj.ca/content/early/2015/10/13/cmaj.150619
- ↑ 14.0 14.1 Kujawski SA, Midgley CM, Rha B, et al. Enterovirus D68-Associated Acute Respiratory Illness - New Vaccine Surveillance Network, United States, July-October, 2017 and 2018. MMWR Morb Mortal Wkly Rep 2019;68:277-280 https://www.cdc.gov/mmwr/volumes/68/wr/mm6812a1.htm
- ↑ Centers for Disease Control and Prevention (CDC) Enterovirus D68. Questions and answers. http://www.ncbi.nlm.nih.gov/pubmed/?term=Schifano+ED