Role of EV-D68 in polio-like illnesses still unclear

Saturday, October 4, 2014
By Paul Martin

Robert Roos
CIDRAP News
Oct 03, 2014

As the nationwide outbreak of enterovirus D68 (EV-D68) infections grew again today, federal and state health officials said they still have no idea whether the virus is contributing to a number of prolonged polio-like illnesses that have cropped up in a few states, especially California and Colorado.

The count of EVD-68 cases, almost all of them in children, climbed to 538, up 24 from yesterday, the Centers for Disease Control and Prevention (CDC) announced today. The number of affected states stayed level at 43.

Colorado officials reported recently that 4 children out of 9 at Children’s Hospital Colorado in Denver who had neurologic illness involving limb weakness and cranial nerve dysfunction tested positive for EV-D68. Today, California health officials reported that a patient in Los Angeles County with a similar illness tested positive for the virus in August.

As reported earlier, the virus was also found in two other California patients with neurologic symptoms in 2012.

Mere coincidence?

But during a teleconference for clinicians today, CDC officials said they don’t know if the polio-like conditions are related to EV-D68 or just coincidental. They also said that, lacking any good baseline data on the neurologic illnesses, they’re not even sure how unusual the numbers are.

“Are these neurologic cases related to EV-D68? I don’t think we can say that they are at this point. We’re really not sure what’s causing this cluster,” said Daniel Feikin, MD, chief of the Epidemiology Branch, Division of Viral Diseases, in the CDC’s National Center for Immunization and Respiratory Diseases

“It’s possible that [EV-D68] is a coincidental finding in these patients and may not be related to their neurologic illness,” he said. “That’s why we need to continue investigating.”

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