Childhood Outbreak of Acute Flaccid Paralysis Linked To Respiratory Virus

Samuel Dominguez MD Departments of Pediatric Infectious Diseases Children's Hospital Colorado and University of Colorado School of Medicine Aurora, COMedicalResearch.com Interview with:
Samuel Dominguez MD

Departments of Pediatric Infectious Diseases
Children’s Hospital Colorado and University of Colorado School of Medicine Aurora, CO

Medical Research: What is the background for this study? What are the main findings?

Dr. Dominguez: Due to global poliovirus eradication efforts, clusters of acute flaccid paralysis (AFP) and/or cranial nerve dysfunction in children are rare and associated with few pathogens, primarily enteroviruses and flaviviruses.  Our study reports the first geographically and temporally defined cluster of acute flaccid paralysis and cranial nerve dysfunction in children associated with an outbreak of EV-D68 respiratory illness, strengthening the potential link between EV-D68 and neurologic disease in children.

Medical Research: What should clinicians and patients take away from your report?

Dr. Dominguez: As with all respiratory pathogens, clinicians and families should remember to practice good respiratory and hand hygiene.  During the upcoming enterovirus season (late summer, early fall) clinicians should be watchful for patients presenting with acute flaccid paralysis and refer them for care to a tertiary care center and notify their public health authorities.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Dominguez: Further research is needed to strengthen our association and hypothesis.  (Our results do not prove that EVD68 is the definitive cause of the neurological cluster that we observed).  Towards this end, serological studies and case control studies could strengthen our findings.  Similarly, full genome sequence comparison of viruses found in children with neurological disease need to be compared with those associated with respiratory disease and historical isolates.  This would help us understand if the virus has changed in some way to potentially make it neurovirulent.  We need continued, active surveillance for EVD68 to help assess the burden of disease moving forward.  If our association is confirmed, and EV-D68 becomes endemic then we will need to develop/explore new antivirals (or testing of old antivirals), immunodulatory medications, and/or vaccines as ways to treat and/or prevent this disease.

Citation:

A cluster of acute flaccid paralysis and cranial nerve dysfunction temporally associated with an outbreak of enterovirus D68 in children in Colorado, USA

Kevin Messacar, MD Teri L Schreiner, MD John A Maloney, MD Adam Wallace, MD Jan Ludke, MD, M Stephen Oberste, PhD W Allan Nix, PhD Christine C Robinson, PhD Mary P Glodé, MD Mark J Abzug, MD Dr Samuel R Dominguez, MD

The Lancet Available online 29 January 2015

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MedicalResearch.com Interview with:, & Samuel Dominguez MD (2015). Childhood Outbreak of Acute Flaccid Paralysis Linked To Respiratory Virus MedicalResearch.com

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