Search

Enterovirus D68 (EV-D68) was recognized as a respiratory virus in 1962 (1). In 2014, unprecedented large outbreaks of EV-D68 infections associated with severe respiratory illnesses occurred in children in the [...]

In August 2012, the California Department of Public Health (CDPH) was contacted by a San Francisco Bay area clinician who requested poliovirus testing for an unvaccinated man aged 29 years with acute flaccid paralysis (AFP) associated with anterior myelitis (i.e., evidence of inflammation of the spinal cord involving the grey matter including anterior horn cell bodies) and no history of international travel during the month before symptom onset. Within 2 weeks, CDPH had received reports of two additional cases of AFP with anterior myelitis of unknown etiology. Testing at CDPH's Viral and Rickettsial Disease Laboratory for stool, nasopharyngeal swab, and cerebrospinal fluid (CSF) did not detect the presence of an enterovirus (EV), the genus of the family Picornaviridae that includes poliovirus. Additional laboratory testing for infectious diseases conducted at the CDPH Viral and Rickettsial Disease Laboratory did not identify a causative agent to explain the observed clinical syndrome reported among the patients. To identify other cases of AFP with anterior myelitis and elucidate possible common etiologies, CDPH posted alerts in official communications for California local health departments during December 2012, July 2013, and February 2014. Reports of cases of neurologic illness received by CDPH were investigated throughout this period, and clinicians were encouraged to submit clinical samples for testing. A total of 23 cases of AFP with anterior myelitis of unknown etiology were identified. Epidemiologic and laboratory investigation did not identify poliovirus infection as a possible cause for the observed cases. No common etiology was identified to explain the reported cases, although EV-D68 was identified in upper respiratory tract specimens of two patients. EV infection, including poliovirus infection, should be considered in the differential diagnosis in cases of AFP with anterior myelitis and testing performed per CDC guidelines.

The article provides information on severe hand, foot, and mouth disease (HFMD) associated with coxsackievirus A6 in the U.S. from November 2011 to February 2012. The U.S. Centers for Disease Control and Prevention (CDC) received reports of 63 persons with signs and symptoms of HFMD or with fever and atypical rash in Alabama, California, Connecticut, and Nevada. Ways HFMD is spread include contact with saliva, respiratory secretions, fluid in vesicles, and feces.

The article reports that the U.S. Centers for Disease Control and Prevention (CDC) received reports of 63 persons with signs and symptoms of hand, foot and mouth disease (HFMD) associated with coxsackievirusA6 in Alabama, California, and Connecticut from November 7, 2011 to February 29, 2012. It states that the age ranges of patients, severity of illness, and seasonality of disease in these cases were unusual for HFMD in the U.S.