Key result
Among 18 children with acute flaccid myelitis, 50% were positive for EV-D68, and most patients showed little clinical improvement despite early aggressive therapy.
Why the study?
An outbreak of polio-like acute flaccid myelitis occurred in Zhejiang province, China, prompting an investigation into the clinical presentation, laboratory findings, and outcomes of patients.
Observational (n=18)
No
Answers are grounded in this paper and cite their sources.
The 2018 outbreak of acute flaccid myelitis in children in Zhejiang province was strongly associated with Enterovirus-D68 subclade B3 and characterized by spinal gray matter abnormalities and poor response to early therapy.
In July-December 2018, an outbreak of polio-like acute flaccid myelitis (AFM) occurred in Zhejiang province, China. Enterovirus (EV)-D68 infection has been reported to be associated with AFM. This study aimed to investigate the clinical presentation, laboratory findings, and outcomes of AFM patients. We investigated the clinical and virologic information regarding the AFM patients, and real-time PCR, sequencing, and phylogenetic analysis were used to investigate the cause of AFM. Eighteen cases met the definition of AFM, with a median age of 4.05 years (range, 0.9-9 years), and nine (50%) were EV-D68 positive. Symptoms included acute flaccid limb weakness and cranial nerve dysfunction. On magnetic resonance imaging, 11 (61.1%) patients had spinal gray matter abnormalities. Electromyography results of 16 out of 17 patients (94.1%) were abnormal. Cerebrospinal fluid (CSF) pleocytosis was common (94.4%), while CSF protein concentration was normal in all patients. There was little improvement after early aggressive therapy. Phylogenetic analysis revealed that EV-D68 subclade B3 was the predominant lineage circulating in Zhejiang province in 2018.
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Gong et al. (2020) conducted an observational in Acute Flaccid Myelitis (n=18). Enterovirus D68 (EV-D68) infection vs. EV-D68 negative patients was evaluated on Clinical presentation, laboratory findings, and outcomes. Among 18 children with acute flaccid myelitis, 50% were positive for EV-D68, and most patients showed little clinical improvement despite early aggressive therapy.
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