Key Points
- Determine the specific viral etiologies responsible for paralytic and nonparalytic illnesses during an epidemic initially attributed to poliomyelitis.
- Conducted virological culture of fecal specimens from 869 patients presenting during an epidemic.
- Performed diagnostic serological antibody assays on acute and convalescent serum specimens from 191 patients lacking stool specimens.
- Fecal testing (n=869) identified no virus in 401 cases, poliovirus in 292, ECHO virus in 100, Coxsackie virus in 73, and unidentified viruses in 3.
- Serological assays (n=191) showed diagnostic antibody shifts for poliovirus in 48 cases, ECHO virus in 14, Coxsackie virus in 6, and no changes in 123.
- Coxsackie and ECHO viruses caused more cases of nonparalytic poliomyelitis and aseptic meningitis than poliovirus, with no distinguishable clinical features among the three virus groups.
Structured PICO
PPopulation1,060 patients during an epidemic of poliomyelitis in Michigan in 1958
OOutcomeViral etiology of infection (poliovirus, ECHO virus, Coxsackie virus, or unidentified)
During the 1958 Detroit poliomyelitis epidemic, a significant proportion of paralytic and nonparalytic cases were caused by ECHO and Coxsackie viruses rather than poliovirus, complicating future immunization efforts.