Key result
The prevalence of EV-D68 significantly correlated with the number of acute flaccid myelitis cases in children during 2009-2018 (Spearman ρ 0.93, p=0.0005), supporting an association between the virus and the disease.
Why the study?
The definitive cause of acute flaccid myelitis remains unconfirmed, though enterovirus D68 is suspected based on concomitant increases in cases.
Observational (n=1,433)
No
Effect estimate: Spearman ρ 0.93
p-value: p=0.0005
The biennial circulation pattern of EV-D68 strongly correlates with acute flaccid myelitis outbreaks, reinforcing the virus as a likely trigger for the paralytic disease.
EV-D68 circulation was associated with AFM incidence; leaves open causal confirmation and prevention strategies in prospective studies.
Acute flaccid myelitis (AFM) is a polio-like disease that results in paralysis in previously healthy persons. Although the definitive cause of AFM remains unconfirmed, enterovirus D68 (EV-D68) is suspected based on 2014 data demonstrating an increase in AFM cases concomitant with an EV-D68 outbreak. We examined the prevalence in children and the molecular evolution of EV-D68 for 2009-2018 in Philadelphia, Pennsylvania, USA. We detected widespread EV-D68 circulation in 2009, rare detections in 2010 and 2011, and then biennial circulation, only in even years, during 2012-2018. Prevalence of EV-D68 significantly correlated with AFM cases during this period. Finally, whole-genome sequencing revealed early detection of the B1 clade in 2009 and continued evolution of the B3 clade from 2016 to 2018. These data reinforce the need to improve surveillance programs for nonpolio enterovirus to identify possible AFM triggers and predict disease prevalence to better prepare for future outbreaks.
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Uprety et al. (2019) conducted an observational in Acute Flaccid Myelitis (AFM) and Enterovirus D68 (EV-D68) (n=1,433). Enterovirus D68 (EV-D68) circulation was evaluated on Correlation between the number of AFM cases and the percentage of RV/EV-positive respiratory samples that typed as EV-D68 from August through November during 2009-2018 (Spearman ρ 0.93, p=0.0005). The prevalence of EV-D68 significantly correlated with the number of acute flaccid myelitis cases in children during 2009-2018 (Spearman ρ 0.93, p=0.0005), supporting an association between the virus and the disease.
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