Key result
Enterovirus D68 was epidemiologically associated with acute flaccid myelitis, a condition for which treatments including IV immunoglobulin, plasmapheresis, and steroids had no effect.
Acute flaccid myelitis cases in the US between 2012 and 2015 were associated with enterovirus D68 and did not respond to standard immunomodulatory or antiviral treatments.
In 2012, illnesses presenting with acute flaccid paralysis were reported in the United States—over 150 cases between 2012 and 2015—with a clinical picture of a prodromal illness followed by rapid onset of weakness and cranial nerve dysfunction in association with CSF pleocytosis and elevated protein level. MRI showed abnormal spinal cord gray matter signal. Treatment with IV immunoglobulin, plasmapheresis, steroids, and antiviral agents had no effect on the natural history of what was named acute flaccid myelitis (AFM). Epidemiologic analysis later showed an association with an enterovirus D68, which was grouped into a recently emerged Clade B1 strain. This virus caused a respiratory illness and was identified in respiratory and gastrointestinal samples.1–3
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Wiznitzer et al. (2017) conducted a review in Acute flaccid myelitis (n=150). Enterovirus D68 was evaluated. Enterovirus D68 was epidemiologically associated with acute flaccid myelitis, a condition for which treatments including IV immunoglobulin, plasmapheresis, and steroids had no effect.
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