Mysterious Polio Like Illness Found in Between 20 to 25 California Children

The research study authors related that there are now between 20 and 25 reported, suspected cases of this polio-like syndrome. Researchers have identified a polio-like syndrome in a cluster of children from California over a one-year period, according to a case report released today that will be presented at the American Academy of Neurology’s 66th Annual Meeting in Philadelphia, April 26 to May 3, 2014. 

The press release below was released when only 5 suspected cases were known. This post was recently updated.

“Although poliovirus has been eradicated from most of the globe, other viruses can also injure the spine, leading to a polio-like syndrome,” said case report author Keith Van Haren, MD, with Stanford University in Palo Alto, Calif., and a member of the American Academy of Neurology and co-author Emanuelle Waubant, MD, with the University of California-San Francisco. “In the past decade, newly identified strains of enterovirus have been linked to polio-like outbreaks among children in Asia and Australia. These five new cases highlight the possibility of an emerging infectious polio-like syndrome in California.”

This MRI shows encephalitis caused by enterovirus.
Two children tested positive for enterovirus-68, a rare virus previously associated with polio-like symptoms. This MRI shows encephalitis caused by enterovirus. Credit CDC

Polio is a contagious disease that sometimes caused paralysis. The United States experienced a polio epidemic in the 1950s, until a vaccine was introduced.

Van Haren said he and his colleagues noticed several of these cases at their medical centers and decided to look for similar cases in California. They reviewed all polio-like cases among children who had samples referred to California’s Neurologic and Surveillance Testing program from August 2012 to July 2013. Cases were included in the analysis if the children had paralysis affecting one or more limbs with abnormal MRI scans of the spinal cord that explained the paralysis. They did not include children who met criteria for Guillain-Barré syndrome and botulism, which can cause similar symptoms.

The five children experienced paralysis of one or more arms or legs that came on suddenly and reached the height of its severity within two days of onset. Three of the children had a respiratory illness before the symptoms began. All of the children had been previously vaccinated against poliovirus.

The children were treated but their symptoms did not improve and they still had poor limb function after six months. Two children tested positive for enterovirus-68, a rare virus previously associated with polio-like symptoms. No cause was identified in the remaining three children.

“Our findings have important implications for disease surveillance, testing and treatment,” said Van Haren. “We would like to stress that this syndrome appears to be very, very rare. Any time a parent sees symptoms of paralysis in a child, the child should be seen by a doctor right away.”

Notes about this neurology and health research

The case report was supported by the McHugh/Sprague Award from the Lucile Packard Foundation.

Contact: Rachel Seroka – AAN
Source: AAN press release
Image Source: The images are credited to the CDC and is in the public domain.
Additional Information: Keith Van Haren will be speaking at the AAN 66th Annual Meeting in Philadelphia, April 26 to May 3, 2014. The abstract (PDF) “A Polio-like Syndrome in California: Clinical, Radiologic, and Serologic Evaluation of Five Children Identified by a Statewide Laboratory over a Twelve-month Period” by Alexandra Roux, Sabeen Lulu, Emmanuelle Waubant, Carol Glaser, and Keith Van Haren, MD is available for preview.

#neurology, #health

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