Enterovirus Antibodies Detected in CSF of Acute Flaccid Myelitis (AFM) Patients; New Study Adds to Knowledge About Rare Condition

A new study analyzing samples from patients with and without acute flaccid myelitis (AFM) provides additional evidence for an association between the rare, but often serious, condition that causes muscle weakness and paralysis, and infection with non-polio enteroviruses. The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, funded the research, which was conducted by collaborating investigators at Columbia University's Center for Infection and Immunity, the Centers for Disease Control and Prevention (CDC), and the University of California San Diego (UCSD). The findings were reported online on August 13, 2019 in the online journal mBio. The open-access article is titled “Antibodies to Enteroviruses in Cerebrospinal Fluid of Patients with Acute Flaccid Myelitis.” There have been 570 confirmed cases since the CDC began tracking AFM in August 2014. AFM outbreaks were reported to the CDC in 2014, 2016 and 2018. AFM affects the spinal cord and is characterized by the sudden onset of muscle weakness in one or more limbs. Spikes in AFM cases, primarily in children, have coincided in time and location with outbreaks of one enterovirus (EV) EV-D68 (image) and a related enterovirus, EV-A71. Both of these viruses typically cause mild respiratory illness from which most people recover fully. Despite the epidemiological link between enterovirus circulation and AFM cases, evidence of direct causality has not been found. The researchers first looked for direct evidence of enterovirus infection in the cerebrospinal fluid (CSF) of 13 children and one adult diagnosed with AFM in 2018. They also examined five CSF samples taken from people with other central nervous system diseases.
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