Acute Neurologic Illness with Focal Limb Weakness of Unknown Etiology in Children

Acute Neurologic Illness with Focal Limb Weakness of Unknown Etiology in Children

Summary

The Centers for Disease Control and Prevention (CDC) is working closely with the Colorado Department of Public Health and Environment (CDPHE) and Children’s Hospital Colorado to investigate a cluster of nine pediatric patients hospitalized with acute neurologic illness of undetermined etiology. The illness is characterized by focal limb weakness and abnormalities of the spinal cord gray matter on MRI. These illnesses have occurred since August 1, 2014 coincident with an increase of respiratory illnesses among children in Colorado. The purpose of this HAN Advisory is to provide awareness of this neurologic syndrome under investigation with the aim of determining if children with similar clinical and radiographic findings are being cared for in other geographic areas. Guidance about reporting cases to state and local health departments and CDC is provided. Please disseminate this information to infectious disease specialists, intensive care physicians, pediatricians, neurologists, radiologists/neuroradiologists, infection preventionists, and primary care providers, as well as to emergency departments and microbiology laboratories.

The United States is currently experiencing a nationwide outbreak of EV-D68 associated with severe respiratory disease. The possible linkage of this cluster of neurologic disease to this large EV-D68 outbreak is part of the current investigation. CDC is seeking information about other similar neurologic illnesses in all states, especially cases clustered in time and place. CDC has particular interest in characterizing the epidemiology and etiology of such cases.

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http://emergency.cdc.gov/han/han00370.asp

Non-Polio Enterovirus

Persons who meet the following case definition should be reported to state and local health departments:

Patients ≥21 years of age with

Acute onset of focal limb weakness occurring on or after August 1, 2014;

AND
An MRI showing a spinal cord lesion largely restricted to grey matter.

CDC requests that state and local health departments report persons meeting the case definition to CDC using a brief patient summary form (in development).

Providers should consult with their local and state health department for laboratory testing of stool, respiratory and cerebrospinal fluid specimens for enteroviruses, West Nile virus and other known infectious etiologies for patients meeting the above case definition.

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http://www.cdc.gov/non-polio-enterovirus/investigation/

Polio Disease In-Short

http://www.cdc.gov/vaccines/vpd-vac/polio/in-short-both.htm