PMID- 25299608
OWN - NLM
STAT- MEDLINE
DCOM- 20141204
LR  - 20240404
IS  - 1545-861X (Electronic)
IS  - 0149-2195 (Print)
IS  - 0149-2195 (Linking)
VI  - 63
IP  - 40
DP  - 2014 Oct 10
TI  - Acute flaccid paralysis with anterior myelitis - California, June 2012-June 2014.
PG  - 903-6
AB  - In August 2012, the California Department of Public Health (CDPH) was contacted 
      by a San Francisco Bay area clinician who requested poliovirus testing for an 
      unvaccinated man aged 29 years with acute flaccid paralysis (AFP) associated with 
      anterior myelitis (i.e., evidence of inflammation of the spinal cord involving 
      the grey matter including anterior horn cell bodies) and no history of 
      international travel during the month before symptom onset. Within 2 weeks, CDPH 
      had received reports of two additional cases of AFP with anterior myelitis of 
      unknown etiology. Testing at CDPH's Viral and Rickettsial Disease Laboratory for 
      stool, nasopharyngeal swab, and cerebrospinal fluid (CSF) did not detect the 
      presence of an enterovirus (EV), the genus of the family Picornaviridae that 
      includes poliovirus. Additional laboratory testing for infectious diseases 
      conducted at the CDPH Viral and Rickettsial Disease Laboratory did not identify a 
      causative agent to explain the observed clinical syndrome reported among the 
      patients. To identify other cases of AFP with anterior myelitis and elucidate 
      possible common etiologies, CDPH posted alerts in official communications for 
      California local health departments during December 2012, July 2013, and February 
      2014. Reports of cases of neurologic illness received by CDPH were investigated 
      throughout this period, and clinicians were encouraged to submit clinical samples 
      for testing. A total of 23 cases of AFP with anterior myelitis of unknown 
      etiology were identified. Epidemiologic and laboratory investigation did not 
      identify poliovirus infection as a possible cause for the observed cases. No 
      common etiology was identified to explain the reported cases, although EV-D68 was 
      identified in upper respiratory tract specimens of two patients. EV infection, 
      including poliovirus infection, should be considered in the differential 
      diagnosis in cases of AFP with anterior myelitis and testing performed per CDC 
      guidelines.
FAU - Ayscue, Patrick
AU  - Ayscue P
FAU - Van Haren, Keith
AU  - Van Haren K
FAU - Sheriff, Heather
AU  - Sheriff H
FAU - Waubant, Emmanuelle
AU  - Waubant E
FAU - Waldron, Paul
AU  - Waldron P
FAU - Yagi, Shigeo
AU  - Yagi S
FAU - Yen, Cynthia
AU  - Yen C
FAU - Clayton, Anna
AU  - Clayton A
FAU - Padilla, Tasha
AU  - Padilla T
FAU - Pan, Chao
AU  - Pan C
FAU - Reichel, John
AU  - Reichel J
FAU - Harriman, Kathleen
AU  - Harriman K
FAU - Watt, James
AU  - Watt J
FAU - Sejvar, James
AU  - Sejvar J
FAU - Nix, William Allan
AU  - Nix WA
FAU - Feikin, Daniel
AU  - Feikin D
FAU - Glaser, Carol
AU  - Glaser C
CN  - Centers for Disease Control and Prevention (CDC)
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - MMWR Morb Mortal Wkly Rep
JT  - MMWR. Morbidity and mortality weekly report
JID - 7802429
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - *Anterior Horn Cells
MH  - California/epidemiology
MH  - Child
MH  - Child, Preschool
MH  - Diagnosis, Differential
MH  - Female
MH  - Humans
MH  - Infant
MH  - Male
MH  - Middle Aged
MH  - Muscle Hypotonia
MH  - Myelitis/*diagnosis/epidemiology
MH  - Paralysis/*diagnosis/epidemiology
MH  - Young Adult
PMC - PMC4584614
EDAT- 2014/10/10 06:00
MHDA- 2014/12/15 06:00
PMCR- 2014/10/10
CRDT- 2014/10/10 06:00
PHST- 2014/10/10 06:00 [entrez]
PHST- 2014/10/10 06:00 [pubmed]
PHST- 2014/12/15 06:00 [medline]
PHST- 2014/10/10 00:00 [pmc-release]
AID - mm6340a6 [pii]
AID - 903-906 [pii]
PST - ppublish
SO  - MMWR Morb Mortal Wkly Rep. 2014 Oct 10;63(40):903-6.