Mysterious polio-like illness paralyzing children in CA

[PrisonerOfHope]

5 California Children Infected by Polio-Like Illness
LiveScience.com
By By Cari Nierenberg

Over a one-year period, five children in California developed a polio-like illness that caused severe weakness or paralysis in their arms and legs, a new case study reports.

In two of the children, their symptoms have now been linked with an extremely rare virus called enterovirus-68.

Like the poliovirus, which has been eradicated in the U.S. since 1979 thanks to the polio vaccine, strains of enterovirus in rare cases can invade and injure the spine.

These are the first reported cases of polio-like symptoms being caused by enterovirus in the United States. During the last decade, outbreaks of polio-like symptoms have been reported in children in Asia and Australia, and these infections have been associated with newly identified strains of enterovirus.

"We think one reason why these cases may have occurred in California is that we are at the western-most part of the United States, so we may have had a higher circulation of the virus that was originally identified in Asia," said Dr. Emmanuelle Waubant, co-author of the case report and a neurologist at the University of California, San Francisco Medical Center. [7 Devastating Infectious Diseases]

Although two of the children tested positive for enterovirus-68, the researchers were not able to identify the cause of muscle weakness and paralysis in the other three children.

The researchers saw these children too late in the game to detect the actual virus, Waubant explained. "It could have been enterovirus, or it may have been another virus," she told Live Science.

The findings were presented today (Feb. 23) at the annual meeting of the American Academy of Neurology in Philadelphia.

Extremely rare virus

"It's very likely that the vast majority of people infected with enterovirus will be fine," Waubant said. Most never develop neurological problems because the virus usually stays in the respiratory tract, where it may cause flu-like symptoms.

In only a very small percentage of people, the virus spreads to the spinal cord and damages nerve cells, resulting in weakness in one or more limbs, or paralysis, Waubant said.

After seeing a few cases of polio-like symptoms in children in their Northern California medical centers, the researchers wanted to find out whether similar symptoms had been reported in kids elsewhere in the state.

So they reviewed all the biological samples and medical histories of cases resembling polio that were referred to a statewide neurological and surveillance testing program between August 2012 and July 2013.

During this one-year period, they identified five cases of polio-like syndrome in California children ages 2 to 16.

Three kids had a respiratory illness before their neurological symptoms developed. All five of the children experienced sudden weakness or paralysis in one or more of their arms or legs that reached its peak severity within 48 hours.

The researchers did not include in their analysis children whose paralysis was known to result from other health problems, such as Guillain-Barre syndrome or botulism.

All five kids had been previously vaccinated against polio.

Increasing awareness

"These cases highlight the possibility of an emerging infectious polio-like syndrome in California," the report concluded.

Although the youngsters received treatment for their symptoms, it had little benefit. "Some of the children have improved a tiny bit, but most have not," Waubant said. Whatever weakness they developed from the illness, they still have, she added.

That's why Waubant said it's important to increase awareness of enterovirus among physicians — so when they see cases of polio-like symptoms in children, they know what it is and can diagnose it early.

By informing the medical community about the virus, doctors can send saliva and nasal swab samples to the appropriate labs who can look for and identify these types of viruses.

"Identifying the bug first is a top priority," Waubant said.


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[PurplePuppy]

Berkeley Girl Among California Children Who Contracted Polio-Like Illness
By NBC Bay Area Staff and Wire Services
| Tuesday, Feb 25, 2014 | Updated 3:43 AM PST




A 4-year-old Berkeley girl is among an alarming number of California children who have experienced mysterious, polio-like symptoms since 2012. Terry McSweeney reports.


A 4-year-old Berkeley girl is among an alarming number of California children who have experienced mysterious, polio-like symptoms since 2012.

The parents of Sofia Jarvis say their daughter suffered paralysis in one arm following a brief respiratory illness. Health experts say a virus related to polio could be responsible.

Dr. Keith Van Haren, a pediatric neurologist from Stanford University's Lucile Packard Children's Hospital, is working with doctors in Southern California to figure out what is causing the symptoms in California children and will present several of the cases at the American Academy of Neurology's upcoming meeting.

"The disease resembles, but is not the same as polio,'' he said. "But this is serious. Most of the children we've seen so far have not recovered use of their arm or their leg.''


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Doctors started seeing the symptoms in Southern California in 2012. Children came in with severe weakness or rapid paralysis in the arms or legs, sometimes after a mild respiratory illness.

Van Haren said he has studied five cases from Monterey up through the San Francisco Bay Area, including two that were identified as the disease enterovirus-68, which is from the same family as the polio viruses. He said there have been about 20 cases statewide.

Van Haren said all five patients had paralysis in one or more arms or legs that reached its full severity within two days. None had recovered limb function after six months.

"We want to temper the concern, because at the moment, it does not appear to represent a major epidemic but only a very rare phenomenon,'' he said, noting similar outbreaks in Asia and Australia.

But for some children, like Sofia, rare doesn't mean safe.

She first developed what looked like asthma two years ago, but then her left arm stopped moving, and it has remained paralyzed ever since.

"You can imagine. We had two boys that are very healthy, and Sofia was healthy until that point,'' said her mother, Jessica Tomei. "We did not realize what we were in store for. We did not realize her arm would be permanently paralyzed.''

Van Haren, who diagnosed Sofia, said polio vaccines do not protect children from the disease, but he stressed that it is still important for children to receive that vaccine.

Dr. Jane Seward of the Centers for Disease Control and Prevention in Atlanta said Monday that the research is still underway in California, and there are a variety of infectious diseases that can cause childhood paralysis.

Any of a number of illnesses could be at work, and it's possible some of the cases had one infection and some had another. Regarding the presence of EV-68 in at least two cases, "it could be an incidental finding,'' Seward said.

Until officials get more information, Seward said they are not looking around the country for similar cases of EV-68.

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The California Department of Public Health has not identified any common causes that suggest that the cases are linked, said Dr. Gil Chavez, the deputy director of the Center for Infectious Disease and state epidemiologist.

"Physicians and public health officials who have encountered similar illnesses have submitted 20 reports to CDPH, and CDPH has conducted preliminary tests on 15 of these specimens,'' he said. "Thus far, the department has not identified any common causes that suggest that the cases are linked.''

University of California, San Francisco, neurology professor Emmanuelle Waubant said doctors believe, but don't have proof, that it's a virus that for most children shows up only as a benign cold. She said a few children, due to their biological makeup, are having much more serious symptoms and she hoped doctors would look for them.

"For a lot of the neurologists who have trained in the last 30 years, it's extremely rare to see polio or polio-like syndrome,'' she said.


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