title: Enterovirus D68 Infection in Children with Acute Flaccid Myelitis, Colorado, USA, 2014.
abstract: During August 8, 2014-October 14, 2014, a total of 11 children with acute flaccid myelitis and distinctive neuroimaging changes were identified near Denver, Colorado, USA. A respiratory prodrome was experienced by 10, and nasopharyngeal specimens were positive for enterovirus D68 (EV-D68) for 4. To determine whether an association exists between EV-D68 infection and acute flaccid myelitis, we conducted a retrospective case-control study comparing these patients with 2 groups of outpatient control children (1 group tested for acute respiratory illness and 1 for Bordetella pertussis infection). Adjusted analyses indicated that, for children with acute flaccid myelitis, the odds of having EV-D68 infection were 10.3 times greater than for those tested for acute respiratory infection and 4.5 times greater than for those tested for B. pertussis infection. No statistical association was seen between acute flaccid myelitis and non-EV-D68 enterovirus or rhinovirus infection. These findings support an association between EV-D68 infection and acute flaccid myelitis.
authors.forename: Negar
authors.initials: N
authors.lastname: Aliabadi
authors.forename: Kevin
authors.initials: K
authors.lastname: Messacar
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Pastula
authors.forename: Christine C
authors.initials: CC
authors.lastname: Robinson
authors.forename: Eyal
authors.initials: E
authors.lastname: Leshem
authors.forename: James J
authors.initials: JJ
authors.lastname: Sejvar
authors.forename: W Allan
authors.initials: WA
authors.lastname: Nix
authors.forename: M Steven
authors.initials: MS
authors.lastname: Oberste
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Feikin
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Dominguez
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003120:Colorado / Q000453:epidemiology; D004196:Disease Outbreaks; D030016:Enterovirus D, Human / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000453:epidemiology* / Q000821:virology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009187:Myelitis / Q000453:epidemiology* / Q000821:virology*; D012189:Retrospective Studies; D013997:Time Factors
keywords: Colorado; United States; acute flaccid myelitis; acute flaccid paralysis; children; enterovirus infections; enterovirus-D68; myelitis; viruses