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What's the mysterious polio-like illness found in 5 California children?

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A mysterious polio-like illness recently has been found in five California children, says new research, according to a February 23, 2014 news release, "Mysterious polio-like illness found in 5 California children." Researchers have identified a polio-like syndrome in a cluster of children from California over a one-year period, according to a case report released today that will be presented at the American Academy of Neurology's 66th Annual Meeting in Philadelphia, April 26 to May 3, 2014.

"Although poliovirus has been eradicated from most of the globe, other viruses can also injure the spine, leading to a polio-like syndrome," said case report author Keith Van Haren, MD, according to the news release. Haren is with Stanford University in Palo Alto, Calif., and a member of the American Academy of Neurology.

Van Haren also works with co-author Emanuelle Waubant, MD, University of California, San Francisco. "In the past decade, newly identified strains of enterovirus have been linked to polio-like outbreaks among children in Asia and Australia. These five new cases highlight the possibility of an emerging infectious polio-like syndrome in California."

Polio is a contagious disease that sometimes caused paralysis

The United States experienced a polio epidemic in the 1950s, until a vaccine was introduced. Van Haren said, according to the news release, that he and his colleagues noticed several of these cases at their medical centers and decided to look for similar cases in California.

They reviewed all polio-like cases among children who had samples referred to California's Neurologic and Surveillance Testing program from August 2012 to July 2013. Cases were included in the analysis if the children had paralysis affecting one or more limbs with abnormal MRI scans of the spinal cord that explained the paralysis. They did not include children who met criteria for Guillain-Barré syndrome and botulism, which can cause similar symptoms.

The five children experienced paralysis of one or more arms or legs that came on suddenly and reached the height of its severity within two days of onset

Three of the children had a respiratory illness before the symptoms began. All of the children had been previously vaccinated against poliovirus. The children were treated but their symptoms did not improve and they still had poor limb function after six months.

What microbe is causing the paralysis? In addition to enterovirus-68, a rare virus with polio-like symptoms, what other 'germ' is causing the illnesses? And from what source did this microbe arise? Is it local or imported? Or is it from food, vaccinations, or from insects or various microbes? The virus is rare in the case of enterovirus-68, but what caused the same symptoms in the other children who tested negative for the enterovirus-68?

Two children tested positive for enterovirus-68, a rare virus previously associated with polio-like symptoms. No cause was identified in the remaining three children

"Our findings have important implications for disease surveillance, testing and treatment," said Van Haren in the news release. "We would like to stress that this syndrome appears to be very, very rare. Any time a parent sees symptoms of paralysis in a child, the child should be seen by a doctor right away."

The case report was supported by the McHugh/Sprague Award from the Lucile Packard Foundation. To learn more about brain disease, check out the the AAN Patients site. The American Academy of Neurology, an association of more than 27,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care.

You also may wish to check out an abstract of a study, "Enterovirus 68 is associated with respiratory illness and shares biological features with both the enteroviruses and the rhinoviruses." Is a type of rhinovirus causing the mystery illnesses in California?

Enterovirus (EV) 68 was originally isolated in California in 1962 from four children with respiratory illness. Since that time, reports of EV68 isolation have been very uncommon. Between 1989 and 2003, 12 additional EV68 clinical isolates were identified and characterized, all of which were obtained from respiratory specimens of patients with respiratory tract illnesses. No EV68 isolates from enteric specimens have been identified from these same laboratories. But is the new virus different, and in which ways does it differ?

Two children tested positive for enterovirus-68, a rare virus previously associated with polio-like symptoms. But what happened to the other three children? No cause was identified in the remaining three California children. So the polio-like illnesses still remain a mystery, says the February 23, 2014 news release, "Mysterious polio-like illness found in 5 California children."

A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer's disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson's disease and epilepsy. For more information about the American Academy of Neurology, visit the AAN.com site. You also can follow the American Academy of Neurology (AAN) on Facebook, Twitter, Google+ and YouTube.

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