Doctors Ask Why Some Enterovirus 68 Patients Developed Polio-Like Paralysis
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ABC News(NEW YORK) — When 4-year-old Allen Howe went from being a little goofball to being unable to move 80 percent of his body, his mother was in tears. Days earlier, he had a fever and a cough.
“I felt helpless,” Teresa Howe told ABC News’ Nightline in December. “He was lying in bed and he literally was screaming, ‘Help me, Mom,’ and I’m just bawling.”
Allen was among the small fraction of children with the respiratory illness enterovirus 68 to develop sudden unexplained paralysis after the initial severe flu-like symptoms. Allen and the others are reportedly recovering, but doctors at the University of San Francisco set out to figure out why the paralysis set in to begin with — and why only some children were hit.
Federal and state health officials have confirmed 1,153 enterovirus 68 cases in 49 states and Washington, D.C., from August through January. Fourteen patients died, and several clusters developed polio-like paralysis.
Doctors now know that the paralysis and weakness is brought on by acute flaccid myelitis, or inflammation of the nerve cells, but it’s tough to say how it’s connected to the virus, experts say.
Dr. Charles Chiu and his team at UCSF studied 25 patients who developed paralysis in California and Colorado for their study published this week in the medical journal The Lancet. They found that of two siblings with identical strains of enterovirus 68, only one developed paralysis, leading Chiu to suspect that the virus alone may not be at fault for the paralysis. It could be an abnormal immune system response.
“This suggests that it’s not only the virus, but also patients’ individual biology that determines what disease they may present with,” Chiu said in a statement.
The researchers also noticed that they didn’t find traces of the virus in the cerebrospinal fluid surrounding the inflamed nerve cells, leading them to believe the virus wasn’t directly attacking them. Chiu said it’s crucial to continue searching for answers.
“Given that none of the children have fully recovered, we urgently need to continue investigating this new strain of EV-D68 [enterovirus 69] and its potential to cause acute flaccid myelitis,” he said.
The peak enterovirus season has been over for some time, but Dr. Kathryn Miller, assistant professor of pediatrics at Vanderbilt University Medical Center in Nashville, Tennessee, said it could come back next year.
As a mother of four, she said she thinks it’s important to remember that cases will go away like normal colds. Parents should remind their children to wash their hands thoroughly, and if a child’s cold seems more severe than usual, parents should call their family doctor.
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