Acute flaccid myelitis - has it gone unrecognised in Australian children?

Junchao Bao; Bruce Thorley; Elizabeth J Elliott; Peter McIntyre; Phillip N Britton

doi:10.33321/cdi.2020.44.22

Acute flaccid myelitis - has it gone unrecognised in Australian children?

Commun Dis Intell (2018). 2020 Mar 16:44. doi: 10.33321/cdi.2020.44.22.

Authors

Junchao Bao¹, Bruce Thorley², Elizabeth J Elliott³, Peter McIntyre⁴, Phillip N Britton¹

Affiliations

¹ Discipline of Child and Adolescent Health, University of Sydney, NSW; The Children's Hospital at Westmead, NSW.
² National Enterovirus Reference Laboratory, the Peter Doherty Institute for Infection and Immunity, Victoria.
³ Discipline of Child and Adolescent Health, University of Sydney, NSW; The Children's Hospital at Westmead, NSW; University of Sydney Faculty of Medicine and Health and Discipline of Child and Adolescent Health and Australian Paediatric Surveillance Unit, Kid's Research, Westmead, NSW.
⁴ The Children's Hospital at Westmead, NSW; National Centre for Immunisation Research and Surveillance, Kid's Research, Westmead, NSW; Department of Women's and Children's Health, University of Otago, Dunedin New Zealand.

PMID: 32178602
DOI: 10.33321/cdi.2020.44.22

Abstract

We have identified a previously unrecognised cluster of a newly recognised condition - acute flaccid myelitis (AFM) - among acute flaccid paralysis (AFP) cases identified by the Australian Paediatric Active Enhanced Disease Surveillance Network (PAEDS) 2007-2017. In the 12 months before and after detection of enterovirus D68 (EV-D68) from a single AFP case in April 2016, 24 of 97 notified cases of AFP were found to be clinically compatible with AFM; of these 24 cases, ten, clustered in early 2016, met magnetic resonance imaging (MRI) criteria for AFM. Detection of emerging enteroviruses requires collection of respiratory, cerebrospinal fluid and stool specimens, and should be routine practice for all AFP cases.

Keywords: AFP Surveillance; Acute Flaccid Myelitis; Acute Flaccid Paralysis; EV-D68; Enterovirus; Polio; Poliomyelitis.

MeSH terms

Australia / epidemiology
Central Nervous System Viral Diseases* / diagnosis
Central Nervous System Viral Diseases* / epidemiology
Child
Disease Outbreaks
Enterovirus D, Human
Enterovirus Infections* / diagnosis
Enterovirus Infections* / epidemiology
Humans
Magnetic Resonance Imaging
Myelitis* / diagnosis
Myelitis* / epidemiology
Neuromuscular Diseases* / diagnosis
Neuromuscular Diseases* / epidemiology

Supplementary concepts

acute flaccid myelitis