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Doctors Bewildered by Paralysis in Children with Enterovirus

The Short of It

Most children who were diagnosed with enterovirus D68 during a recent outbreak only experienced very mild symptoms like fever, runny nose, coughing and sneezing. But some experienced a much worse symptom: unexplained paralysis.

The Lowdown

Doctors believe the unexplained, polio-like paralysis is linked to last year's nationwide outbreak of enterovirus D68, but they haven't been able to prove there's a connection. The outbreak affected millions of children and sent thousands to doctors' offices and emergency rooms with severe respiratory problems, but only about 100 of the kids who caught enterovirus suffered paralysis.

Some of the children, whose average age is 7 years old, have lost the use of an arm or a leg. Some have ended up in wheelchairs or on breathing machines, and almost none have recovered. So why are most children recovering just fine and others are becoming inexplicably paralyzed?

Priya Duggal, a genetic epidemiologist at John Hopkins University, is completely befuddled as to why those particular children developed "acute flaccid melitis" while their brothers and sisters, who also were exposed, did not. Duggal and fellow researchers Aaron Milstone and David Thomas are gathering DNA from patients around the United States to try to find answers for families affected by the paralysis.

"Maybe it's the host, and the virus is a trigger that sets off the paralysis. . . . Maybe it's something in their genetic makeup," Duggal told the Washington Post.

The Upshot

The CDC is putting together a long-term study to track the 112 children it has identified with "acute flaccid melitis" to see how their paralysis progresses, whether they improve over time and which treatments work. It also developed an antibody test to see whether children who became paralyzed were more likely to have had EV-D68 than other children. But when they analyzed the data from last fall and previous years, nearly all of the children had EV-D68 antibodies, which means there was no new evidence that enterovirus was the cause of the paralysis—another dead end.

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