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Researchers seeking the cause of mysterious cases of childhood paralysis seem to be closing in on a culprit. Since 2014, more than 500 children in the United States have suddenly lost muscle control in their arms and legs, a condition called acute flaccid myelitis (AFM), which can cause permanent disability. But the leading explanation—that a normally mild viral infection occasionally results in AFM—has been hard to prove. A new analysis of young patients’ spinal fluid now offers evidence linking a group of common viruses known as enteroviruses to AFM. But questions remain about how such viruses damage nerves and why they seem to do so only rarely.
“I think it’s time to stop debating” whether enteroviruses cause AFM, says Raina MacIntyre, an epidemiologist at the University of New South Wales in Sydney, Australia. “This is very strong evidence.”
Epidemiologists - US - Cases - AFM - Reasons
Epidemiologists tracking recent U.S. cases of AFM already had reasons to suspect a relatively common enterovirus called EV-D68 known to cause generally mild respiratory illness. The timing and location of AFM cases seemed to coincide with EV-D68 outbreaks in 2014, 2016, and 2018. AFM patients, most of them young, commonly had other symptoms consistent with EV-D68 infection, such as cough and muscle aches, days before the condition struck. And a strain of EV-D68 can trigger AFM-like symptoms in mice.
Researchers previously detected enteroviruses in phlegm and stool from children with AFM, but when they’ve looked for enterovirus RNA in spinal fluid—an indication that the virus had invaded the nervous system—most samples came up negative. “Just like other folks, we’ve tried over and over again,” says Michael Wilson, a neurologist at the University of California, San Francisco, and an author on the new study. There were multiple possible explanations for the absent viruses, Wilson says, including that they had come and gone by the time doctors...
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