The audio and transcript from last Friday’s CDC COCA Call on Neurologic Illness with Limb Weakness in Children have yet to be uploaded to the COCA site, but we do have a brief update on the ongoing investigation into recent reports of neurological illness and limb weakness which began around August 1st of this year (see Unexplained Paralysis Hospitalizes Children).
Almost two weeks ago the CDC released a HAN: Acute Neurologic Illness with Focal Limb Weakness of Unknown Etiology in Children, alerting doctors around the country to be aware of this trend, and providing information on reporting cases.
Although the CDC has only identified 17 cases from 12 states thus far, anecdotal reports from doctors around the country suggest the number of unusual presentations of limb weakness or paralysis to be much higher. It will take time for the CDC to fully investigate all of these cases.
As this increase in cases has been coincident with the recent outbreak of EV-D68 (see Enterovirus D-68 (HEV-D68) Update) and at least some of these paralysis cases have tested positive for this emerging enterovirus, investigators are looking at a possible link between the two, although the etiology of this syndrome has yet to be established.
The Centers for Disease Control and Prevention (CDC) is working closely with the Colorado Department of Public Health and Environment (CDPHE) and Children’s Hospital Colorado to investigate a cluster of pediatric patients hospitalized with acute neurologic illness of undetermined etiology characterized by focal limb weakness and abnormalities of the spinal cord gray matter on MRI.
On September 26, CDC issued a request to all states to look for and report other similar neurologic illnesses. We are receiving reports and will update this website with new available data every Wednesday.
As of October 8, CDC has verified reports of 17 cases in 12 states that meet our case definition below. We are working with healthcare professionals and state and local officials to investigate all of these cases.
We are also in the process of verifying dozens of additional reports. These investigations take time and are in the early stages. Therefore, the number of cases will likely increase as we update these numbers weekly on Wednesday, but the increase will not necessarily reflect changes in occurrence of cases in real time.
Persons who meet the case definition should be reported to state and local health departments.
To be considered a case, a patient must meet ALL 4 of the following criteria:
- Patient ≤21 years of age,
- Acute onset of focal limb weakness,
- On or after August 1, 2014, AND
- An MRI showing a spinal cord lesion largely restricted to gray matter