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Circulation of virus linked to paralysis in children is increasing, CDC says

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Surveillance data from the CDC show an increase in the circulation of enterovirus D68 (EV-D68) in the United States.

In addition to increasing cases of rhinovirus (RV) and EV, an increase in emergency room visits for acute respiratory illness has been reported in children and adolescents, and EV-D68 has been identified in an increasing number of these cases. emerges, reports Dr. Kevin C. Ma. of the CDC’s epidemic service, and his colleagues.

“Medical facilities should prepare for the potential for increased use of pediatric care associated with severe EV-D68-related respiratory illness,” the group warned. Weekly reports of morbidity and mortality.

Here are the findings Recent reports Health care providers have reported an increase in the number of pediatric hospitalizations that may be related to the virus, and of particular concern is the biennial outbreak of EV-D68, usually in even years (2014, 2016, 2018)) are associated with an increase in cases of acute flaccid myelitis. (AFM).

“Providers should have a high index of clinical suspicion for AFM in patients with acute flaccid limb weakness, neurological signs and symptoms, or neck or back pain, with a recent history of respiratory illness or fever. “Children with AFM can experience rapid progression of weakness and require immediate hospitalization and referral to specialized care.”

While 15 cases of AFM have been confirmed so far this year (45 under investigation), circulating EV-D68 was now observed in 2018, when 238 rare neurological complications were documented. Similar to peak level. 2020 was an exception with 33 cases, a low number due to increased precautions due to COVID-19. AFM cases in odd-numbered years (2015, 2017, 2019) ranged from 22 to 47.

Acute respiratory illness due to EV-D68 usually affects young children, groups describe, and varies in severity.

“Typical signs and symptoms include coughing, nasal congestion, wheezing, and difficulty breathing,” but EV-D68 infection can also exacerbate asthma or reactive airway disease (RAD). Children with a history of asthma/RAD need medical attention,” said Ma and co-authors.

To assess trends in EV-D68, CDC investigators collected and analyzed data from three sources. – Positive RV/EV test results from the National Respiratory and Enteric Virus Surveillance System (NREVSS); New Vaccine Surveillance Network (NVSN) for her in children admitted to hospital or emergency department for acute respiratory illness Detection of EV-D68.

According to NREVSS data, weekly positive RV/EV results in 2022 appear to be increasing at a rate comparable to past EV-D68 outbreak years, increasing from 15.8% to 31.4% from weeks 32 to 35. doubled. This was his fourth highest number. Percentage compared to the previous year (for example, 31.7% in 2015 to 41.5% in 2014).

Of 5,633 children in NVSN presenting to the emergency department for acute respiratory illness from March to September 2022, RV/EV was detected in 26.4%. Overall, EV-D68 was identified in 17.4% of these RV/EV cases, but the number surged to 56% by the end of the surveillance period.

In addition to cautioning AFM, the CDC advised that clinicians should also consider and test for polio because of clinical similarities to acute flaccid paralysis caused by the poliovirus. Paralytic polio case A poliovirus-positive wastewater sample was found in New York in the summer of 2022. ”

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    Ingrid Hine Staff writer for MedPage Today on Infectious Diseases. She has been a medical reporter for over ten years. follow

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No conflicts of interest were disclosed.

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2/ https://www.medpagetoday.com/infectiousdisease/generalinfectiousdisease/100957

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