Colorado researchers discover US' largest outbreak of neurologic disease in children

Aurora-based Children's Hospital Colorado detected the nation's largest outbreak of enterovirus A71, known to cause severe neurological disease and hand, foot and mouth disease in children, according to a Dec. 16 article published by The Lancet Infectious Diseases. 

The study, conducted by Children's Hospital Colorado Infectious Disease and Neurology teams, along with the CDC and Colorado Department of Public Health and Environment, took place from March 1 to Nov. 30, 2018. Researchers compared biological specimens from children with EV-A71 characteristics to those of children with neurological disease associated with other enteroviruses. Researchers believe the unique symptoms, unusually high number of cases and geographic clustering of children observed indicate an EV-A71 outbreak.

EV-A71 vaccines were developed after the enterovirus caused large-scale epidemics in the Asia-Pacific region beginning in the 1990s. Cases in the U.S., however, have been sporadic and small-scale.

"Enhanced surveillance is needed in order to determine whether this outbreak was an isolated event or a warning of impending cyclic outbreaks of EV-A71 neurological disease in the U.S.," Kevin Messacar, MD, co-author of the study and pediatric infectious disease physician and researcher at Children's Hospital Colorado and Aurora-based University of Colorado Anschutz Medical Campus, said in a Jan. 7 news release. 

The study emphasized the need to improve EV-A71 surveillance and helped identify symptoms that differentiate the disease from others, such as myoclonus, dizziness, weakness and autonomic instability.  

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