Mysterious polio-like illness likely caused by enterovirus strain, study finds

Australian researchers identified enterovirus D68 as the likely cause of a mysterious polio-like illness that has paralyzed children in Europe, Canada and the United States, according to an analysis published in the journal Eurosurveillance.

Acute flaccid myelitis is a condition that affects the spinal cord, inciting limb weakness and paralysis. Researchers have previously linked the condition to several virus strains. In 2014, more than 120 children developed the condition in the U.S. The heightened occurrence of AFM coincided with unusually large outbreaks of enterovirus D68, a virus known to cause coughs, muscle aches, fever and difficulty breathing.

To assess the possible causal relationship between the virus and AFM, researchers reviewed previously published scientific literature on AFM and enterovirus D68. Researchers then applied compiled information to a set of nine principles developed to determine causality, dubbed the Bradfield Hill criteria, which was used to prove smoking caused cancer.

"Our results show that it is very likely that EV-D68 is the cause of the mystery illness and the paralysis of children," said Raina MacIntyre, PhD, head of the school of public health at the University of New South Wales in Sydney. "This link needs to be acknowledged so that public health strategies can focus on prevention of infection. The incidence of EV-D68 infections is increasing worldwide, and a genetically distinct strain has recently evolved. There is no treatment or vaccine for the polio-like illness caused by EV-D68, which makes it important to act quickly to stop outbreaks."

In 2016, the illness affected a cluster of children in Washington state. CDC disease detectives struggled to pin down the source of the paralysis-inducing illness.

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