Acute flaccid paralysis in a child infected with enterovirus D68: A case report

bc medical journal vol. 56 no. 10, december 2014 bcmj.org ABSTRACT: Enterovirus D68 is increasingly being reported as a cause of severe respiratory illness across North America, with several children in Canada testing positive for this virus and experiencing concurrent polio-like symptoms. In one recent case in British Columbia, a 9-yearold patient presented with acute flaccid paralysis of his left arm following a respiratory illness and fever. Enterovirus D68 was eventually isolated in a nasopharyngeal specimen and the patient was treated with intravenous immunoglobulin. To date the patient has experienced only slight improvement in his left arm function. This case illustrates the importance of appropriate screening for polio and nonpolio enteroviruses. Clinicians faced with a case of acute flaccid paralysis should contact their regional health authority or the BC Centre for Disease Control for early guidance on how to collect specimens for testing. While there is no established treatment protocol for enterovirus D68 infection, we do know that hand washing and avoiding close contact with ill people can prevent transmission. Michelle D. Sherwood, MD, Soren Gantt, MD, PhD, MPH, Mary Connolly, MD, FRCPC, Simon Dobson, MD, MBBS