Public health25 children in California stricken with polio-like illness

Twenty-five children in California have been exhibiting a “polio-like syndrome,” leading to paralysis in one or more of their limbs.

 “What’s we’re seeing now is bad. The best-case scenario is complete loss of one limb, the worst is all four limbs, with respiratory insufficiency, as well. It’s like the old polio,” Keith Van Haren, a pediatric neurologist at Lucile Packard Children’s Hospital in Palo Alto, California, told USA Today.

CNN reports that neurologists have identified five patients who have developed paralysis in one or more limbs between August 2012 and July 2013. All five children had been vaccinated against the poliovirus, and treatment did not help the children regain their motor function.

Scientists say that samples from two of the children tested positive for enterovirus 68, a rare virus linked in the past to severe respiratory illness. Dr. Emmanuelle Waubant, a neurologist at the University of California, San Francisco, told CNN that samples from the other three children were not collected or tested soon enough to offer conclusive results.

Waubant, who, with her colleagues, is planning to present a report about these patients’ illnesses at the annual meeting of the American Academy of Neurology in late April, said that health care providers should be on the lookout for similar cases and send her in samples from any patient exhibiting these symptoms.

Dr. Carol Glaser, chief of the Encephalitis and Special Investigation Section at the California Department of Public Health, told CNN that the state is aware of the paralysis cases but believes the risk to families is very low.

“We are evaluating cases as they are reported to us,” Glaser said. “We have not found anything at this point that raises any public health concerns.”

Experts note that the poliovirus has been eradicated in the United States for more than thirty years. The World Health Organization (WHO) says that only three countries in the world are not free of the disease: Afghanistan, Pakistan, and Nigeria. In these three states, Islamist militants disrupt polio vaccination campaign and kill NGO doctors who administer the vaccine, saying that the vaccination effort is a Western plot against Islam.

CDC reports that Enterovirus 68 was first identified in a California lab in 1962, after four children came down with a severe respiratory illness. Only twenty-six cases of enterovirus 68 in the United States were reported to the CDC between 1970 and 2005. Dr. Steven Oberste, chief of the Polio and Picornavirus Laboratory Branch at the CDC, told CNN that since 2000, the government agency has kept a closer watch and has seen forty-seven cases.

CDC reports that more concerning to health officials is enterovirus 71, which was discovered by the same California lab in 1969. The CDC report notes that there were several outbreaks of paralysis caused by enterovirus 71 in Europe in the 1960s and 1970s. In the late 1990s and early 2000s, fatal encephalitis was a big problem in Malaysia and Taiwan.

“Ever since then, the virus has circulated in high levels in Southeast Asia,” Oberste said.

Between 1983 and 2005, 270 cases of enterovirus 71 were reported in the United States, but they have not led to a larger outbreak despite the virus’s infectious nature.

“That’s the really odd thing,” Oberste said. “We see cases from time to time in the United States. Occasionally they’ll be severe. Basically it’s identical to what’s circulating in Asia … but it doesn’t cause the same big outbreak in disease. And we really don’t know why.”

Waubant and her colleagues stress they do not want to alarm anyone. “We would like to stress that this syndrome appears to be very, very rare,” one of Waubant’s colleagues, Dr. Keith Van Haren, said in a prepared statement.