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Association of Enterovirus D68 with Acute Flaccid Myelitis, Philadelphia, Pennsylvania, USA, 2009–2018

Acute flaccid myelitis (AFM) is a polio-like disease that results in paralysis in previously healthy persons. Although the definitive cause of AFM remains unconfirmed, enterovirus D68 (EV-D68) is suspected based on 2014 data demonstrating an increase in AFM cases concomitant with an EV-D68 outbreak....

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Autores principales: Uprety, Priyanka, Curtis, Darcy, Elkan, Michael, Fink, Jeffrey, Rajagopalan, Ramakrishnan, Zhao, Chunyu, Bittinger, Kyle, Mitchell, Stephanie, Ulloa, Erlinda R., Hopkins, Sarah, Graf, Erin H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Centers for Disease Control and Prevention 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6711208/
https://www.ncbi.nlm.nih.gov/pubmed/31407660
http://dx.doi.org/10.3201/eid2509.190468
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author Uprety, Priyanka
Curtis, Darcy
Elkan, Michael
Fink, Jeffrey
Rajagopalan, Ramakrishnan
Zhao, Chunyu
Bittinger, Kyle
Mitchell, Stephanie
Ulloa, Erlinda R.
Hopkins, Sarah
Graf, Erin H.
author_facet Uprety, Priyanka
Curtis, Darcy
Elkan, Michael
Fink, Jeffrey
Rajagopalan, Ramakrishnan
Zhao, Chunyu
Bittinger, Kyle
Mitchell, Stephanie
Ulloa, Erlinda R.
Hopkins, Sarah
Graf, Erin H.
author_sort Uprety, Priyanka
collection PubMed
description Acute flaccid myelitis (AFM) is a polio-like disease that results in paralysis in previously healthy persons. Although the definitive cause of AFM remains unconfirmed, enterovirus D68 (EV-D68) is suspected based on 2014 data demonstrating an increase in AFM cases concomitant with an EV-D68 outbreak. We examined the prevalence in children and the molecular evolution of EV-D68 for 2009–2018 in Philadelphia, Pennsylvania, USA. We detected widespread EV-D68 circulation in 2009, rare detections in 2010 and 2011, and then biennial circulation, only in even years, during 2012–2018. Prevalence of EV-D68 significantly correlated with AFM cases during this period. Finally, whole-genome sequencing revealed early detection of the B1 clade in 2009 and continued evolution of the B3 clade from 2016 to 2018. These data reinforce the need to improve surveillance programs for nonpolio enterovirus to identify possible AFM triggers and predict disease prevalence to better prepare for future outbreaks.
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spelling pubmed-67112082019-09-04 Association of Enterovirus D68 with Acute Flaccid Myelitis, Philadelphia, Pennsylvania, USA, 2009–2018 Uprety, Priyanka Curtis, Darcy Elkan, Michael Fink, Jeffrey Rajagopalan, Ramakrishnan Zhao, Chunyu Bittinger, Kyle Mitchell, Stephanie Ulloa, Erlinda R. Hopkins, Sarah Graf, Erin H. Emerg Infect Dis Research Acute flaccid myelitis (AFM) is a polio-like disease that results in paralysis in previously healthy persons. Although the definitive cause of AFM remains unconfirmed, enterovirus D68 (EV-D68) is suspected based on 2014 data demonstrating an increase in AFM cases concomitant with an EV-D68 outbreak. We examined the prevalence in children and the molecular evolution of EV-D68 for 2009–2018 in Philadelphia, Pennsylvania, USA. We detected widespread EV-D68 circulation in 2009, rare detections in 2010 and 2011, and then biennial circulation, only in even years, during 2012–2018. Prevalence of EV-D68 significantly correlated with AFM cases during this period. Finally, whole-genome sequencing revealed early detection of the B1 clade in 2009 and continued evolution of the B3 clade from 2016 to 2018. These data reinforce the need to improve surveillance programs for nonpolio enterovirus to identify possible AFM triggers and predict disease prevalence to better prepare for future outbreaks. Centers for Disease Control and Prevention 2019-09 /pmc/articles/PMC6711208/ /pubmed/31407660 http://dx.doi.org/10.3201/eid2509.190468 Text en https://creativecommons.org/licenses/by/4.0/This is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.
spellingShingle Research
Uprety, Priyanka
Curtis, Darcy
Elkan, Michael
Fink, Jeffrey
Rajagopalan, Ramakrishnan
Zhao, Chunyu
Bittinger, Kyle
Mitchell, Stephanie
Ulloa, Erlinda R.
Hopkins, Sarah
Graf, Erin H.
Association of Enterovirus D68 with Acute Flaccid Myelitis, Philadelphia, Pennsylvania, USA, 2009–2018
title Association of Enterovirus D68 with Acute Flaccid Myelitis, Philadelphia, Pennsylvania, USA, 2009–2018
title_full Association of Enterovirus D68 with Acute Flaccid Myelitis, Philadelphia, Pennsylvania, USA, 2009–2018
title_fullStr Association of Enterovirus D68 with Acute Flaccid Myelitis, Philadelphia, Pennsylvania, USA, 2009–2018
title_full_unstemmed Association of Enterovirus D68 with Acute Flaccid Myelitis, Philadelphia, Pennsylvania, USA, 2009–2018
title_short Association of Enterovirus D68 with Acute Flaccid Myelitis, Philadelphia, Pennsylvania, USA, 2009–2018
title_sort association of enterovirus d68 with acute flaccid myelitis, philadelphia, pennsylvania, usa, 2009–2018
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6711208/
https://www.ncbi.nlm.nih.gov/pubmed/31407660
http://dx.doi.org/10.3201/eid2509.190468
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