ASM Microbe 2019 — Enterovirus remains a prime candidate in acute flaccid myelitis


  • Emily Willingham, PhD
  • Conference Reports
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Takeaway

  • Although enterovirus (EV) RNA is rarely detected in the central nervous system of children with acute flaccid myelitis (AFM), antibodies to the EV genus are present in most cerebrospinal fluid (CSF) samples.
  • EV antibody positivity is rarer in other neurological diseases.

Why this matters

  • The causative agent in biennial spikes of AFM in the United States has not been pinpointed. 
  • The absence of EV RNA in cerebrospinal fluid and limited presence in other tissue samples has left open the question of whether or not EV is causative.

Key results

  • These authors identified antibodies to EV in 21/29 (72%) samples from patients with AFM compared with 7/71 (9.9%) of samples from patients with other neurological diseases. 
  • Next-generation sequencing still detected no EV RNA in CSF samples from these patients.

Study design

  • The researchers tested CSF from 29 children with AFM and 71 children with other neurological diseases.

Limitations

  • These results were presented at a conference without peer review.
  • Causation remains unestablished.