Enterovirus Antibodies Detected in Acute Flaccid Myelitis Patients

A new study analyzing samples from patients with and without acute flaccid myelitis (AFM) provides additional evidence for an association between the rare but often serious condition that causes muscle weakness and paralysis, and infection with non-polio enteroviruses. NIAID funded the research, which was conducted by investigators at Columbia University’s Center for Infection and Immunity and researchers from the Centers for Disease Control and Prevention. The findings are reported in the online journal mBio.

There have been 570 confirmed cases since CDC began tracking AFM in August 2014. AFM outbreaks were reported to the CDC in 2014, 2016 and 2018. AFM affects the spinal cord and is characterized by the sudden onset of muscle weakness in one or more limbs. Spikes in AFM cases, primarily in children, have coincided in time and location with outbreaks of EV-D68 and a related enterovirus, EV-A71. Both of these viruses typically cause mild respiratory illness from which most people recover fully. Despite the epidemiological link between enterovirus circulation and AFM cases, evidence of direct causality has not been found. 

While other etiologies of AFM continue to be investigated, this study provides further evidence that enterovirus infection may be a factor in AFM. In the absence of direct detection of a pathogen, antibody evidence of pathogen exposure within the central nervous system can be an important indicator of the underlying cause of disease, the researchers note.