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Since enterovirus A71 is known as a pathogen which may cause severe complications as critical neurological manifestations, pulmonary edema, cardio respiratory failure and even death to infected children, therefore, the vaccine against EV-A71 infection has been expected to prevent such serious problems even in Thailand.
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Investigation of acute flaccid myelitis (AFM) in U.S. children, 2014-2016.
Acute flaccid myelitis (AFM) is a rare but serious condition. It affects the nervous system, specifically the area of the spinal cord called gray matter, which causes the muscles and reflexes in the body to become weak. CDC has been thoroughly investigating the AFM cases that have occurred since 2014, when we first noted a large number of cases being reported.
What CDC has learned since 2014
Most of the patients with AFM (more than 90%) had a mild respiratory illness or fever consistent with a viral infection before they developed AFM.
These AFM cases are not caused by poliovirus; all the stool specimens from AFM patients that we received tested negative for poliovirus.
We detected coxsackievirus A16, EV-A71, and EV-D68 in the spinal fluid of four of 440 confirmed cases of AFM since 2014, which points to the cause of their AFM. For all other patients, no pathogen (germ) has been detected in their spinal fluid to confirm a cause.
Most patients had onset of AFM between August and October, with increases in AFM cases every two years since 2014. At this same time of year, many viruses commonly circulate, including enteroviruses, and will be temporally associated with AFM.
Most AFM cases are children (over 90%) and have occurred in 46 states and DC.
Viral infections such as from enteroviruses are common, especially in children, and most people recover. We don’t know why a small number of people develop AFM, while most others recover. We are continuing to investigate this.
