AUTHOR=Gong Liming , Wang Yilong , Zhang Weiqing , Chen Chen , Yang Xinghui , Xu Lu , Zhao Congying , Jiang Lihua , Yuan Zhefeng , Xia Zhezhi , Jiang Peifang , Ge Qiong , Yan Juying , Sun Yi , Chen Yin , Zhao Zhengyan , Zhang Yanjun , Gao Feng TITLE=Acute Flaccid Myelitis in Children in Zhejiang Province, China JOURNAL=Frontiers in Neurology VOLUME=11 YEAR=2020 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.00360 DOI=10.3389/fneur.2020.00360 ISSN=1664-2295 ABSTRACT=

In July–December 2018, an outbreak of polio-like acute flaccid myelitis (AFM) occurred in Zhejiang province, China. Enterovirus (EV)-D68 infection has been reported to be associated with AFM. This study aimed to investigate the clinical presentation, laboratory findings, and outcomes of AFM patients. We investigated the clinical and virologic information regarding the AFM patients, and real-time PCR, sequencing, and phylogenetic analysis were used to investigate the cause of AFM. Eighteen cases met the definition of AFM, with a median age of 4.05 years (range, 0.9–9 years), and nine (50%) were EV-D68 positive. Symptoms included acute flaccid limb weakness and cranial nerve dysfunction. On magnetic resonance imaging, 11 (61.1%) patients had spinal gray matter abnormalities. Electromyography results of 16 out of 17 patients (94.1%) were abnormal. Cerebrospinal fluid (CSF) pleocytosis was common (94.4%), while CSF protein concentration was normal in all patients. There was little improvement after early aggressive therapy. Phylogenetic analysis revealed that EV-D68 subclade B3 was the predominant lineage circulating in Zhejiang province in 2018.