Background
- Enterovirus (EV)-D68 is a non-polio enterovirus
- Transmitted person to person (cough, saliva, fomites)
- Children > adults
- Usually causes "URTI" but may cause "LTRI", flaccid paralysis → resp. failure ±ITU
Clinical
- Acute onset, cough, fever, catarrah, sore throat, fatigue, headache, myalgia, dyspnoea, diarrhoea, and bronchiolitis
- 3-16 days later = limb paresis or flaccid paralysis, ptosis, facial droop, dysarthria, dysphagia, diplopia, no sensory deficits and rarely meningism
Differential Dx
- Polio
- Botulism
- Guillain-Barré syndrome
- Transverse myelitis or other acute cord / root lesion
Investigations
- Only required in severely ill pneumonia patienyts or
- Persons with neurological symptoms (i.e. AFP or meningo-encephalitis)
- Contact the labs to confirm which sample (nasopharyngeal swab, BAL, CSF, stool) and molecular testing requirements
- This is a notifiable disease
Links
Botulism (ascending flaccid paralysis).
https://www.hpsc.ie/a-z/vaccinepreventable/polio/acuteflaccidparalysisafp/