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An outbreak of acute flaccid paralysis in Jamaica associated with echovirus type 22
J P Figueroa1, D Ashley, D King
1Ministry of Health, Kingston, Jamaica.
Abstract:
An outbreak of acute flaccid paralysis in Jamaica in 1986 associated with echovirus type 22 is described. Six patients aged 1 to 27 years developed acute onset of severe flaccid paralysis, with inability to walk. Three cases had facial weakness, four required intensive care with assisted ventilation, and two died. Echovirus type 22 was isolated from the stool of two patients who showed a significant increase in antibody titre. Echovirus type 22 was also isolated from the stool of another patient who had aseptic meningitis without any neurological deficit. There was no evidence of poliovirus infection in any of these patients, most of whom were fully immunized. Of the four surviving cases with flaccid paralysis, three had residual weakness in their lower limbs and walked with an abnormal gait 3 years after the acute paralytic attack. This is the first report in the literature of acute flaccid paralysis associated with type 22 echovirus.
Insights
An outbreak of acute flaccid paralysis in Jamaica was linked to echovirus type 22. This virus caused severe neurological symptoms, including paralysis, in several patients, highlighting a new public health concern.
Area of Science:
- Virology
- Neurology
- Epidemiology
Background:
- An outbreak of acute flaccid paralysis (AFP) occurred in Jamaica in 1986.
- The outbreak was investigated for potential infectious causes, particularly enteroviruses.
Purpose of the Study:
- To describe the clinical features and epidemiological characteristics of an AFP outbreak.
- To identify the causative agent of the observed paralysis and meningitis cases.
Main Methods:
- Clinical case assessment and neurological examination.
- Viral isolation from stool samples.
- Serological testing for antibody titers.
Main Results:
- Echovirus type 22 was identified as the likely cause of the outbreak.
- Six patients presented with acute flaccid paralysis; two died, and three had residual weakness.
- One patient developed aseptic meningitis without neurological deficits.
Conclusions:
- Echovirus type 22 can cause acute flaccid paralysis and aseptic meningitis.
- This is the first documented association of echovirus type 22 with acute flaccid paralysis.
- Public health surveillance for non-polio enteroviruses is crucial for managing outbreaks.