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Acute flaccid myelitis in Switzerland - association with enterovirus D68

Sandra Bigi1,2, Alban Ramette3, Maria Teresa Barbani3

  • 1Institute of Social and Preventive Medicine, University of Bern, Switzerland.

Swiss Medical Weekly
|February 14, 2023
PubMed

Insights

Enterovirus D68 (EV-D68) causes polio-like acute flaccid myelitis (AFM) in children, often leading to permanent paralysis. Early diagnosis and surveillance are crucial for managing this emerging neurological threat.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Virology

Background:

  • Enterovirus D68 (EV-D68) has emerged globally, causing polio-like acute flaccid myelitis (AFM).
  • AFM primarily affects children, presenting with limb weakness and potential respiratory compromise.
  • Most cases result in permanent neurological deficits, with no specific treatment available.

Purpose of the Study:

  • To report the first documented case of EV-D68 associated AFM in Switzerland.
  • To highlight the clinical presentation and diagnostic challenges of AFM.
  • To recommend enhanced surveillance strategies for EV-D68 in Switzerland.

Main Methods:

  • Case report of the first documented AFM in Switzerland.
  • Description of clinical features, including prodrome, onset, and neurological sequelae.
  • Review of diagnostic workup and public health reporting recommendations.

Main Results:

  • The first confirmed case of EV-D68 associated AFM in Switzerland is described.
  • A second suspected case occurred in temporal association.
  • AFM presents with acute, asymmetrical limb weakness, often affecting upper extremities and respiratory muscles.

Conclusions:

  • Comprehensive diagnostic workup and timely reporting are essential for AFM cases.
  • Extending poliomyelitis surveillance to include EV-D68 monitoring in respiratory samples is warranted in Switzerland.
  • Surveillance could involve enteroviral typing of samples from patients with acute flaccid paralysis.

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