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Neonatal paralytic poliomyelitis. A case report
Insights
Neonatal poliomyelitis, a rare disease, has re-emerged in the US. Poliovirus vaccine type caused apnea and permanent leg weakness in an infant, highlighting the need for accurate diagnosis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Neonatal poliomyelitis was historically rare, with no reported US cases since the widespread adoption of the live oral poliovirus vaccine (Sabin's vaccine).
- The continued circulation of poliovirus, even vaccine-derived strains, poses a potential risk for vulnerable infant populations.
Observation:
- A case of neonatal poliomyelitis is reported in the United States.
- The infant presented with apnea at 18 days of age and later developed permanent monoparesis.
Findings:
- Serologic and cultural evidence confirmed the causative agent as poliovirus vaccine type.
- Transmission likely occurred from another infant who received the live oral poliovirus vaccine.
Implications:
- This case underscores that poliovirus infections can still occur in the United States.
- Accurate diagnosis requires awareness and appropriate serologic, cultural, and typing tests for suspected cases.
- Prompt recognition and diagnosis are crucial for managing and preventing further spread of poliovirus in neonates.
Abstract:
Neonatal poliomyelitis, which was rare even when poliomyelitis was widespread, has not been reported in the United States since use of live oral poliovirus vaccine (Sabin's vaccine) became widespread. We report a child who became symptomatic with apnea at 18 days of age and who subsequently developed a permanent monoparesis. Serologic and cultural evidence indicated the virus as poliovirus vaccine type. Another infant who received live oral poliovirus vaccine was probably the source of the infecting virus. Recognition that poliovirus infection can still occur in the United States and an understanding of the serologic, cultural, and typing tests required to substantiate this diagnosis are needed so that such patients will be accurately diagnosed.