New Polio-like illness found in children in California

A report issued Sunday by Dr. Keith Van Haren of Stanford University and his co-author, Dr. Emanuelle Waubant with the University of California-San Francisco, states that 5 children residing in California have been diagnosed with a polio-like illness.  Poliomyelitis (Polio) is an infectious virus that causes muscle weakness and eventually full paralysis.  The virus affects mainly the grey matter of the brain and spinal cord, but can also move to the lungs (causing polioencephalitis), causing acute paralysis.

CDC/ Dr. Fred Murphy, Sylvia Whitfield

Dr. Van Haren and Dr. Waubant noticed initially that there were children at their respective affiliate hospitals who had shown up with polio-like symptoms.  After ruling out such illnesses as Guillain-Barré and botulism, which can also cause muscle weakness and paralysis, the doctors determined the illness was most likely polio.  They then screened California hospital patient files, using similar exclusion criteria, to identify 3 more children who had been suffering from the same symptoms.

Initially, the children presented with one or more paralyzed limbs, with severe symptom presentation occurring two days after.  Three of the five children had developed respiratory symptoms before the start of paralysis. 

After 6 months of treatment, the symptoms did not abate and the children still did not have full use of their limbs.  While 3 of the children developed symptoms from an as-yet-unknown cause, two of the children tested positive for enterovirus-68, a rare viral type known to cause polio.

What is most worrisome is that all 5 children had been vaccinated for polio.  Jonas Salk developed the first successful vaccine in 1955, showing it provided immunity for >99% of the individuals receiving it.  Albert Sabin then developed an oral form, which rapidly became the vaccination method of choice due to its ease of administration and inexpensive production.  Since the 1960s, polio has thought to have been eradicated in the United States due to the use of both these vaccines.

The doctors want to stress two important points for healthcare workers and the general public.  First, the illness may not be polio at all.  Dr. Van Haren notes, “In the past decade, newly identified strains of enterovirus have been linked to polio-like outbreaks among children in Asia and Australia”, meaning this illness could be a result of a foreign virus making its way to the US.  Secondly, the authors state, “We would like to stress that this syndrome appears to be very, very rare”.  So children should still feel free to play with friends and go to school as normal.

This disease is not to be discounted though.  Dr. Van Haren says their “findings have important implications for disease surveillance, testing and treatment”, and that “[a]ny time a parent sees symptoms of paralysis in a child, the child should be seen by a doctor right away”.

Edward Marks is a PhD student at the University of Delaware.  His research involves the healing of burns and other chronic wounds using nanomedicine techniques, with the goal of pushing any advancement directly into the clinic.  Edward received his BS from Rutgers University and Masters from the University of Delaware.

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