The respiratory illness associated with Enterovirus D-68 has spread to many states at this point, and now a cluster of cases have been found in Colorado with limb weakness, possibly due to the same virus.
Starting in August, Colorado and the CDC have identified a cluster of children 1-18 years of age (median age of 10) with acute focal limb weakness. At this time, there have been 9 confirmed cases. Most of the children are in the Denver metropolitan area, and all of them have been hospitalized. Specific testing has been done, including CSF analysis via lumbar puncture looking for meningitis. None of the cases had bacteria or virus isolated from the CSF, though there were signs of inflammation present. Spinal MRI scans showed lesions in the grey matter of the spinal cord, and some had brainstem lesions on MRI as well. Most children report having a respiratory illness associated with fever in the two weeks prior to developing limb weakness. No cases have had Enterovirus D-68 in the spinal fluid, although 6 of 8 cases did have Enterovirus D-68 isolated from nasal specimens. Further testing is being done.
The CDC is working closely with Colorado, and they have posted a health advisory on their website at:
http://emergency.cdc.gov/HAN/han00370.asp
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