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Health officials look for link between respiratory infection outbreak, paralysis-like symptoms in kids

Children’s Mercy Hospital in Kansas City has reported three cases in children of neurologic illnesses that cause a weakening of limbs.
Children’s Mercy Hospital in Kansas City has reported three cases in children of neurologic illnesses that cause a weakening of limbs. THE KANSAS CITY STAR

Federal health officials are investigating illnesses with paralysis-like symptoms among children in Missouri, Colorado and Virginia that may be related to the outbreak of severe respiratory infections that has swept the nation.

Three cases of the neurologic illnesses have been reported by Children’s Mercy Hospital in Kansas City, 10 by Children’s Hospital Colorado in the Denver area and one by the Virginia Department of Health in the northern part of the state.

Common to the cases has been weakness in the children’s limbs that ranges in severity. Some children are experiencing mild weakness in their arms and legs; others are in intensive care, needing help breathing and eating.

The federal Centers for Disease Control and Prevention is asking all state and local health departments to report similar cases as it investigates possible causes, including a potential link to the summer respiratory disease outbreak.

The neurologic illnesses started appearing in August, about the same time as the first cases of respiratory illnesses caused by enterovirus D68. The enterovirus outbreak was first identified in Chicago and Kansas City in August. Since then, 472 people in 41 states have been confirmed to have EV-D68 illnesses, according to the CDC. Because relatively few laboratory tests are run, the actual number who’ve gotten ill from the virus is likely many times higher.

Most of the Missouri and Colorado children who’ve had neurologic illnesses also had colds or fevers with respiratory symptoms in the two weeks before their arms and legs weakened. But just four of the 10 Colorado children with neurologic illnesses tested positive for EV-D68, with lab results still pending on two others. And none of the Missouri children has had EV-D68 infections.

That opens the possibility that something else, including other enteroviruses, may be causing the paralysis-like illnesses.

“We’re suspicious (about EV-D68), but we simply don’t know,” said Mary Anne Jackson, chief of infectious diseases at Children’s Mercy. “There are other potential culprits out there.”

Jackson said the three cases at Children’s Mercy have been among children preschool to school age, all from Missouri. One of the children has been able to return home, another is receiving rehabilitation at the hospital and the third is in intensive care.

Much remains to be discovered about the neurologic illnesses, Jackson said. Rehabilitation can be arduous, so it may take weeks to months before doctors know how well the children recover.

The risks of developing the paralysis-like illnesses are still unknown because it isn’t yet clear how often children are exposed to their cause without having such severe symptoms.

With respiratory infections so common and the neurologic illnesses still so rare, Jackson said parents should not be overly concerned when their children start to cough or sneeze.

“They should be reassured that if their children have a cold, it is probably a cold,” she said. “They shouldn’t be on pins and needles waiting for limb weakness.”

To reach Alan Bavley, call 816-234-4858 or send email to abavley@kcstar.com.

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