News

Rare, polio-like virus striking Bay Area children

Doctors discuss cases at press conference, stress rarity of the disease

A polio-like illness has stricken 25 children in California, Lucile Packard Children's Hospital officials announced Monday at a press conference.

Patients suffering from the disease quickly and permanently become paralyzed in one or more legs or arms. Some patients have respiratory symptoms before the paralysis begins, said Dr. Keith Van Haren, a pediatric neurologist.

"We suspect it is a virus," but doctors have not yet confirmed its presence in all of the patients, he said.

Van Haren and Dr. Emmanuelle Waubant, professor of neurology at the University of California at San Francisco, are researching the cases and have found a virus, enterovirus-68, in the nasal swabs of two, but that sample is too small to draw conclusions, Waubant said. Enterovirus-68 is in the same family as the polio virus.

The polio vaccine does not protect against enterovirus-68, and there is no evidence that the vaccine causes the disease. Doctors Monday emphasized the disease is rare. It has been seen occasionally in the Bay Area, but the presence of five cases in the past 18 months is unusual, Van Haren said.

Other enteroviruses can cause similar symptoms. Another strain, enterovirus-71, has been implicated in similar cases of acute flaccid paralysis in southeast Asia and Australia, but that strain is not known here, Van Haren said.

The enterovirus-68 cases, which began in September 2012, have ranged from Monterey County to the North Bay, with others in southern California. There are no confirmed cases outside California.

Most of those stricken are ages 2 to 16 years old, but the disease has affected some adults, Van Haren said.

In some cases, the paralysis is preceded by a respiratory infection. In other cases, sudden muscle weakness rapidly progresses to flaccid paralysis, in which the limb hangs and cannot move.

"All of the children have permanent weakness," Van Haren said. "So far, we've seen modest to very little recovery."

But in most cases, the virus won't progress to paralysis, the doctors said.

"We think it's a very small number of patients infected with this virus who will have the neurological condition," Waubant said.

Any weakness that lasts for a few hours should be immediately looked at by a physician, the doctors said.

One case investigated at Lucile Packard involved a Berkeley girl, Sofia Jarvis, who is now 4 years old. In November 2012, Sofia, then 2, suffered from a respiratory infection and severe wheezing. Her parents took her to the doctor, and she was treated with Albuterol, an inhaler medicine that opens airways, her mother, Jessica Tomei, said. On the way home, Sofia started vomiting.

She was admitted to the hospital with breathing distress, Doctors thought she had asthma, her mother said. After four days, she returned home. The next day, she returned to her pediatrician for a follow-up appointment, as the doctor had not ruled out pneumonia.

After the visit, Sofia reached into the treasure box in the family's waiting room.

"I saw her left hand in mid-grasp stop working," Tomei said. "Over three days, she was not using her left arm."

Sofia's parents said they were speaking out publicly to alert other parents about what happened to their daughter.

"I know we are so lucky that she is here, and she is going to do amazing things," Tomei said.

Sofia, a lively girl with wavy red hair, calls her dangling arm "Lefty." It's a way to keep the arm integrated with the rest of her body as she tries to regain some movement, Tomei said.

The disease has not affected Sofia mentally, her mother said. She loves to dance, attends a Montessori preschool and is still academically advanced for her age. But she must learn alternate ways to dress herself and tie her shoes, Tomei said. She is currently in physical and occupational therapy.

Van Haren and Waubant will present their findings at the American Academy of Neurology's annual meeting in late April. The California Department of Public Health is also tracking the cases.

Comments

 +   Like this comment
Posted by CherylP
a resident of University South
on Feb 25, 2014 at 12:01 am

I wonder if molds were considered as the culprit for the paralysis in the children? Their homes need to be checked.


 +   Like this comment
Posted by Local parent
a resident of Another Palo Alto neighborhood
on Feb 25, 2014 at 7:06 am

This is interesting and frightening. Enterovirus 71 was implicated in numerous deaths among Cambodian children where they were also given steroids to reduce inflammation. (Or, at least I think that's what happened. All the articles are extremely sketchy on details. In recent years, there have been many articles written in medical journals belittling "steroid fears" among parents because so many kids are given steroids as the preferred treatment for eczema and asthma and the result seems to be a professional conclusion to underplay their side effects and over reassure to the point of possibly undercutting informed consent. At least, from a patient perspective. It makes me wonder if it creates any blind spots here that's concerned among doctors.)
Web Link

But newer inhaled steroids really are supposed to be safer - could they reduce the possibility of contracting this in the first place? Or make it worse? So many kids are on the inhaled steroids now, I wonder if anyone has looked at this? What if they are on the steroids because of moldy environments causing the symptoms - those can also increase susceptibility to viral respiratory tract infection. That would be a different scenario than kids on steroids for other allergy, where the steroids would probably reduce the risk of infection. Probably.

Also, I heard an interview with Alan Alda years ago - he had polio as a child and was given some kind on intense localized heat treatment by a nurse who had great results with it. I wonder if it's another one of those cases where a medical professional somewhere comes up with something helpful that everyone then forgets? Here it is - Sister Kenny, and it became an Institute associated with a hospital in MN Web Link

I wonder if like the ketogenic diet, it's something practiced one place but forgotten everywhere else?

What about the approach with hepatitis? Someone is found to have it and anyone exposed is given antibodies to prevent them from getting sick - is there anything like that here? I'd vaccinate if it were possible. This is rare, but extremely devastating.


 +   Like this comment
Posted by SCB94303
a resident of Adobe-Meadows
on Feb 25, 2014 at 1:03 pm

SCB94303 is a registered user.

Does anyone know the age range in children that this virus has affected? How young up to how old? Thanks!


 +   Like this comment
Posted by Margie Dally
a resident of another community
on Feb 25, 2014 at 3:04 pm

I used a heating pad from China. I broke out with a shingle like infection. It was tested and it wasn't shingles, but a virus.
I had to get a polio vaccine in Jan. 2014 and I felt as if I had it. Now I have white spot appearing and disappearing. I feel as if my body is doing battle in my back.
The world is getting smaller and a different virus is coming to us.
My prays are with these children because it is very painful and the damage isn't correctable.


 +   Like this comment
Posted by Rupert of henzau
a resident of Midtown
on Feb 25, 2014 at 3:46 pm

Margie-- shingles is caused by a virus-- the same virus that causes chicken pox


 +   Like this comment
Posted by Sarah
a resident of Embarcadero Oaks/Leland
on Feb 25, 2014 at 5:21 pm

Wonder if this could be associated somehow with West Nile Virus?


 +   Like this comment
Posted by Wellness check
a resident of Stanford
on Feb 25, 2014 at 7:05 pm

The US appears to be one of only two airports that do not check incoming foreigners for signs of illness. This is most likely from a foreign source, the telltale evidence being the fact that it is only in California.

Narita Airport in Tokyo has been known to detain obviously sick foreigners for two or more weeks to curb incoming viruses. Beijing Airport has a temperature-reading apparatus that all incoming foreigners must walk through.

Up until the twentieth century, all incoming immigrants and travelers were checked at ports of entry for signs of illness. When and why did we become so dangerously lax? Only Bangkok Airport is as lax as the US!


 +   Like this comment
Posted by Elizabeth Henin Misich
a resident of Another Palo Alto neighborhood
on Feb 25, 2014 at 7:41 pm

Thanks to Sue Dremman for another informative, thoughtful report of wrenching interest to our community, here somewhat broader in scope than usual.


 +   Like this comment
Posted by Local parent
a resident of Another Palo Alto neighborhood
on Feb 25, 2014 at 10:40 pm

"When and why did we become so dangerously lax?"
It might have something to do with the shambles our public health system is in?


 +   Like this comment
Posted by Wellness check
a resident of Stanford
on Feb 26, 2014 at 3:31 pm

Local Parent: very good point. Someone in power chose saving money over public health and safety!


 +   Like this comment
Posted by European
a resident of Adobe-Meadows
on Feb 26, 2014 at 5:30 pm

@ Wellness check.

You must not travel outside of Asia much. In Europe, for instance, they don't check your health or detain you any more than happens at US airports.


 +   Like this comment
Posted by Amy Szymoniak
a resident of another community
on Mar 3, 2014 at 3:27 pm

HAS ANYONE CONSIDERED GULLIAN BARRE SYNDROME. THE SYMPTOMS ARE AMOST IDENTICAL TO WHAT MY DAUGHTER HAD THE AGE OF 3. IT TOOK A LONG TIME FOR A PROPER DIAGNOSIS AND SHE WAS EVENTUALLY TREATED WITH GAMMAGLOBULIN, WHICH IS A COMBINATION OF BLOOD PLATELETS AND ANIT VIRAL MEDICATION. PLEASE CHECK INTO THIS AS A POSSIBILITY! MY DAUGHTER IS NOW A BEAUTIFUL HEALTHY 19 YEAR OLD!


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