[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]
Pediatr Int. 2019 Dec 30. doi: 10.1111/ped.14128. [Epub ahead of print]
Respiratory illness and acute flaccid myelitis in the Tokai district in 2018.
Okumura A1, Numoto S1, Iwayama H1, Kurahashi H1, Natsume J2, Saitoh S3, Yoshikawa T4, Fukao T5, Hirayama M6, Takahashi Y2; Aichi Pediatric Clinical Study Group.
Author information: 1 Department of Pediatrics, Aichi Medical University, 1-1 Yazako Karimata, Nagakute, Aichi, 480-1195, Japan. 2 Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan. 3 Department of Pediatrics, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan. 4 Department of Pediatrics, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. 5 Department of Pediatrics, Gifu University Graduate School of Medical Sciences, 1-1 Yanagido, Gifu City, 501-1194, Japan. 6 Department of Pediatrics, Mie University Graduate School of Medical Sciences, 2-174 Edobashi, Tsu, Mie, 5148507, Japan.
An outbreak of acute flaccid myelitis was chronologically correlated with that of severe respiratory illness in Japan in 2015. We hypothesized that increases in children hospitalized with severe respiratory illnesses might be associated with increase in acute flaccid myelitis also in autumn 2018.
We explored the temporal correlations between respiratory illness outbreaks and acute flaccid myelitis during autumn season between 2016 and 2018 using questionnaire surveys. One questionnaire explored the monthly numbers of children with acute flaccid myelitis, Guillain-Barre syndrome, and other acute flaccid paralyses. The other questionnaire explored the monthly numbers of children hospitalized with respiratory illnesses associated with wheezing. A correlation between the monthly numbers of children with acute flaccid myelitis and those with respiratory illness was analyzed by the Pearson correlation test.
Although the number of patients hospitalized with respiratory illness did not correlate with the number of those admitted with myelitis, increases in children aged 7-12 and 13-19 years requiring ICU admission correlated temporally with an outbreak of acute flaccid myelitis.
An increase in intensive care unit admissions to treat respiratory disease occurred in association with a cluster of acute flaccid myelitis. An increase in the number of ICU admission due to respiratory illness may be a clue to expect the occurrence of acute flaccid myelitis.
© 2019 Japan Pediatric Society.
KEYWORDS: acute flaccid myelitis; enterovirus D68; outbreak; respiratory illness; temporal correlation
PMID: 31886594 DOI: 10.1111/ped.14128
Keywords: EV-D68; Pediatrics; Japan; AFM.