Friday, November 3, 2017

Enterovirus D68 in Argentina

The documented history of non-polio enteroviruses in the Americas has been rather persistent (the most famous enterovirus is definitely polio, but there's a whole genus of others!, grand right??); in the U.S. alone, they cause anywhere from 10 to 15 million infections ranging from asymptomatic to mild colds to more serious complications in immunocompromised patients. Enterovirus D68 specifically has had a sporadic presence; first identified in California in 1962, it has mostly only had a small presence in the U.S. with a abnormal spike in infections in 2014. A respiratory illness, this virus resides in mucus, saliva, and sputum, which explains its spread through coughs and sneezes.

Though it has not been widely documented in the U.S. since its 2014 outbreak, it has found it's way to other continents. Specifically, it caused a uproar in several European countries that recorded clusters of infections in 2016. Fast forward to 2017 and one finds that is has travelled to Sudamerica, taking up residence in Argentina. The equivalent of the Argentinian CDC discovered multiple cases of acute flaccid myelitis (AFM), a neurological disorder characterized by numb limbs with an otherwise idiopathic origin. AFM has previously been linked to D68, so this presentation of symptoms can be used to retroactively trace/identify D68 infection. These Argentinian infections appear only in children under the age of 15 (mostly identified in nasal aspirate but also observed in CSF of some, indicating its neuroinvasive capacity). The presence of this virus (and the related Enteroviruses B and C) emphasizes how little is known about the neuroinvasiveness of enteroviruses and their contribution to disease. Maybe events such as this will encourage future research!

Entero, hasta luego :) ;)

Javarcia Ivory

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