No images? Click here MEDICAL ADVISORY: Enterovirus D68 and Acute Flaccid ParalysisIssued by: M. Mustafa Hirji, MD, MPH, FRCPC, Medical Officer of Health & Commissioner (Acting) On Sept. 9, 2022, the Center for Diseases Control (CDC) in the United States issued a health advisory on increases in pediatric hospitalizations in patients with severe respiratory illness who also tested positive for rhinovirus (RV) and/or enterovirus (EV). Some specimens have been positive for enterovirus D68 (EV-D68). Concurrently, surveillance reports from the United States show a higher proportion of EV-D68 positivity in children who are RV/EV positive compared to previous years. EV-D68 primarily causes acute respiratory illness, which can range in severity. However, EV-D68 has also been associated with acute flaccid myelitis (AFM), a rare but serious neurologic complication involving limb weakness. AFM is a subset of acute flaccid paralysis (AFP). Public Health Ontario labs have now confirmed that EV-D68 is present in Ontario. However, the overall cases of EV does not seem to be higher than baseline thus far. Nonetheless, health care providers are reminded of the importance of EV testing; particularly now as EV infections tend to be more common in the fall. Testing for Enterovirus
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