ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
Clinical Features of Acute Flaccid Myelitis Temporally Associated With an Enterovirus D68 Outbreak: Results of a Nationwide Survey of Acute Flaccid Paralysis in Japan, August-December 2015.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 3 of them syntheses that pooled it.
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Who cites it
52 citing papers in PubMed, 3 syntheses or guidelines pooled it, 125 citations in OpenAlex.
- Upper extremity nerve transfers for acute flaccid myelitis: a systematic literature review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2022Pooled it
- Global prevalence and case fatality rate of Enterovirus D68 infections, a systematic review and meta-analysis.PLoS neglected tropical diseases · 2022Pooled it
- Neurological involvement of coronavirus disease 2019: a systematic review.Journal of neurology · 2020Pooled it
- Enterovirus D68 in United States wastewater: a longitudinal surveillance study integrating climatic, demographic, and clinical data.Lancet regional health. Americas · 2026Article
- Prospective use of wastewater surveillance for early detection of enterovirus D68 in community outbreaks among children, Niigata City, Japan, 2024.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2026Article
- Article
- Clinical Insights and Severity of Enterovirus D68 Respiratory Infections in Vietnamese Children.Open forum infectious diseases · 2026Article
- Acute flaccid myelitis in Europe between 2016 and 2023: indicating the need for better registration.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Detection of community-acquired respiratory viruses during COVID-19 pandemic in subtropical region in Japan.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- Adult-onset Acute Flaccid Myelitis Accompanied by Rhombencephalitis Which First Presented with Prominent Psychiatric Symptoms and Dysautonomia Mimicking Anti-N-methyl-D-aspartate Receptor Encephalitis.Internal medicine (Tokyo, Japan) · 2024Article
- Human B cells and dendritic cells are susceptible and permissive to enterovirus D68 infection.mSphere · 2024Article
- Exploring the Phenotypic Profile of Acute Flaccid Paralysis: Insights from a Third-Level Pediatric Emergency Room.Iranian journal of child neurology · 2024Article
- Enterovirus-D68 - A Reemerging Non-Polio Enterovirus that Causes Severe Respiratory and Neurological Disease in Children.Frontiers in virology (Lausanne, Switzerland) · 2024Article
- Enterovirus genotype diversity with emergence of coxsackievirus A2 circulating in pediatric patients with acute gastroenteritis in Thailand, 2019-2022.Frontiers in microbiology · 2024Article
- Nerve Transfer Surgery in Acute Flaccid Myelitis: Prognostic Factors, Long-Term Outcomes, Comparison With Natural History.Pediatric neurology · 2024Article
- Neutralizing activity of intravenous immune globulin products against enterovirus D68 strains isolated in Japan.BMC infectious diseases · 2023Article
- Changes in transmission of Enterovirus D68 (EV-D68) in England inferred from seroprevalence data.eLife · 2023Article
- Acute flaccid myelitis: not uncommon in rural Uganda?Brain communications · 2023Article
- Animal Models of Enterovirus D68 Infection and Disease.Journal of virology · 2022Review
- Enterovirus D68 epidemic, UK, 2018, was caused by subclades B3 and D1, predominantly in children and adults, respectively, with both subclades exhibiting extensive genetic diversity.Microbial genomics · 2022Article
Corrections and comments
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Authors and funding
14 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Acute flaccid myelitis (AFM) is an acute flaccid paralysis syndrome with spinal motor neuron involvement of unknown etiology. We investigated the characteristics and prognostic factors of AFM clusters coincident with an enterovirus D68 (EV-D68) outbreak in Japan during autumn 2015. Methods: An AFM case series study was conducted following a nationwide survey from August to December 2015. Radiographic and neurophysiologic data were subjected to centralized review, and virology studies were conducted for available specimens. Results: Fifty-nine AFM cases (58 definite, 1 probable) were identified, including 55 children and 4 adults (median age, 4.4 years). The AFM epidemic curve showed strong temporal correlation with EV-D68 detection from pathogen surveillance, but not with other pathogens. EV-D68 was detected in 9 patients: 5 in nasopharyngeal, 2 in stool, 1 in cerebrospinal fluid (adult case), and 1 in tracheal aspiration, nasopharyngeal, and serum samples (a pediatric case with preceding steroid usage). Cases exhibited heterogeneous paralysis patterns from 1- to 4-limb involvement, but all definite cases had longitudinal spinal gray matter lesions on magnetic resonance imaging (median, 20 spinal segments). Cerebrospinal fluid pleocytosis was observed in 50 of 59 cases (85%), and 8 of 29 (28%) were positive for antiganglioside antibodies, as frequently observed in Guillain-Barré syndrome. Fifty-two patients showed variable residual weakness at follow-up. Good prognostic factors included a pretreatment manual muscle strength test unit score >3, normal F-wave persistence, and EV-D68-negative status. Conclusions: EV-D68 may be one of the causative agents for AFM, while host susceptibility factors such as immune response could contribute to AFM development.
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