Statement on Limb Weakness Associated with Viral Infections, with Tips for Parents

October 01, 2014

Over the past two years, doctors in California have observed rare instances of what may be a new disease. In these cases, patients, usually children, have quickly and sometimes permanently lost muscle function in an arm or leg after experiencing symptoms of an upper respiratory infection.

Last spring, Dr. Emmanuelle Waubant, of UCSF Benioff Children's Hospital San Francisco, and Dr. Keith Van Haren, of Stanford University's Lucile Packard Children's Hospital, presented several cases of this illness in detail at the annual meeting of the American Academy of Neurology.

On Friday, September 26, 2014, the Centers for Disease Control and Prevention (CDC) released an Official Health Advisory, describing a group of nine children in Colorado affected by what may be the same illness.

The CDC report and continuing work by Waubant, Van Haren and Dr. Jonathan Strober, pediatric neurologist at UCSF Benioff Children's Hospital San Francisco, suggests that the illness may be related to infection with a virus known as Enterovirus D68 (EV-D68), which causes symptoms including fever, runny nose, sneezing and cough. However, this link has not been confirmed. A similar type of rare limb weakness caused by a virus related to EV-D68 has been reported for many years in Asia and Australia.

Waubant, Van Haren and Strober are actively working with the California Department of Public Health to identify and track cases, with the goal of firmly establishing the cause of the disease.

It is important to note that the current illness is extremely rare, and does not represent an epidemic: Only about 25 suspected cases have been reported in California, a state with a population of 38.3 million people, of whom 9.2 million are under age 18, according to the U.S. Census Bureau. Also, no two children from the same family have been affected in either California or Colorado.

Advice for Parents

Although the polio vaccine does not appear to protect against this possibly new disease, Waubant and Strober advise that children continue to receive the vaccine to protect against polio. They also offer the following advice and recommendations to parents:

  • Be calm! Most upper respiratory viral infections or colds are not related to EV-D68.
  • Of these infections, only a very small number have been associated with neurological complications.
  • To prevent upper respiratory infections, encourage your kids to thoroughly and regularly wash their hands.
  • Children and adults with upper respiratory infections, such as the common cold, should not go to school or work as long as they have symptoms, such as runny nose or fever.
  • If you or your child develop sustained weakness in one or more limbs, please call your primary care physician to get rapid medical attention.

UCSF has set up a hotline for people who need medical attention or advice on recently developed weakness that they think may be related to this illness. Call (415) 353-3857, or toll-free at (855) 487-7824, to reach the hotline.