Enterovirus A71 in Colorado Causing Neurologic Disease in Kids

By Kelly Young

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

Colorado is experiencing an outbreak of enterovirus (EV) A71 that causes neurologic disease in children. The virus is a common cause of hand, foot, and mouth disease.

From May through August, 34 children with neurologic disease tested positive for EV-A71. The first 13 children identified experienced the following, as reported in MMWR:

• Meningitis (12 cases)

• Encephalitis (9)

• Acute flaccid myelitis (3)

• Brain abnormalities on imaging (6)

• Ataxia (7)

• Myoclonus (6)

• Limb weakness (4)

Of the 11 whose cerebrospinal fluid (CSF) was tested, only two came back positive for enterovirus. However, all 13 tested positive for EV-A71 in nasopharyngeal, pharyngeal, or rectal specimens.

The authors write: "This investigation highlights the importance of testing nonsterile sites when [central nervous system] disease associated with EV is suspected and CSF is negative. Furthermore, health care providers should consider EV-A71 as an etiology when febrile patients display myoclonus, ataxia, or limb weakness."