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Acute flaccid paralysis due to spinal motor neuron injury, termed acute flaccid myelitis, has been relatively uncommon in the U.S. since the successful eradication of poliovirus by 1979. In 2012, several reports of acute flaccid paralysis of unknown etiology in California led to enhanced statewide surveillance before and concurrent with the 2014 North American outbreak of enterovirus D68. Cases were defined as acute onset of flaccid weakness in one or more limbs with radiographic or electrodiagnostic evidence of spinal gray matter/anterior horn cell abnormalities. Now, investigators summarize 59 cases reported between June 2012 and July 2015.
Most (95%) of the 59 patients (median age, 9 years) were immunocompetent. Nineteen percent had a his…