{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T22:55:03Z","timestamp":1790463303297,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,11,12]],"date-time":"2018-11-12T00:00:00Z","timestamp":1541980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100003186","name":"National Rosacea Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100003186","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:label\/><jats:p>Enterovirus D68 (<jats:styled-content style=\"fixed-case\">EV<\/jats:styled-content>\u2010D68) is an emerging infection associated with acute flaccid myelitis (<jats:styled-content style=\"fixed-case\">AFM<\/jats:styled-content>). Cases of <jats:styled-content style=\"fixed-case\">AFM<\/jats:styled-content> associated with <jats:styled-content style=\"fixed-case\">EV<\/jats:styled-content>\u2010D68 infection have increased in recent years and the evidence for a causal link is growing. However, our understanding of the epidemiology, clinical features, prognosis, and neurological sequelae of <jats:styled-content style=\"fixed-case\">EV<\/jats:styled-content>\u2010D68 requires ongoing surveillance and investigation. We report five cases of <jats:styled-content style=\"fixed-case\">AFM<\/jats:styled-content> in previously typically developing children (2\u20136y) from South East Scotland during September and October 2016 after infection with <jats:styled-content style=\"fixed-case\">EV<\/jats:styled-content>\u2010D68 (all detected in the nasopharyngeal aspirates). All cases presented with significant neurological symptoms, which were severe in two cases requiring intensive care support because of respiratory paralysis. At 18\u2010month follow\u2010up, two cases remain ventilator\u2010dependent with other cases requiring ongoing community rehabilitation. These cases represent one of the largest reported paediatric cluster of <jats:styled-content style=\"fixed-case\">AFM<\/jats:styled-content> associated with <jats:styled-content style=\"fixed-case\">EV<\/jats:styled-content>\u2010D68 in Europe. The epidemiology and clinical information add to the knowledge base and the 18\u2010month outcome will help clinicians to counsel families.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Nasopharyngeal aspirate is more sensitive for viral isolation and isolated in all cases.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Clinical outcome at 18 months after enterovirus D68 with acute flaccid myelitis provides information on extent of recovery and level of disability.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.14096","type":"journal-article","created":{"date-parts":[[2018,11,12]],"date-time":"2018-11-12T09:04:40Z","timestamp":1542013480000},"page":"376-380","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Outcome of paediatric acute flaccid myelitis associated with enterovirus D68: a case series"],"prefix":"10.1111","volume":"61","author":[{"given":"Amir","family":"Kirolos","sequence":"first","affiliation":[{"name":"Directorate of Public Health and Health Policy National Health Service, Lothian Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Mark","sequence":"additional","affiliation":[{"name":"Directorate of Public Health and Health Policy National Health Service, Lothian Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3114-4002","authenticated-orcid":false,"given":"Jay","family":"Shetty","sequence":"additional","affiliation":[{"name":"National Health Service, Lothian The Royal Hospital for Sick Children Edinburgh UK"},{"name":"Department of Child Life and Health University of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandita","family":"Chinchankar","sequence":"additional","affiliation":[{"name":"National Health Service, Lothian The Royal Hospital for Sick Children Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Mcdougall","sequence":"additional","affiliation":[{"name":"National Health Service, Lothian The Royal Hospital for Sick Children Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Eunson","sequence":"additional","affiliation":[{"name":"National Health Service, Lothian The Royal Hospital for Sick Children Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Directorate of Public Health and Health Policy National Health Service, Lothian Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Templeton","sequence":"additional","affiliation":[{"name":"Department of Child Life and Health University of Edinburgh Edinburgh UK"},{"name":"Department of Virology National Health Service, Lothian Royal Infirmary Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"NHS Lothian EV\u2010D68 Associated AFM Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972-2327.128561"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.epirev.a018041"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/6.Supplement_2.S387"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.pu.13.050192.001323"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.24920"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2204.151588"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909233411302"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix860"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2018.23.3.17-00310"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)00543-5"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2016.21.4.30119"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a120693"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.24410"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1006199"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30094-X"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2018.01.008"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2017.22.45.16-00807"}],"container-title":["Developmental Medicine &amp; 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