{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T22:54:32Z","timestamp":1790463272233,"version":"4.1.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2016,12,20]],"date-time":"2016-12-20T00:00:00Z","timestamp":1482192000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Child Neurol"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:p>We describe the presenting features and long-term outcome of an unusual cluster of pediatric acute flaccid paralysis cases that occurred in Canada during the 2014 enterovirus D68 outbreak. Children (n = 25; median age 7.8 years) presenting to Canadian centers between July 1 and October 31, 2014, and who met diagnostic criteria for acute flaccid paralysis were evaluated retrospectively. The predominant presenting features included prodromal respiratory illness (n = 22), cerebrospinal fluid lymphocytic pleocytosis (n = 18), pain in neck\/back (n = 14) and extremities (n = 10), bowel\/bladder dysfunction (n = 9), focal central gray matter lesions found in all regions of the spinal cord within the cohort (n = 16), brain stem lesions (n = 8), and bulbar symptoms (n = 5). Enterovirus D68 was detectable in nasopharyngeal specimens (n = 7) but not in cerebrospinal fluid. Acute therapies (corticosteroids, intravenous immunoglobulins, plasmapheresis) were well tolerated with few side effects. Fourteen of 16 patients who were followed beyond 12 months post onset had neurologic deficits but showed ongoing clinical improvement and motor recovery.<\/jats:p>","DOI":"10.1177\/0883073816680770","type":"journal-article","created":{"date-parts":[[2017,1,16]],"date-time":"2017-01-16T01:49:13Z","timestamp":1484531353000},"page":"301-307","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":48,"title":["Longitudinal Outcomes in the 2014 Acute Flaccid Paralysis Cluster in Canada"],"prefix":"10.1177","volume":"32","author":[{"given":"Carmen","family":"Yea","sequence":"first","affiliation":[{"name":"Division of Neurology, The Hospital for Sick Children, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari","family":"Bitnun","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, The Hospital for Sick Children, Ontario, Canada"},{"name":"Department of Pediatrics, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Robinson","sequence":"additional","affiliation":[{"name":"Stollery Children\u2019s Hospital, University of Alberta, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Mineyko","sequence":"additional","affiliation":[{"name":"Section of Neurology, Department of Pediatrics, Alberta Children\u2019s Hospital, University of Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Barton","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, London Health Sciences Centre, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean K.","family":"Mah","sequence":"additional","affiliation":[{"name":"Section of Neurology, Department of Pediatrics, Alberta Children\u2019s Hospital, University of Calgary, 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Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Brophy","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Children\u2019s Hospital of Eastern Ontario, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Crone","sequence":"additional","affiliation":[{"name":"Section of Neurology, Department of Pediatrics, Alberta Children\u2019s Hospital, University of Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalini","family":"Desai","sequence":"additional","affiliation":[{"name":"McMaster Children\u2019s Hospital, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliette","family":"Hukin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, British Columbia Children\u2019s Hospital, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Jones","sequence":"additional","affiliation":[{"name":"McMaster Children\u2019s Hospital, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Muir","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, British Columbia Children\u2019s Hospital, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Pernica","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department of Pediatrics, McMaster University, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Pless","sequence":"additional","affiliation":[{"name":"Public Health Agency of Canada, Ottawa, Ontario, 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