Paralysis cluster cases linked to polio-like virus transmitted by Obama's disease spreading illegals.

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A team of researchers led by UCSF scientists has found strong
evidence that recent, alarming clusters of sudden-onset
paralysis cases — most of them in California and Colorado — were
caused by the same virus that was also responsible for hundreds
of severe respiratory infections in U.S. children last year.

Particularly worrisome is that the enterovirus identified in the
research is a new strain that appears to have mutated to become
more polio-like, raising the prospects of future outbreaks of
the disease, scientists said in a paper published Monday.

“The changes were always in the direction to make it more
similar to polio,” said Dr. Charles Chiu, head of the viral
diagnostics laboratory at UCSF and lead author of the paper. “I
want to make sure we don’t alarm people. There’s a chance this
virus may never come back, which would be the best-case
scenario. But we certainly need to be prepared.”

The virus scientists like Chiu have been hunting is called
Enterovirus D68, which is a relatively common pathogen that
typically causes mild symptoms associated with the common cold
but can cause more serious illness.

Two years ago, however, doctors in California — including
physicians at UCSF and Stanford — investigating a handful of
cases of sudden-onset paralysis in children, noted that two
patients carried Enterovirus D68.

The clusters
Then, last year, a massive wave of severe respiratory infections
caused by Enterovirus D68 swept across the United States,
targeting children. By the end of the year, more than 1,150
cases, all of them positive for Enterovirus D68, had been
reported.

And at the same time, two hospitals — one in Colorado and one in
California — reported small clusters of sudden-onset paralysis,
with some of the patients testing positive for the same virus.
Among the children eventually with paralysis, many have shown
some improvement in symptoms but none has recovered fully.

But no one could say for sure that Enterovirus 68 was causing
the paralysis. Baffling scientists and frustrating doctors, some
of the affected children tested positive for the infection, but
many did not.

Chiu’s team collected blood, tissue and fluid samples from 25
patients who were part of the paralysis clusters and used highly
sensitive equipment to search for any traces of enterovirus.
Most of those patients had never tested positive for
enterovirus, but Chiu was able to detect Enterovirus D68 in 12
of them.

A full genomic analysis of the viruses Chiu found showed that
almost all of them were of a mutated strain known as B1, which
was only identified about five years ago. The strain has similar
features to both the virus that causes polio and another virus —
Enterovirus D70 — that’s also known to cause neurological
problems.

“It’s a small study, and we’re not showing causality yet, but
we’re really inching that way,” said Dr. Emmanuelle Waubant, a
UCSF neurologist who treated some of the first California
patients with sudden-onset paralysis but was not part of Chiu’s
research team.

“This work is definitely going to encourage investigators to go
back to the bench and try to really understand better the
neurological complication potential of this virus.”

Chiu and other scientists said they don’t yet have the “smoking
gun” evidence they need to say for certain that Enterovirus D68
is the culprit in the paralysis cases. He wasn’t able to find
any virus in the cerebral spinal fluid of affected patients,
which would be a logical place for the pathogen if it’s causing
neurological problems.

But viruses that cause paralysis — including polio-causing
viruses — are notoriously tricky to locate, scientists say. And
the fact that Chiu and other scientists haven’t been able to
find any other possible causes of illness is another point in
favor of Enterovirus D68.

It’s rare for Enterovirus D68 to cause paralysis and unclear why
some patients end up with more severe symptoms than others. In
the paper, scientists found the virus in a pair of siblings, one
of whom suffered some paralysis and the other only minor cold
symptoms.

Individual genetics or environmental factors may explain the
differences, and Chiu has plans to further study the siblings.
Just how concerning this virus is remains to be seen, doctors
said.

Last year’s outbreak — including the hundreds of respiratory
infections and the clusters of paralysis — are “not apocalyptic
by any means,” said Dr. Keith Van Haren, a pediatric neurologist
at Stanford’s Lucile Packard Children's Hospital who studied the
first cases and was an author of the new paper. “But it’s
potentially a serious, sentinel event of things that may come.”

One big question is whether Enterovirus D68 will make a comeback
this year, Chiu said. Enteroviruses are not like influenza,
which tends to reliably turn up every year with only two or
three circulating strains. There are more than 100 strains of
enterovirus, and many of them only show up sporadically, causing
large clusters of illness before disappearing for many years.

“It’s hard to predict what will happen this year or next year.
Certainly enterorvirus will crop up again,” Chiu said. “The
question is will it be this strain or another strain? This year
will be very informative.”

Outlook unclear
Meanwhile, the families affected by the paralysis still struggle
with a lack of information about what caused the initial illness
and what the long-term prospects are for the children.

Nirupa Muruhathasan, whose son Vikash, 11, lost partial use of
his arm after falling sick two years ago, said while she’s eager
to better understand what happened to him, she’s more interested
in his future.

“He still does physical therapy every single day. He hasn’t
plateaued yet. That’s the message I want to give other parents,”
said Muruhathasan, who moved from the Bay Area to San Diego with
her family last year. “I just feel like everybody wants to focus
on the problem rather than finding a solution for these kids.”

Erin Allday is a San Francisco Chronicle staff writer. E-mail:
eal...@sfchronicle.com

http://www.sfgate.com/bayarea/article/Paralysis-cluster-cases-
linked-to-polio-like-virus-6169033.php