• Guadalupe Pérez, María T Rosanova, María C Freire, María I Paz, Silvina Ruvinsky, Carlos Rugilo, Víctor Ruggieri, Daniel Cisterna, Soledad Martiren, Cristina Lema, Andrea Savransky, Soledad González, Leila Martínez, Diana Viale, and Rosa Bologna.
• Servicio de Control Epidemiológico e Infectología. Hospital de Pediatría "Prof. Dr. Juan P. Garrahan". guaperez@hotmail.com.
• Arch Argent Pediatr. 2017 Aug 1; 115 (4): 364-369.

IntroductionThe association between enterovirus D68 and acute flaccid myelitis was first described in the United States in 2014. Since then, sporadic cases have been reported in Canada and Europe. This study describes a series of cases of acute flaccid myelitis at Hospital de Pediatría "Prof. Dr. Juan P. Garrahan," in Buenos Aires, Argentina, during 2016.MethodsDescriptive, retrospective study. All patients with acute flaccid myelitis and lesions in the spinal cord involving the gray matter, as observed in the magnetic resonance imaging (MRI) scan, hospitalized from 04/01/2016 to 07/01/2016, were included in the study. Samples of nasopharyngeal secretions, fecal swabs and cerebrospinal fluid were collected and processed to look for the causative agent.ResultsTen patients were included. The median age was 4 years old (range from 3 months to 5 years old). Eight patients had a self-limiting febrile condition before the onset of neurological symptoms. Neurological findings were flaccid weakness in, at least, one limb, cervical paralysis (n= 2) and facial paralysis (n= 2). All patients had longitudinal lesions in the spinal cord, with gray matter involvement, mainly in the anterior horn. In all cases, a lumbar puncture (spinal tap) was performed. Pleocytosis was observed in 7 patients. In four children, enterovirus D68 was identified in nasopharyngeal secretions, and in one, it was detected in the cerebrospinal fluid. Neurological deficit persisted in all patients at the time of discharge.ConclusionsThe first outbreak of acute flaccid myelitis associated to enterovirus D68 is reported in Argentina. Active epidemiological surveillance will help to determine the true incidence, epidemiology and etiology of this disease.Sociedad Argentina de Pediatría

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