enterovirus 68 and acute respiratory illness

Discussion in 'Fibromyalgia Main Forum' started by simpsons, Oct 10, 2011.

  1. simpsons

    simpsons Member

    as there has been interest in dr chia and his work with enteroviral infections here is some research regading enterovirus and m.e.
    reposted with permission

    MED: Acute respiratory illness clusters attributed to human enterovirus 68

    Note: Dr. Chia's research among others correlates enteroviral
    infections with ME and CFS as noted by the author below. Gudrun Lange,
    PhD., who was a member of the distinguished external review panel that
    in 2008 evaluated
    the CFS program at CDC, testified in 2009 saying, "...it is rather
    surprising that CDC has not shown any initiative to address obvious
    research questions posed by the H1N1 epidemic. Why are we not
    surveilling the population for postinfectious fatigue following H1N1?
    The question again may be whether the CDC is once again choosing not
    to address the obvious."

    October 10, 2011
    Acute respiratory illness clusters attributed to human enterovirus 68
    Akira Suzuki TI. MMWR. 2011;60:1301-1304.

    Six clusters of respiratory illness-associated human enterovirus 68
    have been recently reported in Asia, Europe and the United States. The
    illness has caused mild to severe infection and three fatalities,
    according to data published in a recent Morbidity and Mortality Weekly
    Report.

    “Clinicians should be aware of [human enterovirus 68 (HEV68)] as one
    of many possible causes of viral respiratory disease and should report
    clusters of unexplained respiratory illness to the appropriate public
    health agency,” the researchers wrote.
    Between 2008 and 2010, six clusters of respiratory illness-associated
    HEV68 were reported:

    21 cases that included two fatalities were reported in the Philippines.
    More than 120 cases, including one fatality were reported in Japan;
    clinical and demographic data were only available on a subset of 11
    pediatric patients.
    24 cases were identified in a prospective, hospital-based study of
    respiratory infections in the Netherlands.
    Six cases were reported in a hospital in Atlanta.
    28 cases were reported in a pediatric hospital in Philadelphia.

    A community hospital in Arizona sent seven nasopharyngeal specimens to
    the CDC; five were identified as HEV68.

    HEV68 cases were confirmed by reverse transcription-polymerase chain
    reaction (RT-PCR) testing in each cluster, followed by partial
    sequencing of the structural protein genes, VP4-VP2, VP1, the gold
    standard test for HEV 68 detection, according to the researchers.

    The researchers cautioned that some diagnostic tests, such as the CDC
    rhinovirus real-time RT-PCR assay, may not detect HEV68 or may
    misidentify the infection as human rhinovirus.

    In an accompanying editorial, CDC officials wrote: “Identification of
    a large number of patients with HEV68 respiratory disease detected
    during a single season, such as described in this report, is a recent
    phenomenon. Whether this increase in recognized cases is attributable
    to improved diagnostics or whether the clusters themselves represent
    an emergence of the pathogen is unknown.”


    For the past few years, it has been realized that many enterovirus
    infections can also be transmitted through the respiratory route.
    Thus, the biologic and clinical borders between the enterovirus and
    the rhinovirus groups are fading, at least in part. HEV68 is peculiar
    in this regard. In fact, since 2002, it is known that HEV68 shares
    antigenic properties with the human rhinovirus 87 (HRV87), that these
    agents are almost genetically identical, that both are acid-sensitive
    and grow better at temperatures lower than 37•C (characteristics that
    are proper of rhinoviruses and that probably explain their lack of
    enteropathogenicity), and that both share the same cellular receptor
    (DAF). Thus, HEV68 and HRV87 are now held as strains of a single virus
    type that presents features of both rhinoviruses and enteroviruses. As
    a consequence, HRV87 has been removed from the rhinovirus group.

    The MMWR researchers suggest that it remains unclear ‘whether this
    increase in recognized HEV68 cases is attributable to improved
    diagnostics or whether the clusters themselves represent an emergence
    of the pathogen.’ Studies conducted in Finland indicate that
    neutralizing antibodies to HEV68 were widely represented in the
    population in 2002. Thus, in at least some communities, this agent is
    not new or rare.

    The report, in any case, recalls pediatricians and clinicians of the
    vast and still undefined array of diseases that are possibly
    associated with the entero/rhinovirus group of agents. This is
    particularly important, since many of these viruses are responsible
    for relevant clinical syndromes, and are suspected to produce, in a
    minority of cases, persistent and severe conditions (eg, dilated
    myocardiopathy, post-polio syndrome, chronic fatigue syndrome with
    fibromyalgia).

    Finally, this work draws attention to the need for specific
    antipicornaviral drugs.

    The necessity of these agents has been recently evidenced by the WHO
    as an essential component of the final steps of the polio eradication
    campaign. In the mean time, the compassionate use of antivirals under
    development and/or intravenous immunoglobulin may be of help in
    critical cases.

    Antonio Toniolo, MD
    University of Insubria, Varese, Italy

    Disclosure: Dr. Toniolo reports no relevant financial disclosures.
    http://www.pediatricsupersite.com/view.aspx?rid=88324
  2. Mikie

    Mikie Moderator

    For citing the origin of this material and that you posted it with permission.

    Love, Mikie