Enterovirus D68 (EV-D68) has emerged worldwide as an important cause of respiratory disease. Between mid-August 2014 and January 15, 2015, the Centers for Disease Control and Prevention confirmed 1153 cases of EV-D68–associated respiratory illness originating from 49 states.

With this outbreak, there have been at least 107 cases of children presenting with acute flaccid myelitis associated with lesions identified on magnetic resonance imaging that were largely restricted to the spinal gray matter.

Children with this syndrome typically present with an acute febrile respiratory syndrome followed within 2 weeks by the development of acute flaccid myelitis, characterized by motor weakness, decreased tone and reflexes, and relatively preserved sensation. 

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