Institute of Social and Preventive Medicine, University of Bern, Switzerland.
Department of Neurology, Bern University Hospital, Inselspital, University of Bern, Switzerland.
Swiss Med Wkly. 2023 Feb 8;153:40045. doi: 10.57187/smw.2023.40045.
Poliomyelitis-like acute flaccid myelitis associated with enterovirus D68 (EV-D68) has emerged globally during the past decade. Here we describe the first documented case reported from Switzerland, and a second, suspected case occurring in temporal association. AFM occurs primarily in children, is usually heralded by a febrile, respiratory prodrome followed by acute-onset, usually asymmetrical, limb weakness with some predilection for the upper extremities, and respiratory muscle compromise in one third of reported cases. There is no specific therapy and the majority of cases result in permanent neurological sequelae. A comprehensive diagnostic workup and timely reporting to the health authorities are essential. Surveillance of respiratory and stool samples for EV-D68 and other neurotropic enteroviruses is in place in several European countries and warrants consideration in Switzerland. This could entail the extension of the poliomyelitis surveillance program of the Federal Office of Public Health by monitoring and enteroviral typing of respiratory samples from patients with acute flaccid paralysis.
在过去十年中，与肠病毒 D68（EV-D68）相关的脊髓灰质炎样急性弛缓性脊髓炎在全球范围内出现。在此，我们描述了首例从瑞士报告的病例，以及第二例疑似病例，它们在时间上存在关联。急性弛缓性脊髓炎主要发生在儿童中，通常以发热、呼吸道前驱症状为前驱，随后出现急性发作、通常为不对称性的肢体无力，上肢受累较多，三分之一的报告病例存在呼吸肌受累。目前尚无特异性治疗方法，大多数病例会导致永久性神经后遗症。全面的诊断性检查和及时向卫生当局报告至关重要。在几个欧洲国家已经对呼吸道和粪便样本中的 EV-D68 和其他神经营养性肠道病毒进行了监测，瑞士也有必要考虑进行监测。这可能需要通过监测和对急性弛缓性麻痹患者的呼吸道样本进行肠道病毒分型，来扩展联邦公共卫生局的脊髓灰质炎监测计划。
