The Centers for Disease Control and Prevention (CDC) issued a health advisory Friday concerning an investigation of a cluster of nine pediatric patients hospitalized with acute neurologic illness of undetermined etiology mostly in the Denver, Colorado area. The CDC is doing the investigation in concert with the Colorado Department of Public Health and Environment (CDPHE) and Children’s Hospital Colorado.

Colorado counties map/David Benbennick
Colorado counties map/David Benbennick

The nine cases were identified during August 9–September 17, 2014 among children aged 1–18 years (median age 10 years). Most of the children were from the Denver metropolitan area. All were hospitalized.

The CDC says common features included acute focal limb weakness and specific findings on magnetic resonance imaging (MRI) of the spinal cord consisting of non-enhancing lesions largely restricted to the gray matter. Most children reported a febrile respiratory illness in the two weeks preceding development of neurologic symptoms.

The investigation shows CSF testing to date has been negative for West Nile virus and enteroviruses, including poliovirus. Nasopharyngeal specimens were positive for rhinovirus/enterovirus in six out of eight patients that were tested. Of the six positive specimens, four were typed as EV-D68, and the other two are pending typing results. Testing of other specimens is still in process. Eight out of nine children have been confirmed to be up to date on polio vaccinations. Epidemiologic and laboratory investigations of these cases are ongoing.

From mid-August to September 26, 2014, CDC or state public health laboratories have confirmed a total of 279 people from 40 states and the District of Columbia with respiratory illness caused by EV-D68. The possible linkage of this cluster of neurologic disease to this large EV-D68 outbreak is part of the current investigation. For more infectious disease news and information, visit and “like” the Infectious Disease News Facebook page