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Thursday, October 9, 2014


Investigation of Acute Neurologic Illness with Focal Limb Weakness of Unknown Etiology in Children, Fall 2014

The Centers for Disease Control and Prevention (CDC) is working closely with the Colorado Department of Public Health and Environment (CDPHE) and Children’s Hospital Colorado to investigate a cluster of pediatric patients hospitalized with acute neurologic illness of undetermined etiology characterized by focal limb weakness and abnormalities of the spinal cord gray matter on MRI.

On September 26, CDC issued a request to all states to look for and report other similar neurologic illnesses. We are receiving reports and will update this website with new available data every Wednesday.


As of October 8, CDC has verified reports of 17 cases in 12 states that meet our case definition below. We are working with healthcare professionals and state and local officials to investigate all of these cases.
We are also in the process of verifying dozens of additional reports. These investigations take time and are in the early stages. Therefore, the number of cases will likely increase as we update these numbers weekly on Wednesday, but the increase will not necessarily reflect changes in occurrence of cases in real time.

Case Definition

Persons who meet the case definition should be reported to state and local health departments.
To be considered a case, a patient must meet ALL 4 of the following criteria:
  1. Patient ≤21 years of age,
  2. Acute onset of focal limb weakness,
  3. On or after August 1, 2014, AND
  4. An MRI showing a spinal cord lesion largely restricted to gray matter

Patient Summary Form

CDC requests that state and local health departments report persons meeting the case definition to CDC using a patient summary form:

  • Acute Neurological Illness with Limb Weakness in Children: Patient Summary Form Word[v 2.0, 6 pages]
  • Acute Neurological Illness with Limb Weakness in Children: Patient Summary Form PDF[v 2.0, 6 pages]
State health departments should send completed investigation forms to CDC by email at or via secure fax at 404-471-8442.

Specimen Collection Instructions

Providers should follow these Specimen Collection Instructions for collecting specimens from patients that meet all 4 criteria of the case definition.
Health departments may contact CDC for further laboratory and epidemiologic support by phone through the CDC Emergency Operations Center (770-488-7100), or by email at Confirmation of the presence of EV-D68 currently requires typing by molecular sequencing.

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