Enterovirus D68: a test case for the use of immunological surveillance to develop tools to mitigate the pandemic potential of emerging pathogens

Abstract

In the autumn of 2014, the USA faced an unexpected spike in cases of previously healthy children stricken with polio-like paralysis following a febrile respiratory illness. Since that time, research efforts have shed light on the causes, mechanisms, and outcomes of this disease, now termed acute flaccid myelitis.1 However, subsequent seasonal outbreaks have continued, in North America and Europe in 2016 and 2018, and have been increasingly recognised around the globe. To date, there remain no known effective treatments or prevention strategies for acute flaccid myelitis, which has left over 650 children in the USA profoundly affected, most with permanent paralysis.