A probable case of poliomyelitis imported to Malaysia

Chee Geap Tay, Lai Choo Ong, Khean Jin Goh, Kartini Rahmat, Choong Yi Fong

Research output: Contribution to journalArticle

Abstract

We report a previously well 10-month-old Somalian girl who acquired asymmetric lower limb weakness in July 2013 in Mogadishu, Banadir, before arriving in Malaysia at 12 months of age. In May 2013, there was a wild poliomyelitis outbreak in that area, as reported by the World Health Organization. Laboratory investigation, including cerebrospinal fluid, was unremarkable, and electrophysiological studies showed active axonal denervation in the left lower limb. The whole spine T2-weighted MRI revealed non-enhancing hyperintensities of the bilateral anterior horn cells, predominantly on the left side at T11-12. The viral isolations from two stool specimens at her presentation to our centre, 2 months after the onset of illness and 2 weeks apart, were negative. Despite lacking the acute virological evidence of poliomyelitis, in view of the girl's clinical, electrophysiological and classical spinal neuroradiological features, together with her temporal relationship with a World Health Organization reported wild poliomyelitis outbreak, we believe these findings are consistent with a diagnosis of imported poliomyelitis. A review at 30 months of age showed persistent left lower limb monoplegia with little recovery. Our patient reiterates the importance of maintaining awareness of wild polio importation, and keeping abreast of the latest news of global poliomyelitis outbreaks when treating patients with flaccid paralysis, even if they arrive from non-endemic poliomyelitis areas.

Original languageEnglish
Pages (from-to)1994-1995
Number of pages2
JournalJournal of Clinical Neuroscience
Volume22
Issue number12
DOIs
Publication statusPublished - 1 Dec 2015
Externally publishedYes

Fingerprint

Malaysia
Poliomyelitis
Disease Outbreaks
Lower Extremity
Anterior Horn Cells
Hemiplegia
Denervation
Paralysis
Cerebrospinal Fluid
Spine

Keywords

  • Acute flaccid paralysis
  • Anterior horn cells
  • MRI spine
  • Poliomyelitis

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Physiology (medical)

Cite this

Tay, C. G., Ong, L. C., Goh, K. J., Rahmat, K., & Fong, C. Y. (2015). A probable case of poliomyelitis imported to Malaysia. Journal of Clinical Neuroscience, 22(12), 1994-1995. https://doi.org/10.1016/j.jocn.2015.07.001

A probable case of poliomyelitis imported to Malaysia. / Tay, Chee Geap; Ong, Lai Choo; Goh, Khean Jin; Rahmat, Kartini; Fong, Choong Yi.

In: Journal of Clinical Neuroscience, Vol. 22, No. 12, 01.12.2015, p. 1994-1995.

Research output: Contribution to journalArticle

Tay, CG, Ong, LC, Goh, KJ, Rahmat, K & Fong, CY 2015, 'A probable case of poliomyelitis imported to Malaysia', Journal of Clinical Neuroscience, vol. 22, no. 12, pp. 1994-1995. https://doi.org/10.1016/j.jocn.2015.07.001
Tay, Chee Geap ; Ong, Lai Choo ; Goh, Khean Jin ; Rahmat, Kartini ; Fong, Choong Yi. / A probable case of poliomyelitis imported to Malaysia. In: Journal of Clinical Neuroscience. 2015 ; Vol. 22, No. 12. pp. 1994-1995.
@article{d45b559601674757acafb7a11c6a132b,
title = "A probable case of poliomyelitis imported to Malaysia",
abstract = "We report a previously well 10-month-old Somalian girl who acquired asymmetric lower limb weakness in July 2013 in Mogadishu, Banadir, before arriving in Malaysia at 12 months of age. In May 2013, there was a wild poliomyelitis outbreak in that area, as reported by the World Health Organization. Laboratory investigation, including cerebrospinal fluid, was unremarkable, and electrophysiological studies showed active axonal denervation in the left lower limb. The whole spine T2-weighted MRI revealed non-enhancing hyperintensities of the bilateral anterior horn cells, predominantly on the left side at T11-12. The viral isolations from two stool specimens at her presentation to our centre, 2 months after the onset of illness and 2 weeks apart, were negative. Despite lacking the acute virological evidence of poliomyelitis, in view of the girl's clinical, electrophysiological and classical spinal neuroradiological features, together with her temporal relationship with a World Health Organization reported wild poliomyelitis outbreak, we believe these findings are consistent with a diagnosis of imported poliomyelitis. A review at 30 months of age showed persistent left lower limb monoplegia with little recovery. Our patient reiterates the importance of maintaining awareness of wild polio importation, and keeping abreast of the latest news of global poliomyelitis outbreaks when treating patients with flaccid paralysis, even if they arrive from non-endemic poliomyelitis areas.",
keywords = "Acute flaccid paralysis, Anterior horn cells, MRI spine, Poliomyelitis",
author = "Tay, {Chee Geap} and Ong, {Lai Choo} and Goh, {Khean Jin} and Kartini Rahmat and Fong, {Choong Yi}",
year = "2015",
month = "12",
day = "1",
doi = "10.1016/j.jocn.2015.07.001",
language = "English",
volume = "22",
pages = "1994--1995",
journal = "Journal of Clinical Neuroscience",
issn = "0967-5868",
publisher = "Churchill Livingstone",
number = "12",

}

TY - JOUR

T1 - A probable case of poliomyelitis imported to Malaysia

AU - Tay, Chee Geap

AU - Ong, Lai Choo

AU - Goh, Khean Jin

AU - Rahmat, Kartini

AU - Fong, Choong Yi

PY - 2015/12/1

Y1 - 2015/12/1

N2 - We report a previously well 10-month-old Somalian girl who acquired asymmetric lower limb weakness in July 2013 in Mogadishu, Banadir, before arriving in Malaysia at 12 months of age. In May 2013, there was a wild poliomyelitis outbreak in that area, as reported by the World Health Organization. Laboratory investigation, including cerebrospinal fluid, was unremarkable, and electrophysiological studies showed active axonal denervation in the left lower limb. The whole spine T2-weighted MRI revealed non-enhancing hyperintensities of the bilateral anterior horn cells, predominantly on the left side at T11-12. The viral isolations from two stool specimens at her presentation to our centre, 2 months after the onset of illness and 2 weeks apart, were negative. Despite lacking the acute virological evidence of poliomyelitis, in view of the girl's clinical, electrophysiological and classical spinal neuroradiological features, together with her temporal relationship with a World Health Organization reported wild poliomyelitis outbreak, we believe these findings are consistent with a diagnosis of imported poliomyelitis. A review at 30 months of age showed persistent left lower limb monoplegia with little recovery. Our patient reiterates the importance of maintaining awareness of wild polio importation, and keeping abreast of the latest news of global poliomyelitis outbreaks when treating patients with flaccid paralysis, even if they arrive from non-endemic poliomyelitis areas.

AB - We report a previously well 10-month-old Somalian girl who acquired asymmetric lower limb weakness in July 2013 in Mogadishu, Banadir, before arriving in Malaysia at 12 months of age. In May 2013, there was a wild poliomyelitis outbreak in that area, as reported by the World Health Organization. Laboratory investigation, including cerebrospinal fluid, was unremarkable, and electrophysiological studies showed active axonal denervation in the left lower limb. The whole spine T2-weighted MRI revealed non-enhancing hyperintensities of the bilateral anterior horn cells, predominantly on the left side at T11-12. The viral isolations from two stool specimens at her presentation to our centre, 2 months after the onset of illness and 2 weeks apart, were negative. Despite lacking the acute virological evidence of poliomyelitis, in view of the girl's clinical, electrophysiological and classical spinal neuroradiological features, together with her temporal relationship with a World Health Organization reported wild poliomyelitis outbreak, we believe these findings are consistent with a diagnosis of imported poliomyelitis. A review at 30 months of age showed persistent left lower limb monoplegia with little recovery. Our patient reiterates the importance of maintaining awareness of wild polio importation, and keeping abreast of the latest news of global poliomyelitis outbreaks when treating patients with flaccid paralysis, even if they arrive from non-endemic poliomyelitis areas.

KW - Acute flaccid paralysis

KW - Anterior horn cells

KW - MRI spine

KW - Poliomyelitis

UR - http://www.scopus.com/inward/record.url?scp=84948712260&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84948712260&partnerID=8YFLogxK

U2 - 10.1016/j.jocn.2015.07.001

DO - 10.1016/j.jocn.2015.07.001

M3 - Article

VL - 22

SP - 1994

EP - 1995

JO - Journal of Clinical Neuroscience

JF - Journal of Clinical Neuroscience

SN - 0967-5868

IS - 12

ER -