Cases of polio-like illness, AFM, rise in US

Henrietta Strickland
November 17, 2018

Experts, and the CDC, still don't know what causes the condition.

Puzzled by a rise in US children with sudden paralysis in their arms or legs, health officials are probing whether a virus or auto-immune disorder may be to blame. The pace of cases this year appears to be on track to have the same number as in the past few outbreaks, Messonnier says.

A total of 252 cases of the disorder known as acute flaccid myelitis (AFM) are now under investigation in the U.S., an increase of 33 since last week, said Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the U.S. Centers for Disease Control and Prevention (CDC), in a Tuesday news conference.

It's not clear what's causing some children to lose the ability to move their face, neck, back, arms or legs.

The illness usually starts as a fever and seemingly routine respiratory symptoms. No one has died from it this year, but CDC officials say at least half the patients do not recover from the paralysis and some have serious complications. There is no evidence the condition is being caused by the polio virus. Doctors have suspected the cause might be some kind of enterovirus, which in most people causes cold symptoms. The spinal cord fluid was positive in two cases. Another type of enterovirus called EV-A71 was found in only one other patient. "It's also possible the infection is triggering the body's own immune response, and it's actually the immune response that's causing AFM".

"What we need to sort out is what is the trigger for the AFM", Messonnier said.

Parents and even some scientists have criticized the agency for not solving the riddle. "And I know parents want answers", Dr. Nancy Messonnier, director of the CDC's National Center for Immunization and Respiratory Diseases, said during a briefing for reporters. "I'm frustrated. I want answers too", said Messonnier, who is overseeing the agency's outbreak investigation.

During a CDC press briefing Tuesday, Dr. Nancy Messonnier, director for the National Center for Immunizations and Respiratory Diseases said, "CDC has tested 125 spinal cord fluid respiratory and stool specimens from 71 of the 80 confirmed AFM cases (the number of confirmed cases reported as of November 5)". More than 400 cases have been confirmed through lab tests since 2014, the first year the syndrome emerged. Another 149 were reported in 2016. A couple dozen cases were confirmed in 2015 and 2017.

The illnesses have spiked in September each year there's been a wave and tailed off significantly by November. Enteroviruses and rhinoviruses were found in about half of respiratory or stool specimens taken from patients with confirmed cases of AFM, Messonnier said.

Other reports by Click Lancashire

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