New Cases Of Polio-Like Illness That Paralyses Children Increasing

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In the first six months of this year 32 people, predominantly children, have been diagnosed with a polio like illness called Acute Flaccid Myelitis. The AFM info sheet  published by the California Department of Public Heath gives the following details:

Acute Flaccid Myelitis

In 2012, CDPH began receiving reports of patients with acute flaccid myelitis (AFM). The clinical picture of these patients was similar to that of poliomyelitis, but they were not infected with poliovirus.

Clinical symptoms included respiratory or gastrointestinal prodrome, fever, limb myalgia and pain or burning sensations in weak limbs and/or the back.

Probable/Possible Etiology

The specific cause(s) of this illness are still under investigation. However, these cases are most similar to illnesses caused by viruses, including:

  •  enteroviruses (polio and non-polio)
  •  adenoviruses
  •  flaviviruses (West Nile virus)
  •  herpesviruses

Out of the 32 cases this year only three children have made a full recovery. Last year there were only 21 cases across the United States and nobody is sure why this year has seen a surge in cases, particularly since April.

In 2014 the illness sickened 120 children and only one has completely recovered. There was an outbreak of D68 at the same time and doctors initially thought there was a link between the two conditions but 71 of the children sickened in the 2014 outbreak had no enterovirus in their spinal fluid.

Speaking to The New York Times Dr. Samuel Dominguez an epidemiologist and an infectious disease specialist at Children’s Hospital Colorado said:

“It’s unsatisfying to have an illness and not know what caused it,”

The report goes on to say:

For many families, the onset of persistent limb paralysis has been a bewildering experience. Roughly two thirds of the children with A.F.M. have reported some improvement, according to the C.D.C. About a third show none. Only one child has fully recovered.

And while enterovirus 68 is the prime suspect, the C.D.C. has not ruled out another infectious cause, said Mark A. Pallansch, the director of viral diseases.

The CDC is working to find the cause of the disease that is leaving children with disabilities across the country. At this point they are not saying which states or locations are affected in the latest outbreak of AFM, which is worrying. Warning people that a disease is in their area and publicising the symptoms of that disease makes people more aware and likely to take children for treatment far more quickly than they otherwise would have done. Knowing so little about the disease I would have thought this was of prime importance. Time could be of the essence for these children. From digging around I have found that both Texas and New Hampshire have reported cases of AFM in children.

Take the example of Jack, still suffering from AFM two years after contracting it.

In August, Jack Wernick, a first grader in Kingsport, Tenn., developed a “crummy little cold,” said his father, Dan Wernick, who works for a paper company. It seemed ordinary, until Jack complained that his right arm was heavy, his face began drooping and pain started shooting down his right leg.

Today, Jack still cannot lift his right arm, though he never lost use of the affected leg. He is adapting well, but his mother, Nicole Wernick, says she worries that he will never be able to tie his shoes again or drive when he is older.

“I’ve run out of tears,” she said.

Parents like her are desperate for scientists to identify the cause, and they are already pursuing a number of theories. But the research will be slow and painstaking.

And while enterovirus 68 is the prime suspect, the C.D.C. has not ruled out another infectious cause, said Mark A. Pallansch, the director of viral diseases.

Jack was one of the children who tested negative for the D68 enterovirus.  The Washington Post has the stories of two children whose lives have been changed forever by this mysterious illness.

In May and June 2016, the Department of State Health Services (DSHS) received reports of seven children suspected of having acute flaccid myelitis (AFM). The patients have been reported from Central Texas and the Dallas/Fort Worth Metroplex areas. Prior to May, no AFM cases had been confirmed in Texas in 2016 and five had been reported nationally. Due to the sudden increase in case reports, DSHS is urging clinicians to be aware of AFM and to report suspect cases to DSHS or their local health department (LHD). Reporting of cases will help DSHS monitor clusters or increases in this illness and better understand potential causes, risk factors, and preventive measures.

AFM clinical presentation

Patients with AFM present with acute focal limb weakness, frequently two to three weeks after a respiratory or febrile illness. They may also have facial droop, diplopia, dysphagia, or dysarthria. You can download the full PDF here

There are nowhere near enough answers about AFM coming from public health services. Parents should be alerted to the signs and symptoms of this condition regardless of if it is in their area or not. We are seeing a very low full recovery rate from the disease. Children who don’t fully recover are going to be affected for the rest of their lives and more effort needs to be put into tracking down the cause of this terrifying condition.

Take Care

Liz

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