A mysterious “polio-like” illness has been striking children in Washington state. The Washington State Department of Health confirmed that 8 of 9 children who were exhibiting symptoms of Acute Flaccid Myelitis (AFM), a highly contagious polio-like disease, were confirmed to have the illness. AFM first spiked in the U.S. in 2014, when there were 120 people diagnosed in 34 states. In 2015 there were 21 people diagnosed in 16 states. According to the Centers for Disease Control, 89 people in 33 states have been diagnosed with AFM so far this year, 37 of them in September.
Dr. Kevin Messacar, a pediatric infectious disease physician and researcher at Children’s Hospital Colorado, says the condition is still not common. “This is a very rare condition,” he said, “but I think it’s important that we take it seriously because it does have long-term and potentially disabling consequences.”
“The key with AFM is that it’s sudden onset,” said Dr. Manisha Patel, AFM team lead at the CDC and a practicing pediatrician. “Symptoms include limb weakness, facial drooping and difficulty swallowing and talking,” Patel said. “AFM is an illness that can be seen with a variety of different causes. The most famous one is polio, but there are also enteroviruses, which are circulating very broadly in the US and other countries.”
Messacar says, “It’s important to understand that there’s a wide spectrum of severity of this disease. On one end, you see mild weakness in one extremity. On the other, you’ve got children who have lost the ability to breathe on their own and exhibit complete paralysis in their arms and legs.”
Both Drs. Patel and Messacar are in agreement that no therapies exist that are proven to work, but that early detection and treatment are vital. According the the CDC’s website:
A doctor can tell the difference between AFM and other diseases with a careful examination of the nervous system, looking at the location of the weakness, muscle tone and reflexes. Magnetic resonance imaging (MRI) can be very helpful in diagnosing cases of AFM. Finally, by testing the cerebrospinal fluid (CSF, the fluid bathing the brain and spinal cord), clinicians can look for findings suggestive of AFM.
The disease is most likely viral in nature but could also be caused by Guillain-Barre Syndrome, genetic disorders, or environmental toxins.
Patel recommends taking logical precautions like washing hands, getting vaccinated, and avoiding mosquito bites. AFM has been linked to West Nile Virus and other strains in the same family.
Messacar says there is a bit of hope in the situation in that “Enteroviruses tend to appear in the late summer and early fall and go away in the winter. We understand this condition better than we did in 2014, but there’s still a lot to learn. The process is slow, but progress is being made.”