62 cases of AFM confirmed across 22 states: CDC

Pearl Mccarthy
October 17, 2018

A rare condition causing weakness in the arms or legs - and sometimes paralysis - has been confirmed in 62 children so far this year, the Centers for Disease Control and Prevention said Tuesday.

The CDC will determine whether the suspected cases in Maryland are AFM based on clinical information and lab tests, a spokeswoman for the state health department said in an email.

"CDC has been actively investigating AFM, testing specimens and monitoring disease since 2014, when we first saw an increase in cases", Messonnier said.

More than 120 confirmed or possible cases are under investigation nationwide, according to the CDC.

"Despite a lot of investigation by CDC and our partners, AFM remains a mystery disease", said Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases for the CDC. And in very rare cases, AFM can trigger fatal neurological complications, according to the CDC.

The spikes were significantly higher in 2014, 2016 and 2018-to-date than in 2015 or 2017. For example, 11 of the Colorado cases of AFM this year have tested positive for EV A71, a rare type of enterovirus not usually seen in the U.S., rather in Asia and other parts of the world, according to state epidemiologist Dr. Rachel Herlihy.

AFM may be caused by other viruses, including enterovirus, environmental toxins and a condition in which the body's immune system attacks and destroys tissue that it mistakes for foreign material, Messonnier said: "This is a mystery so far, and we haven't solved it yet, so we have to be thinking broadly". Several cases have been linked to enteroviruses or other germs, but officials have not been able to find a cause for the majority of these cases.

Symptoms include arm and leg weakness, loss of muscle tone and reflexes, in addition to facial drooping or weakness, difficulty moving the eyes, drooping eyelids, difficulty with swallowing or slurred speech.

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The outlook for patients with AFM can vary from a quick recovery to ongoing paralysis, Messonnier said. "As a parent myself, I understand what it's like to be scared for your child", she said.

Officials said they will be conducting additional analysis on this year's cases.

One child has died of the condition, called acute flaccid myelitis, or AFM. A spokeswoman for hospital said they have notified the health department and are working with the CDC to learn more about the illness.

Messonnier said it was important for parents and clinicians to remember that this is a rare condition, affecting less than one in 1 million children under 18. "We just don't know enough". Then in 2016, there were 149 confirmed cases.

The agency doesn't know who may be at higher risk for developing this condition or the reasons they may be at higher risk.

There is no specific treatment for AFM, but neurologists who specialize in treating brain and spinal cord illnesses may recommend certain interventions, such as physical or occupational therapy, on a case-by-case basis.

The CDC referred calls to individual state health departments.

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