Federal health officials are asking parents and health workers to be able to look for symptoms of a mysterious paralyzing disease among children before the expected seasonal outbreak in the next few months.
Polio is called acute lukewarm myelitis or AFM and tends to peak every other year in the United States. The latest jump in cases was in 2018, when a record 238 cases were registered in 42 states, according to the Centers for Disease Control and Prevention.
In the same year, 35% of patients were not hospitalized for two or more days after showing signs of limb weakness, making it difficult for children to be detected early and getting a full recovery, the CDC said.
“AFM can progress rapidly over hours or days, leading to permanent paralysis and / or a life-threatening complication of respiratory failure in previously healthy patients, so delays in care can be serious,”
“Parents and doctors should suspect AFM in patients with sudden limb weakness, especially in August to November,” the CDC added. “Recent respiratory illness or fever and the presence of neck or back pain or some neurological symptom should increase their concern.”
There is no proven method for treating, testing, or preventing AFM, which had the first known peak of 120 cases in the United States alone in 2014.
Most patients had fever and / or respiratory disease for approximately six days before showing signs of limb weakness. Almost all patients, or 98%, were hospitalized, and slightly more than half were admitted to the intensive care unit. Of those hospitalized, a quarter need ventilation, the CDC said.
“Recognition and early diagnosis are crucial,” CDC Director Robert Redfield said in a statement. “The CDC and public health partners have strengthened systems for early detection of the disease, a vital step towards rapid treatment and rehabilitation for children with AFM.
Enteroviruses that enter the gut are thought to be responsible for the increase in cases every other year. The most common virus identified among patients is EV-D68, but other viruses can cause the condition. Although the symptoms of AFM resemble polio, all samples taken from patients tested negative for the virus, the CDC said.
The researchers said more information was needed, especially in determining whether the condition was linked to a virus that directly attacked the central nervous system or whether the immune response played a role.
“Further research is needed to assess risk factors, establish a causal relationship and develop a more comprehensive understanding of the mechanisms that lead to AFM,” the researchers said in a study published last fall.
CDC guidelines for preventing enterovirus infection include washing hands with soap and water for at least 20 seconds; avoid touching eyes, noses and mouths with unwashed hands; avoiding close contact with sick people; cover cough and sneeze with a sleeve of cloth or shirt; cleaning and disinfection of frequently touched surfaces; and stay home when they are sick.
Health officials have expressed uncertainty about whether the current COVID-19 pandemic will complicate early detection of patients or whether efforts to socially distance themselves and improve hand washing will reduce the risk of occurrence.
“These practices can lead to reduced circulation of other viruses, including enteroviruses, and therefore either increase or slow down AFM this year,” said Dr. Janele Ruth, CDC medical officer and AFM team leader, at a presentation last month. .
Rachel Scott – whose son, Braden, was 5 when he was diagnosed with AFM in 2016 – formed the Acute Flaccid Myelitis Association in early 2019. She recently spoke about her diagnosis and ongoing recovery to inform other parents and medical professionals about the condition and importance of early detection.
“I really believe that awareness of AFM will save children in the coming months. “Even in our current pandemic, parents need to know that any form of limb weakness after a cold must be taken seriously,” she said during the CDC’s presentation to the AFC last month.
Her son is one of the earliest known examples of the condition. He became almost completely paralyzed after contracting something that looked like a common cold – something Rachel Scott said her other children had become infected and recovered.
“I attributed everything to what I believed was a sore throat. I think he was weak because he didn’t eat and he didn’t eat because his throat hurt. “We never had fun with the possibility of his muscles being paralyzed when he swallowed and the paralysis spreading slowly throughout his body,” she said.
Due to uncertainty about his condition, Braden was not immediately hospitalized and was not properly diagnosed by doctors. Rachel Scott said she wondered how different his life would be today if he knew what to look for at the time.
Today, after years of daily physical therapy and undergoing nerve transfer and decompression, Braden is able to travel short distances independently and has regained his certain ability to swallow on his own, she said.
“Our battle is endless,” Rachel Scott said. “We are so desperate for more awareness and more research that children can be treated quickly and effectively.”
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