CDC Expresses Concerns Regarding Increase in Number of Acute Flaccid Myelitis Cases

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A spike in the number of children with a rare neurological disease that causes polio-like symptoms has health officials across the country scrambling to understand the illness.

Two children from Allegheny County and one from Washington County remain in Children's Hospital with the "modern polio" disease, for which the main symptom is weakness of one or more limbs. Ninety percent of those affected are children.

"Many times it can start with what looks like a respiratory illness, a little bit of a fever", Tara Narula, a cardiologist and medical contributor to CBS News, told CBS This Morning. "It affects the nervous system, specifically the area of spinal cord called gray matter, which causes the muscles and reflexes in the body to become weak". The average age is 4 years old. The federal Centers for Disease Control and Prevention is investigating 127 cases of possible AFM, including 62 that have been confirmed in 22 states this year.

Dr. Messonnier added that there has not been any significant geographic clustering, and the peaks of the disease have been late summer and early fall-though every other year, in 2014, 2016, and now, 2018. The CDC will determine if the samples are positive for AFM.The cases were reported from hospitals in Birmingham a Mobile.

King's Daughters pediatrician Dr. Aaron McGuffin says the condition is getting more attention because of the severity of the symptoms. Many people who had polio as children and recovered suffered muscle weakness again decades later.

"Obviously it would be very disconcerning if your child suddenly can not move their arms and their legs or their eye movements change or their face started to droop and those sorts of things", McGuffin said.

Still, because this is a "pretty dramatic disease", Messonnier said health officials want to raise awareness about the symptoms to make sure parents seek medical care immediately if their children show a sudden onset of weakness or loss of muscle tone in their arms and legs. The CDC emphasized that none of the children who developed these symptoms had the polio virus. Also, reporting of AFM is still voluntary in most states, so it's not clear how many cases have gone unreported or misdiagnosed.

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"This is truly a mystery disease", Messonnier told CBS News. "We don't know if it's a virus or an autoimmune process that's secondary to the virus". "For some of the previous cases we've identified one pathogen or another, but we have no unifying diagnosis".

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. None of the USA patients tested positive for polio, a crippling and often deadly disease which was eliminated in this country thanks to the polio vaccine. That virus was closely linked to the 2014 outbreak, he says.

Pavia agrees enterovirus D68 is the most likely cause for the majority of AFM cases, but "we have to wait and see" whether this year's outbreak will follow the same pattern as 2014 and 2016.

Unfortunately, there is now no specific treatment plan for the disease, though medics may advise physical or occupational therapy on a case-by-case basis.

"We know that some patients diagnosed with AFM have recovered quickly and some continue to have paralysis and require ongoing care". "If they can't breathe, we put them on a ventilator".

Hunter was hospitalized with AFM when he was 15 months old.

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