As more cases confirmed, CDC says evidence suggests 'viral association' for AFM

Maricruz Casares
Noviembre 14, 2018

Parents of children who had a horrifying polio-like illness are accusing the Centers for Disease Control of hiding the deaths of two children who suffered from the condition. The pace of cases this year appears to be on track to have the same number as in the past few outbreaks, Messonnier says.

A total of 252 cases of the disorder known as acute flaccid myelitis (AFM) are now under investigation nationwide, an increase of 33 since last week, said Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the US Centers for Disease Control and Prevention (CDC). Nearly all complained of fever and respiratory illness three to 10 days before suddenly experiencing paralysis in their arms or legs.

Health officials saw the first wave of AFM cases in 2014, when 120 cases were confirmed in the United States. No one has died from it this year, but CDC officials say at least half the patients do not recover from the paralysis and some have serious complications.

The CDC has tested 125 spinal cord fluid samples, and half were positive for rhinovirus or enterovirus, which commonly cause symptoms like fever, runny nose, vomiting, diarrhea and body aches. But CDC officials say that's not clear.

Messonnier said the CDC has not been tracking every case of AFM since 2014, leading to gaps in the federal agency's knowledge of the illness, which experts are now trying to fill.

The illness tends to spike in the fall every other year. Another type of enterovirus called EV-A71 was found in another patient.

But there are questions about that, too.

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For example, if the illness is caused by a virus, Messonnier said, it is possible that the now available tests are unable to pick it up, or perhaps the germ has already cleared the spinal fluid by the time the testing was conducted, or that it is hidden elsewhere in the body.

Or perhaps the paralyzing illnesses are caused by some new germ for which no lab test has been developed.

Another theory is that there's something in certain individuals that predisposes their immune system to react so severely that it triggers paralysis.

Parents and even some scientists have criticized the agency for not solving the riddle.

Messonnier said she understands parents' alarm but stressed that the disorder remains "rare". While the disease is rare, there have been more cases this year than ever before. Another 149 were reported in 2016.

A couple dozen cases were confirmed in 2015 and 2017. But it can take weeks to determine which cases should be counted in the outbreak. There are a total of 252 cases now under investigation.

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