The Mercury News

Mysterious polio-like condition hitting kids

CDC: Average age of 4 in 62 confirmed cases in 22 states

- By Lena H. Sun

Federal health officials are worried about an increase in a mysterious and rare condition that mostly affects children and can paralyze arms and legs, with 127 confirmed or suspected cases reported as of Tuesday.

Of those, 62 cases of acute flaccid myelitis, or AFM, have been confirmed in 22 states, according to Nancy Messonnier, a top official at the Centers for Disease Control and Prevention. More than 90 percent of the confirmed cases have been in children 18 and younger, with the average age being 4 years old.

The surge in cases has baffled health officials, who on Tuesday took the unusual step of announcing a change in the way the agency will count cases in the future. They also wanted to raise awareness about the frightenin­g

condition so parents can seek medical care if their child develops symptoms, and so reports of the illness can be quickly relayed back to the CDC.

“We understand that people, particular­ly parents, are concerned about AFM,” said Messonnier, director of the National Center for Immunizati­on and Respirator­y Diseases. Despite extensive laboratory and other testing, the CDC has not been able to find the cause for the majority of the cases. “There is a lot we don’t know about AFM, and I am frustrated that despite all of our efforts, we haven’t been able to identify the cause of this mystery illness.”

The increase in cases has been happening since 2014, usually in August and September, but only in 2014 and

“We know this can be frightenin­g for parents, and I know many parents want to know what signs and symptoms they should be looking out for in their children.” — Nancy Messonnier, a top official at the Centers for Disease Control and Prevention

2016, Messonnier said in a news briefing with reporters. The CDC knows of one child who died with the disorder in 2017.

Since officials have been unable so far to determine how the disease spreads, they are starting to count suspected cases as well as confirmed to better anticipate increases in confirmed cases over the coming months, she said.

There is no specific treatment for the disorder, and long-term outcomes are unknown. The rare but serious disorder affects a person’s nervous system, specifical­ly the spinal cord. Neurologic­al conditions like it have a variety of causes, such as viruses, environmen­tal toxins and genetic disorders.

Among the cases under investigat­ion are five reported to Maryland health officials in recent weeks, a health department spokeswoma­n said Tuesday. Maryland’s first case was reported Sept. 21. No known cases have been reported in Virginia or the District of Columbia this year, but there were three confirmed cases in Virginia in 2016, health department officials said.

“We know this can be frightenin­g for parents, and I know many parents want to know what signs and symptoms they should be looking out for in their

children,” Messonnier said.

Parents should seek medical care right away if their child develops sudden weakness or loss of muscle tone in the arms and legs.

Some patients diagnosed with this condition have recovered quickly, but some continue to have paralysis and require ongoing care, she said.

CDC began tracking the condition in 2014, when there were 120 confirmed cases. Then in 2016, there were 149 confirmed cases. Officials said it’s too early to know whether the total for 2018 will surpass those previous years. But the data reported Tuesday represents “a substantia­lly larger number than in previous months this year,” Messonnier said.

She said it was important for parents and clinicians to remember that this is a rare condition, affecting less than 1 in 1 million people under 18. “As a parent myself, I understand

what it’s like to be scared for your child,” she said. “Parents need to know that AFM is rare even with the increase in cases we are seeing now.”

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 in their arms and legs.

The agency knows that poliovirus is not the cause of these cases, because CDC has tested every single stool specimen from patients, and none have tested positive for poliovirus. Messonnier said West Nile virus, which had been listed as a possible cause on CDC’s website, is not causing the illnesses.

In some individual­s, health officials have determined that the condition was from infection with a type of virus that causes severe respirator­y illness.

So far, the CDC has found no relationsh­ip between vaccines and children diagnosed with AFM from the 2014 cases. Officials will be conducting additional analysis on this year’s cases.

“Our medical team has been reviewing vaccine records when available during this year’s investigat­ion and do not see a correlatio­n,” said CDC spokeswoma­n Kristen Nordlund.

The disorder has been diagnosed in children who have received some of their recommende­d vaccinatio­ns and in unvaccinat­ed children, she said.

The CDC is not releasing a list of the 22 states with confirmed and suspected cases because of privacy issues. But some state health department­s have been making public their reported cases. States are not required to provide this informatio­n to CDC, but they have been voluntaril­y reporting their data.

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