Mysterious polio-like disease has reached a record high with 158 cases this year

The polio-like disease that causes paralysis in children has reached a record high, health officials in the US have confirmed.

Acute flaccid myelitis, which leaves youngsters unable to move their face, neck, back or limbs, has been confirmed in 158 youngsters so far this year.

This is nine more than in 2016 and a staggering 155 more than when the disease emerged in the country just six years ago.

Although no children who developed AFM this year have died, around half have been admitted to intensive care and hooked up to ventilators to help them breathe.

The figures come after Government officials said last week cases appeared to have peaked.

The polio-like disease that causes paralysis in children reached record numbers with 158 confirmed cases. Pictured is five-year-old Carter Roberts, of Richmond, Virginia, who died in September after catching the disease in 2016. No deaths have been reported in this outbreak

AFM is a rare but serious condition that attacks the area of the spinal cord called gray matter, which causes the body’s muscles and reflexes to weaken.  

Patients first develop flu-like symptoms, which slowly turn into muscle weakness, difficulty moving the eyes and finally polio-like symptoms, including facial drooping and difficulty swallowing. 

‘If [AFM affects gray matter] lower in the spinal cord [paralysis will] be more in the legs and, if it’s higher up, it’ll be more in the arms,’ Dr Fernando Acosta, a pediatric neurologist at Cook Children’s Medical Center, in Fort Worth, Texas, told DailyMail.com in an interview in October.

‘Or if it’s closer to the neck, they can’t move head, neck and shoulders. We had one case of that and that was just awful.’

In severe cases, respiratory failure can occur when the muscles that support breathing become weak. In rare cases, AFM can cause life-threatening neurological complications.

AFM first emerged in 2012, with just three cases. The number of incidences has since surged, with outbreaks occurring biannually. This has left experts stumped as to the disease's cause  

AFM first emerged in 2012, with just three cases. The number of incidences has since surged, with outbreaks occurring biannually. This has left experts stumped as to the disease’s cause  

Although no children who developed AFM this year have died, around half were admitted to intensive care and hooked up to ventilators to help them breathe. Pictured is five-year-old Elizabeth Storrie, of Willow Park, Texas, who was one of 2018's confirmed cases

Although no children who developed AFM this year have died, around half were admitted to intensive care and hooked up to ventilators to help them breathe. Pictured is five-year-old Elizabeth Storrie, of Willow Park, Texas, who was one of 2018’s confirmed cases

AFM was first reported in 2012, when three cases of extreme limb weakness were noted in California. 

The disease has been likened to polio, which struck tens of thousands of children a year in the US before its vaccine was introduced in the 1950s. However, this virus is not thought to be responsible for the outbreaks.

AFM went on to affect at least 120 children in 2014, followed by 149 confirmed cases two years later. For unclear reasons, incidences were much lower in 2015 and 2017, however, one child died from the disease last year.

The paralysis, which can be lasting, may be caused by the EV-D68 virus, which is a distant relative of polio and coincided with many cases in 2014. 

Dr Ruth Lynfield, a member of a AFM Task Force established by the Center for Disease Control and Prevention (CDC) to offer advice to investigators, calls EV-D68 ‘the leading hypothesis’. EV-A71, another polio relative, and rhinovirus are also suspects.

However, outbreaks since 2014 have not strongly linked EV-D68 with AFM, with tests for the virus also coming up as negative in every case.

EV-D68 is also not a new infection, with many Americans previously being exposed to it. Experts are therefore baffled as to how this virus could potentially be causing paralysis and why outbreaks occur every two years.

AFM affects the nervous system by attacking part of the spinal cord, which causes the body's muscles and reflexes to weaken. Pictured is seven-year-old Quinton Hill, who was among the first children in Minnesota to be diagnosed after losing movement in his arm in September 

AFM affects the nervous system by attacking part of the spinal cord, which causes the body’s muscles and reflexes to weaken. Pictured is seven-year-old Quinton Hill, who was among the first children in Minnesota to be diagnosed after losing movement in his arm in September 

WHAT IS ACUTE FLACCID MYELITIS (AFM)?

The term ‘myelitis’ means inflammation of the spinal cord.

Transverse myelitis is the broad name of the disease, and there are various sub-types.

It is a neurological disorder which inflames the spinal cord across its width (‘transverse’), destroying the fatty substance that protects nerve cells.

That can lead to paralysis.

AFM is an unusual sub-type of transverse myelitis.

Patients starts with the same spinal inflammation, but their symptoms are different and the disease develops differently.

The main distinction is that AFM patients are weak and limp, while patients with general transverse myelitis tend to be rigid.

Most AFM patients start to struggle with movement of the limbs, face, tongue, and eyes.

They then begin to lose control of one limb or sometimes the whole body – though many maintain control of their sensory, bowel and bladder functions.

Unlike transverse myelitis, which has been around for years, doctors are still in the dark about why and how AFM manifests itself.

More than 17 countries have reported the odd AFM case, however, only the US has  biannual surges. 

The average age of those affected is four years old and more than 90 per cent of cases are in children under 18.

Outbreaks typically peak in September and October, before tailing off. This year’s incidence rate may rise even higher if investigators count cases that occurred during the summer. 

As of yesterday, 311 reports were being investigated. Confirmed cases require an MRI scan showing lesions in the part of the spinal cord that controls muscles.

This year’s outbreak is spread across 36 states, peaking in Texas with 21 incidences followed by Colorado with 15 and Ohio with ten. 

This may just be due to better diagnosis, with Colorado being at the centre of the 2014 outbreak and its doctors therefore being more aware of AFM’s symptoms. 

No specific treatment is available for AFM and interventions are generally recommended on a case-by-case basis.  Children with weakness in their limbs may be offered physical or occupational therapy.

The CDC advises people get vaccinated against poliovirus and West Nile Virus due to both being potential causes.

Experts also recommend people protect themselves against mosquitoes and practice good hand hygiene.  

‘It’s a one-in-million chance so it’s extremely unlikely your child will get this,’ said Dr Acosta.

‘Even if they have sudden onset of weakness, AFM is unlikely to have caused it. It’s more likely to be a stroke. However, if your child develops it, bring them in and this gives them best chance of survival.’

The EV-D68 virus is pictured, which is a distant relative of polio and may be to blame for AFM 

The EV-D68 virus is pictured, which is a distant relative of polio and may be to blame for AFM 

Read more at DailyMail.co.uk