Acute Flaccid Myelitis: More Paralyzing Polio-Like Illness This Year Says the CDC

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The 'conscious uncoupling' of Gwyneth Paltrow and Chris Martin, the Apple watch, the ice-bucket challenge, John Travolta's inability to say a name correctly - these are all events that occurred two years ago - in 2014. 

If you think back, you may also remember that a mysterious illness made headlines that summer - a previously unknown disease that looked a lot like polio left children paralyzed. And, as the case numbers grew (there were 120 cases between August and December that year) and people became more frightened - scientists grew more baffled. 

Now, we know a bit more about what happened in 2014 - although still not much. The illness that was making headlines is called acute flaccid myelitis (AFM.)  The US Centers for Disease Control and Prevention (CDC) has been actively tracking it since August of 2014 and has reported an increase in the number of cases seen thus far this year. 

The terrifying aspects of AFM are that the cause is unknown, anyone can get it, and it affects the nervous system. Even worse, most of the cases are in children. The only silver lining is that it is rare. In the first eight months of this year, 50 cases have been confirmed in 24 states in the US. 

The CDC reports that multiple different viruses are linked to the cause of AFM including, but not limited to enteroviruses, West Nile virus (WNV) and other viruses in the same family as WNV (Japanese encephalitis virus and Saint Louis encephalitis virus,) and adenoviruses. 

AFM has a list of terrifying signs associated with it. The hallmark of the disease is how quickly the effects take hold with a sudden onset of weakness of limbs, loss of muscle tone and reflexes.  Some people also have facial droop/weakness, difficulty moving the eyes, drooping eyelids, or difficulty with swallowing or slurred speech.

The degree to which someone is affected is extremely variable. A child may be rendered usable to breathe on their own, or, on the other spectrum, left with muscle loss in an arm or leg. 

The outbreak of AFM in 2014 was thought to be linked to an uptick in infections of enterovirus D68 (EV-D68) - a close relative of poliovirus.  However, it could not be proven because every person with AFM did not have evidence of an EV-D68 infection, meaning that no virus or even antibodies (immune proteins made to a virus that is infecting the body) were present in their system. In addition, there were no cases of EV-D68 in 2015 (and 21 cases of AFM) and only a few cases of EV-D68 have been reported this year. Since June of this year, there has been a significant increase in EV-D68 cases in the Netherlands making that an area to watch for AFM cases.

 

References: 

http://www.cdc.gov/acute-flaccid-myelitis/afm-surveillance.html