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Health officials are alarmed by the growing waves of paralyzing disease in children. So far, the disease has only affected a few hundred children in the United States, but the exact cause and the best treatment for this disease remain unknown.
Known as acute flaccid myelitis, or AFM, this rare condition can sometimes cause respiratory failure or even death.
In the United States, there have been 228 confirmed cases of AFM in 2018, with increases every two years since 2014, reports the (CDC).
"There has been an increase in the number of cases with each group, but it is difficult to say whether it is more likely that the number of cases will be higher," said Dr. Mark Hicar, badistant professor of pediatrics and pediatric infectious disease specialist at the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo.
Several European countries, as well as Canada and Japan, have also reported cases of AFD.
In the USA, have been in children.
Dr. Peter Gill, a pediatrician and researcher at Toronto's Hospital for Sick Children, said last year in CMAJ podcasts that the disease usually affects children between the ages of 4 and 15 years old.
Most people show symptoms of viral infection – such as fever or benign upper respiratory tract disease – before developing an AFM.
This is followed by the sudden onset of "flaccid paralysis", which, according to Hicar, appears as a flaccid leg or arm, with little or no muscle tone in the limb.
People can also have others , such as drooping eyelids or face, difficulty speaking or difficulty swallowing.
If the muscles that control breathing are weakened, people may develop respiratory failure. As a result, they may need a fan to help them breathe.
In some cases, the AFM can trigger serious neurological complications that can lead to death.
To date, the CDC is not aware of any AFM-related deaths in but he reports in a child with AFM.
Scientists suspect that probably play a role in the AFM, although further research is needed to confirm it.
"We do not know the cause of MFA in these recent case groups," Hicar said. "However, some viruses with similarities to polio are leading candidates."
One clue is that most people who developed AFM initially presented the symptoms of a viral disease. MFA cases also peaked between August and October, the usual season for enteroviruses, a group of viruses that includes poliovirus.
There are also several who are responsible for millions of diseases each year. Only a small number of people develop a serious complication of these.
Since 2014, the CDC has detected nonpolio enteroviruses in the cerebrospinal fluid of four AFM patients. However, there was no evidence of poliovirus in the stool samples of AFM patients.
The doctors diagnose AFM based on the patient's symptoms, the presence of a virus in the cerebrospinal fluid, MRI images of the brain and spinal cord, and other tests.
Hicar said "that a number of therapies have been performed for the AFM, primarily targeting the immune system, but none has shown obvious efficacy."
include steroids, medicines to strengthen the immune system and filter the blood. They are widely used on a case by case basis.
Deaths due to AFM are rare, especially with early treatment. But Gill said that "unfortunately, most patients have a form of lasting impairment."
Questions about the cause of AFM and the best treatment have left many parents of affected children and doctors hope for more.
In November, the CDC announced a bring together experts from several fields to solve this public health problem.
One thing they hope to clarify is whether the number of cases will continue to increase.
, director of the National Institute of Allergy and Infectious Diseases, wrote Tuesday in the journal mBio that "the trajectory of the AFM over the past five years suggests that the problem worsens ".
"Although theoretically possible," said Hicar, "we have had three peaks of small numbers of cases over the past five years."
So it's hard to know. And without a good understanding of the cause of MFA, it is also unclear how many people infected with an enterovirus develop an MAF.
Although the AFM is a serious illness, Hicar warned people to keep it in perspective.
Since 2014, a few hundred children have developed AFM, it is much less prevalent than other causes of injuries in children, such as car accidents.
"The potential for paralysis of a limb for life is scary, but we must remember that it is rare events," Hicar said.
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