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Polio-like crippling disease spreads in 31 US states



The number of children struck by acute flaccid myelitis (AMF) in the United States rose to 116, officials said.

Thirty-one states have now reported cases of poorly understood disease that can cause paralysis and, in rare cases, death.

The Centers for Disease Control and Prevention (CDC) is currently investigating another 170 cases of people with symptoms suggestive of AFM.

There have been more than three and a half times more cases than last year, but doctors remain puzzled as to the cause of the disease.

Colorado, with 15 confirmed cases, was the most affected state so far this year, followed closely by Texas with 14 people in whom acute flaccid myelitis was diagnosed. A total of 31 states have seen people - mostly children - affected by the disease, 19 of which have not been affected so far.

Colorado, with 15 confirmed cases, was the most affected state so far this year, followed closely by Texas with 14 people in whom acute flaccid myelitis was diagnosed. A total of 31 states have seen people – mostly children – affected by the disease, 19 of which have not been affected so far.

The CDC released its latest figures on Tuesday, stating that there were 286 reports of people with acute flaccid myelitis (AM) in 31 states, with 116 confirmed.

More than 90% of people affected by the disease are under 18 years old and the average age of patients is four years.

It is thought that it is caused by a combination of viruses and that children usually show the first signs of fever and cough for 3 to 10 days.

But after a flu-like illness, AFM can suddenly leave people paralyzed for life or even become fatal.

The AFM has been described as a polio-like disease because of its similarity to the viral infection, which affected hundreds of thousands of people in the mid-twentieth century.

It is thought that the disease is unlikely to be contagious among the population, but it could be caused by viruses that spread easily.

Last week, the CDC set up a task force to fight the disease by researching its causes and looking for a way to treat it.

Colorado was the most affected country, with 15 cases, followed by Texas with 14.

WHAT IS ACUTE FLACCID MYELITE (AFM)?

The term "myelitis" means inflammation of the spinal cord.

Transverse myelitis is the broad name of the disease, and there are various subtypes.

It is a neurological disorder that inflamed the spinal cord across its entire width ("transverse"), destroying the fatty substance that protects the nerve cells.

This can lead to paralysis.

AFM is an unusual subtype of transverse myelitis.

Patients start with the same inflammation of the spine, but their symptoms are different and the disease evolves differently.

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

Most AFM patients begin to have difficulty moving limbs, face, tongue and eyes.

They then begin to lose control of a limb or sometimes the whole body – even though many keep control of their sensory, intestinal and bladder functions.

Unlike transverse myelitis, which has been around for years, doctors still do not know why and how the AFM manifests itself.

Next come Washington, Minnesota, Ohio and Pennsylvania (eight each), Illinois (seven) and New Jersey and Wisconsin (six).

There have been three state-confirmed cases in Arkansas, Alabama, Georgia, and Maryland, and two in Maine, New York City, the Carolinas, Kentucky, and the United States. Iowa.

And Nevada, Arizona, New Mexico, Montana, Wyoming, Oklahoma, Missouri, Louisiana, Mississippi, Indiana, Virginia, and Rhode Island have experienced only one case.

The remaining 19 states have not reported any patients with the disease.

According to experts, there will probably be more cases, and officials do not know if the risk is higher in states where the number of cases is higher, or if they simply have better notification.

Doctors are encouraged to report MFA cases, but they are not obliged to do so.

Most patients with the disease are struck between August and October.

Although the situation remains very rare, Dr. Robert Redfield, director of the CDC, who took office in March this year, said that it was the top priority of the agency .

Scientists are studying a number of causes, including viruses, environmental toxins and genetic disorders.

In previous outbreaks, a virus called EV-D68 was involved in the development of AFM.

"We know that the EV-D68 – as well as other enteroviruses – can cause limb weakness, but we do not know what triggers the AFM in these patients," said Dr. Nancy Messonnier of the CDC.

In a recent interview, Dr. Redfield said, "Since 2014, the CDC has been working hard in this area to try to understand causation and etiology.

"While we are sitting here today, we do not understand the cause.

"You know, we continue to strengthen our efforts, working in partnership with state and territory health departments and academic experts to try to understand this."

WHAT IS AFM?

AFM is a rare but serious condition that affects the nervous system. Specifically, it attacks the area of ​​the spinal cord called gray matter, which weakens the muscles and reflexes of the body.

Symptoms often develop after a viral infection, such as enterovirus or West Nile virus, but often no clear cause is found.

Patients start with flu-like symptoms, including sneezing and coughing. It slowly turns into muscle weakness, difficulty moving the eyes, and polio-like symptoms, including facial relaxation and difficulty swallowing.

& # 39; If [AFM affects gray matter] lower in the spinal cord [paralysis will] be more in the legs and if it is higher, it will be more in the arms, "said Dr. Fernando Acosta, pediatric neurologist at Cook Children's Medical Center, in Fort Worth, Texas.

"Or if it's closer to the neck, they can not move their head, neck and shoulders. We had one case and it was awful.

In the most severe cases, respiratory failure can occur when the muscles that support breathing weaken.

In rare cases, AFM can lead to neurological complications that can lead to death.

"It's a pretty dramatic disease. children have a sudden onset of weakness, "said Dr. Messonier of the CDC.

No specific treatment is available for the AFM and interventions are usually recommended on a case-by-case basis.

Children who have weakness in their arms or legs may have physical or occupational therapy.

The average age of those affected is four years and more than 90% of cases involve children 18 years old and under. Among them is Julia Payne, two (pictured) from Chicago, Illinois

The average age of those affected is four years and more than 90% of cases involve children 18 years old and under. Among them is Julia Payne, two (pictured) from Chicago, Illinois

However, doctors admit that they are not aware of the long-term results for people with AFM.

WHO WAS AFFECTED BY AFM?

The CDC does not follow the AFM in terms of prevalence, but rather in case of epidemic.

Since its appearance in Colorado in August 2014, the agency has confirmed 386 cases, almost all of them involving children.

The CDC has confirmed 33 cases of AFM in 2017, 149 cases in 2016, 22 cases in 2015 and 120 cases from August to December 2014.

Although the AFM pattern most resembles an infectious disease, there is still a lot of unknown about the disease.

Two-year-old Julia Payne of Chicago is one of the infected children.

She remained at the Pediatric Intensive Care Unit of Lurie Children's Hospital for weeks with a respirator and a feeding tube because she was unable to swallow .

Since then, she has been released and transferred to Shirley Ryan AbilityLab, a rehabilitation center where she will have to deal with weeks of physical therapy to regain strength and movement.

In Minnesota, four-year-old Orville Young was probably the first confirmed case in the state, according to the Star Tribune.

Orville has been in physical therapy for a month and a half. His mobility and gait have not returned to normal, but his legs are mostly functional now.

His right arm, up to now, is still paralyzed.

Fortunately, many or almost all recover their movement, just like Elizabeth Storrie, five years old, Willow Park, Texas.

She spent a month at Cook's Children's Hospital in Fort Worth, with intravenous solutions and a feeding tube until her condition improved.

The AFM affects the nervous system and most often resembles the polio virus. Health officials determined that it was a virus, but were unable to determine the exact cause. Orville Young, four (pictured) from Minnesota, was probably the first confirmed case in the state

The AFM affects the nervous system and most often resembles the polio virus. Health officials determined that it was a virus, but were unable to determine the exact cause. Orville Young, four (pictured) from Minnesota, was probably the first confirmed case in the state

WHAT ARE THE IMPLICATIONS IN THE FIGHT AGAINST POLIO?

AFM has been described as a polio-like disease because of its similarity to the viral infection that affected hundreds of thousands of people, especially between the late 1940s and the early 1950s.

According to the CDC, the symptoms "look a lot like the complications of an infection with certain viruses, including polioviruses, non-polio enteroviruses, adenoviruses and West Nile virus".

Poliovirus does not cause any of these cases, but some cases have been linked to enteroviruses EV-A71 and EV-D68, both close to polio.

Some cases have also been linked to rhinovirus.

"I'm not old enough to have seen a case of polio while I was working, but my colleagues who said [AFM] is similar to what they saw at the time, "said Dr. Acosta.

& # 39; Is this a variant? Potentially, but we do not know.

In 1957, the US government approved the polio vaccine.

After the launch of a national campaign to vaccinate children, the number of people began to fall, and in 1979 polio was declared eradicated in the United States.

This year, Afghanistan and Pakistan are the only two countries where wild poliovirus cases have been confirmed, largely because of poor sanitation and low immunization coverage.

However, global eradication is now threatened by vaccine-derived poliovirus (VDPV) in five countries in Africa this year.

Health experts say that this could result in silent transmission of polio and AFM because both can lead to paralysis if they are not detected.

Anti-vaxxers blamed epidemics for childhood polio vaccines, although doctors said there was no evidence to suggest that this was the case.

"There is no evidence that vaccines are the cause," said Dr. Acosta.

And if we identify the agent that causes it, the next step would be to develop a vaccine.

"If you observe lower rates of polio, whooping cough and other diseases, it's because we have vaccines that have made them very rare."

HOW CAN YOU PROTECT?

The CDC advises to be vaccinated against poliovirus and West Nile virus, both of which may be potential causes of AFD.

Health experts say that this does not just mean staying up to date with vaccines, but also minimizing mosquito exposure.

In addition, you can use hot water and soap to prevent getting sick and spreading germs.

"There is a one in a million chance to get it, so it's extremely unlikely that your child will get it," Dr. Acosta said.

"Even if they have a sudden weakness, it is unlikely that the AFM has provoked it. It's more likely to be a stroke.

"However, if your child develops it, bring it and it will give him the best chance of survival."


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