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Health officials said that a disease that, in rare cases, caused a state similar to that of polio has been reported in various states of the country.
AP

The mystery behind the polio-like disease that is spreading in the United States(Photo: CDC)

The number of cases of rare but crippling disease continues to increase, parents of distressed children urging federal health authorities to more quickly identify a cause and possible treatments.

Centers for Disease Control and Prevention Tuesday increased the number of cases of acute flaccid myelitis reported this year to 27 in 27 states. An additional 162 patients are under investigation.

The disease is rare: it afflicts less than a child in a million. But the symptoms change the life. It can paralyze the arms and legs of a child. Some need fans to breathe. It can also cause muscle weakness, speech problems and difficulty in moving your eyes and swallowing.

CDC officials are still working to identify the causes of the AFM.

Even though a strain of a respiratory virus called enterovirus that circulated in late summer and fall was the prime suspect when the CDC started following the disease in 2014,Federal health officials say they do not have enough evidence to conclude that the virus in question is responsible for AFM.

More: Scientists seek answers to AFM, a disease causing polio-like paralysis in children

More: What parents should know about the polio-like crippling disease that the CDC warns about

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Nancy Messonnier, director of the CDC's National Center for Immunization and Respiratory Diseases, said patients with FMD usually had fever or respiratory illness three to 10 days before developing weakness in their arms or legs.

In addition to looking for enterovirus as a possible cause, the CDC is looking into whether the body's immune response to a virus is causing the disease.

Messonnier noted that respiratory viruses are common at this time of year, but that a small number of children have developed AFM.

"What we do not know is what triggers the AFM," said Messonnier. "Maybe it's one of the viruses we've tested, maybe it's a virus that we have not detected yet, or maybe the virus is starting another process and it's triggers (AFM) through an autoimmune process. "

The disease peaks every two years, from the end of summer to the beginning of autumn. Public health officials began tracking him in 2014. They identified 120 cases in 34 states.

The number fell to 22 cases in 2015, but increased again in 2016, with 149 cases in 39 states.

So far in 2018, Messonnier said that the number of confirmed and under-surveyed cases was similar to trends in 2014 and 2016. Most cases confirmed in 2018 were children.

Although no deaths were reported in 2018, Messonnier acknowledged that the CDC has not continued to follow patients diagnosed in recent years. The agency has asked state health departments to map confirmed AFM cases to death registries since 2014 to verify whether children or adults have died.

The doctors tested respiratory and faecal samples from patients in whom the AFM had been diagnosed this year. About half of these patients had either an enterovirus or another cold virus, rhinovirus.

Doctors think that cerebrospinal fluid is a more definitive measure of whether a virus causes disease or not. An adult under immune system and a child quickly paralyzed by the AFM were the only two people whose cerebrospinal fluid had been tested positive for enterovirus.

In other cases, said Messonnier, it is possible that the virus has already cleared the spinal cord or hid in tissues more difficult to test.

"It is possible that the pathogen is absent because we perform tests at the point of weakness of the limbs, and not at the point where the disease breaks out," said Messonnier.

The CDC, which pays close attention to the disease, said it has evaluated more reports of children with AFM-like symptoms in the last three months.

The CDC has sought to educate physicians who are encouraged to report possible cases to local health departments. This probably means that more doctors are reporting possible cases and more families are asking questions about the symptoms.

The federal agency said it has worked with local and state health departments and hospitals to gather information and confirm suspected cases more quickly.

While investigators are trying to determine the cause of the disease, CDC officials said it was important to take precautionary measures, such as getting the recommended vaccinations, washing their hands and avoiding mosquito bites.

Parents of children with AFM became frustrated with the speed with which they identified the cause of the disease. In social media publications and interviews, parents urged the CDC and local health services to aggressively search for the cause of the disease.

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