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BOSTON – In Massachusetts, the number of suspected cases of a rare disease resembling polio, called acute flaccid myelitis, has decreased by one, while confirmed cases in this state remain at two.
"We are still two confirmed, but we are still four in the process of investigation because the fifth case just to be determined as not being AFM and has been canceled, "said a spokesman for the Massachusetts Department of Public Health on Monday.
Nationally, the number of confirmed cases of the most common condition in children and in its most severe form that can lead to paralysis has risen to 80 confirmed cases in 25 states since the beginning of 2018 , according to this week's report from the Centers for Disease Control and Prevention.
The 80 cases are part of the 219 reports the CDC received on patients under investigation for AFM.
This means that the number of confirmed cases has increased by 18 in recent weeks, with a number of patient reports under investigation for AFM increasing by 92 and in three other states.
In 2017, the CDC received information on 33 confirmed cases of AFD in 16 states in the United States.
The highest number of confirmed cases in recent years was 120 in 2014 in 34 states and 149 in 2016 in 39 states.
The CDC held a press conference about the AFM on October 16 on concerns over the growing number of confirmed cases in the country since the beginning of the year – 62 out of a total of 127 patient cases under investigation in 22 states, including a peak in August.
A week later, the CDC reported receiving a total of 155 patient reports under investigation.
Last week, the CDC said that there were 72 confirmed cases of MFA out of a total of 191 patient reports under investigation being investigated in 24 states of the United States.
The Massachusetts Department of Public Health reported on October 17 two confirmed and four suspect cases.
According to the DPH, confirmed cases remained at two, but suspect cases increased from one to five.
He said Monday that the presumed diagnosis of this fifth case had been "canceled".
The CDC indicates on its website that it has recently received an increase in the number of reports of patients under investigation for AFM presenting symptoms in August, September, and October and that it had announced in October that it was "noticeable". it would publish weekly updates on Monday "so that people can better anticipate increases in confirmed cases over the next few months".
His data now show that between August 2014 and October 2018, he received information on a total of 404 confirmed cases of MFA across the country, most of the cases being children.
He notes on his website that he is "concerned about the AFM, a serious condition that causes weakness in the arms or legs", but that "even with an increase in the number of cases since 2014, the AFM remains a very rare condition ".
It is said that less than one in a million people in the United States receive AFM each year.
This condition, which sometimes presents itself as a respiratory disorder, then progresses to muscle weakness, causes inflammation of the spinal cord and interferes with the transmission of nerve signals to and from the brain. This is partly an MRI diagnosis.
There is no specific treatment, although some hospitals have treated with immunotherapy, including corticosteroids, intravenous immunoglobulin and / or plasma exchange to improve the long-term results. term for patients.
The CDC website contains a chart of confirmed AFM cases that the CDC has been informed from 2 November with the onset of the disease until 31 October.
The CDC stated that the data presented on the graph from August 2014 to July 2015 are based on the AFM case definition of investigation: onset of acute limb weakness as of August 1 2014 and magnetic resonance image showing a largely restricted spinal cord injury. gray matter in a patient under 21 years of age.
The data presented from August 2015 to date would be based on the AFM case definition adopted by the State Council and territorial epidemiologists – acute onset of focal limb weakness and MRI showing significantly limited spinal cord injury to the gray matter and covering one or more patients. more segments of the spine, regardless of age.
The CDC notes that it is "currently difficult to interpret trends in AFM data as" the collection of information on patients under investigation for AFM is relatively new "and that" there may initially be greater variability in the AFM data from year to year, making it difficult to interpret or compare the number of cases between years ".
The CDC stated that it "encouraged health care providers to recognize and report to patients of their health service patients suspected of having an AFM, and to the health ministries of health. send this information to the CDC to help us understand the national burden of this drug. "
Under "What We Know" since 2014, when the CDD started following the AFM, the CDC on its website indicates that the following information has been learned about AFM cases:
- Most patients are children.
- Patients' symptoms were very similar to the complications of infection with some viruses, including polioviruses, non-polio enteroviruses, adenoviruses, and West Nile virus.
- All cases of MFA gave a negative result for poliovirus.
- Enteroviruses most often cause mild illness. They can also cause neurological diseases, such as meningitis, encephalitis and AFM, but they are rare.
- The CDC has tested many specimens from AFM patients to detect a wide range of pathogens (germs) that can cause AFM. To date, no pathogen (germ) has been systematically detected in the patient's cerebrospinal fluid. a pathogen detected in the cerebrospinal fluid would be good evidence to indicate the cause of MFA since this condition affects the spinal cord.
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