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Karen [email protected]
PORTSMOUTH – A rare but potentially serious condition affecting mainly children is closely monitored by physicians.
Sarah Stanley, spokesperson for the New Hampshire Department of Health and Human Services, said officials were concerned about the increase in the frequency of acute flaccid myelitis in the United States.
"Since 2014, we have identified 4 confirmed cases and 1 probable case of MFA in New Hampshire, all occurring in children," said Stanley. "Fortunately, to date in 2018, we have not identified any cases, but we continue to monitor."
Acute flaccid myelitis (AFM) affects the nervous system, particularly the area of the spine called gray matter, which weakens the muscles and reflexes of the body. The condition is not new, but the increase in the number of cases since 2014 is new.
The exact cause of the AFM is not yet known, but the disease is not considered a transmissible person, said Dr. David Itkin, specialist in infectious diseases at the hospital Portsmouth Regional Council.
The Centers for Disease Control (CDC) indicate that there are a variety of possible causes of AFM, such as viruses and environmental toxins. Most of the cases that CDC has heard about have been in children, but Itkin said that adults can contract the virus.
According to the CDC follow-up, in 2018, there were 72 confirmed cases of MFA. (The cases occurred in 24 states of the United States).
Itkin said that there had been no confirmed cases in New Hampshire, although there is currently a suspicious case in Rockingham County. He said that since 2014, there have been five confirmed cases in the state.
"This is not a new condition, but we have seen an increase in activity over the summer months," Itkin said. "There has been a lot of activity since 2014. There was an outbreak of enterovirus D68 (a non-polio virus) in 2014, which was at the origin of some cases, but not all. We believe that cases occur because of other entero strains such as West Nile, but many cases are undefined and it is difficult to know what this means. "
The 72 confirmed cases are among the 191 reports received by the CDC concerning patients under investigation. The CDC has recently received an increase in the number of PUI cases with symptoms in August, September and October. The CDC and state and local health departments are still investigating some of these PUIs.
In 2017, CDC received information on 33 confirmed cases of MFA. (The cases occurred in 16 US states)
In 2016, it was confirmed that 149 people were suffering from AFM. (The cases occurred in 39 states of the United States and DC)
In 2015, it was confirmed that 22 people were suffering from AFM. (The cases occurred in 17 US states)
From August to December 2014, 120 people were confirmed as having AFM. (The cases occurred in 34 US states)
The number of cases represents only those cases for which information has been sent and confirmed by the CDC.
AFM is an inflammation of the spinal cord and possibly fluid of the spinal cord. Itkin said that this usually caused abnormalities in cerebrospinal fluid and that limb weakness was a hallmark.
"It's a motor rather than a sensory condition," said Itkin. "These are usually weaknesses, not tingling. If there is a high lesion in the spinal cord, say in the neck; this can affect the control of the respiratory muscles and the patient may need a ventilator to facilitate breathing. "
Although the symptoms of AFM resemble those of polio, Itkin said it was like polio, but it was not polio.
"It sounds like a test, but no polio test has been detected," Itkin said. "In most cases, the cause is undetermined. Because of this antiviral treatment may not have any effect. Steroids are not recommended and can be harmful. Gama-globulins and plasmapheresis are also contraindicated. The main treatment is largely favorable. "
Symptoms (CDC)
Sudden weakness of the arms or legs and loss of muscle tone and reflexes occur in most people. Some people, in addition to weak arms or legs, will have: sagging / weakening of the face, difficulty moving the eyes, droopy eyelids or difficulty swallowing or having speech problems.
Numbness or tingling is rare in people with AD, although some people have pain in their arms or legs. Some people with AFM may be unable to urinate. The most serious symptom of AFM is respiratory failure that can occur when the muscles involved in breathing weaken. This may require urgent fan support. In very rare cases, it is possible that the process in the body that triggers the AFM also triggers other serious neurological complications that can lead to death.
The results of a child who contracted the AFM are variable. Itkin said some people would come out apparently unscathed, while others could have long-term effects.
"Some may have persistent weakness six months later, or may show no improvement," Itkin said. "What will happen 2-3 years from now is unknown. There is not enough information because it is difficult to say how they get it. There is no smoking gun. "
If you or your child develops any of these symptoms, seek immediate medical attention. Your doctor will collect information about your symptoms and forward it to NHDHHS. In fact, CDCs ask doctors to be vigilant when dealing with patients with AFM symptoms.
"Health care providers must inform the AFM of NHM," said Mr. Stanley. "NH DHHS will send a health alert message to health care providers in the coming days to remind them to remain vigilant with regard to the MFA in all age groups and to report patients with acute weakness of a flaccid limb at NH DHHS. Case reporting will help states and CDCs monitor the onset of AFM and better understand the factors associated with this disease.
"I understand that it's scary for parents, even though less than one in a million people will have it," Itkin said. "It's a stranger and we want to protect our kids. This creates fear and anxiety. We do not treat this as a contagious disease. If a person is hospitalized, we do not use extraordinary precautions. As in all conditions, we would have good hygiene, good hand washing and disinfectants, but we do not think this poses a transmissible risk. "
"We do not know for sure what is the cause of MFA, but since we believe that some viral infections are related to this disease, we recommend that people take preventative measures such as keeping abreast of vaccines. , wash yourself. your hands and protect yourself from mosquito bites, "Stanley said.
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