More and more cases of crippling disease diagnosed in children as officials investigate

More and more children have been diagnosed with a mysterious paralyzing disease in recent weeks and US health authorities said Tuesday that they were still not sure what was causing it.

This year's figures could exceed the figures recorded during similar outbreaks in 2014 and 2016, officials said. Fortunately, the disease remains rare: this year, there have been 90 cases in 27 states, announced the Centers for Disease Control and Prevention.

What makes some children lose the ability to move their face, neck, back, arms, or legs is unclear. Symptoms tend to manifest about a week after children's fever and respiratory illnesses.

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Health officials have described this disease as acute flaccid myelitis. No one has died of this disease this year, but CDC officials say that at least half of the patients do not recover from paralysis and that some have serious complications.

Poliomyelitis and West Nile virus have been excluded. Doctors suspected the cause could be a kind of enterovirus, which causes in most people symptoms of colds. But CDC officials say it is not clear.

The first mysterious wave of paralysis cases in 2014 coincided with an upsurge in the number of enterovirus-related diseases called EV-D68, CDC officials said. But there was no such peak during the waves of 2016 or this year.

There is also a lack of clinical evidence: CDC officials checked the cerebrospinal fluid for about three quarters of the 90 patients and found the EV-68 in one. Another type of enterovirus called EV-A71 was found only in another patient.

But there are questions about it too. If the virus is the cause, it is possible that the test is not good enough or that the germ has left the cerebrospinal fluid at the time of the tests, said Dr. Nancy Messonnier of the CDC. It is also possible that the culprit is hiding elsewhere in the body.

Or maybe the crippling diseases are caused by a new germ for which no laboratory test has been developed. Or perhaps there is a predisposing factor in some patients that makes their immune system respond so severely to a germ or other trigger that the immune response causes paralysis, say CDC officials.

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Parents and even scientists have blamed the agency for not solving the riddle.

"I understand why parents are frustrated, I am frustrated, I also want answers," said Messonnier, who oversees the agency's investigation of the epidemic. CDC officials pledged to do more to ask doctors to look for possible cases and to look more closely at cases from previous years to find other clues.

About 120 cases were confirmed in 2014, the first time that such a wave has occurred. A further 149 were reported in 2016. In 2015 and 2017, the numbers were much lower, and we do not know why.

Diseases increased in September each year and there was a wave that went down considerably in November. But it can take weeks to determine which cases should be counted in the outbreak. More than 160 cases are still under investigation, and some of them could join the count, said CDC officials.