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There have been few cases in North Carolina of a very rare condition that can cause severe arm and leg weakness, particularly in children, state health officials said.
There are one confirmed and two probable cases of acute flaccid myelitis (AFM), according to the N.C. Department of Health and Human Services.
Other symptoms include: facial droop or weakness; difficulty moving the eyes or drooping eyelids; difficulty swallowing; and slurred speech.
DHHS has not identified with the disease or where the cases originated. The stance is similar to its policy in recent years.
Fewer than one million people in the United States get AFM each year. In North Carolina, there are two confirmed cases in 2014 and four confirmed cases in 2016.
Novant Health Neurosurgeon Dr. Rashid Janjua said more than 90 percent of the AFM cases are in children under age 10.
"I want to stress that this is a very rare, one-in-a-million occurrence," Janjua said.
"The symptoms to be on the face of their legs, their arms or their face. If necessary, an MRI of the cervical spine will help with the diagnosis.
"Unfortunately, treatment is supportive only. Since this is caused by a viral illness, there is no need for antibiotics. "
While AFM is not reportable by law, the N.C. Division of Public Health does not report cases of suspected cases, DHHS spokesperson Cobey Culton said.
Federal, state and local health care officials are not responsible for the illness.
Culton said the department is collaborating with the CDC to check suspected cases, testing laboratory specimens and providing guidance to health professionals.
The CDC said "there are different possible causes, such as viruses, environmental toxins and genetic disorders."
"It's always important to practice disease prevention steps, such as staying up-to-date on polio vaccines, washing your hands and protecting yourself from mosquito bites."
The CDC said cases of AFM became noticeable nationwide in August 2014. The CDC said the AFM symptoms in 2017, the only known fatality.
Dr. Christopher Ohl, infectious diseases expert at the Wake Forest Baptist Medical Center. ARM subset from an umbrella of illnesses that can cause damage and lead to paralysis in severe cases.
"There is no geographic clustering of AFM, it does not appear to be contagious, it is not an adverse reaction to a vaccine, and it is not related to polio," said Ohl.
"Some individuals may have a predisposition to be vulnerable to AFM because of their genetics."
Ohl said children may be more likely because they have not built up the level of immunity that adults typically do. He cautioned that adults can come down with AFM as well.
"As we continue to learn about AFM, we urge parents to seek AFM," Ohl said.
Ohl said national and local recognition of AFM also of D68.
The suspected germ is an uncommon strain of a common family of viruses that typically hits summertime through autumn. The virus causes mild cold-like symptoms, including runny noses, coughing and wheezing.
There were more than 540 confirmed cases nationwide in 2014, including 10 in North Carolina.
"Asphysia reviewed for cases of D68, there was an awareness in a small number of cases that something else was happening that proved to be AFM," Ohl said.
Richard Craver is a reporter for the Winston-Salem Journal.
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