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MINNEAPOLIS – Public health officials alerted doctors after six Minnesota children were diagnosed with a rare, polio-like disorder that caused reduced mobility or paralysis of the arms and legs.
The six cases of acute flaccid myelitis, or AFM, have been reported since September 20, prompting the Minnesota Department of Health to ask doctors to monitor the disorder, which has serious but mysterious consequences.
"It's very rare and it's certainly something we take very seriously," said Kris Ehresmann, who heads the infectious diseases section of the Department of Health. "It's a very devastating situation" for children and their families, she said.
The disease attacks the nervous system via the spinal cord and can be transmitted by a virus. Symptoms usually include sudden weakness of the arms or legs and loss of muscle reflexes, but may also include droopy eyelids, slurred speech, difficulty in swallowing and breathing.
James Hill, of Lakeville, said his son, Quinton, was suffering from cold symptoms early in the school week last month. At the end of the week, he vomited and stayed home. At the end of the week, his left arm and neck were stiff.
Because the disease is rare – affecting less than a child in a million – the doctors in the children's hospital did not consider it at first, Hill said. They performed blood tests, imaging tests and lumbar puncture to reach a diagnosis.
The AFM drew the attention of the US Centers for Disease Control and Prevention (CDC) in 2014 after the discovery of case groups in Colorado and California, related to the spread of a type of virus called EV- D68.
Since then, states have reported 362 cases, some of which were devoid of viruses and others that appeared to be linked to other West Nile viruses.
The six children in Minnesota, aged 10 and under, were hospitalized because of their condition. They come from the twin cities of central Minnesota and northeastern Minnesota. Ms. Ehresmann said she hoped that further study of the children – and any other cases revealed by the latest alert to doctors – could reveal the causes.
"We are looking for something in common, but for the moment … we have nothing to conclude," she said.
The cases are not even verified by the results of the laboratory tests. Ehresmman said it was the "constellation of symptoms" that united them.
Orville, Elaine Young's 4-year-old son, may have been the first child to suffer from AMF in the Minnesota cluster. In July, he experienced typical cold symptoms, which quickly gave way to leg immobility and paralysis of the right upper arm. Limited muscle activity in his diaphragm also limited his breathing, which may be a fatal complication of AFM.
Ms. Young said the doctors had diagnosed her fairly quickly – after initially dismissing a stroke – when she had brought Orville to the Masonic Children's Hospital of the University of Minnesota, where a neurologist wrote an article on the MFA. But faced with one of the first cases in Minnesota, she had to know what to do on her own, she said, and found a way to go to Gillette Children's Specialty Services in St. Paul.
Physical rehabilitation, combined with electrical muscle stimulation over the past two months, has allowed Orville to regain 90% of the function of his legs. The upper half of his right arm remains motionless.
"It certainly affected my father and myself a lot, at least emotionally, because we can look forward to his future," Young said. "At age 4, each alarm clock is a big change. So, lose the use of your arm? He said, "I can not really cuddle anymore, but I do all my exercises!"
Orville still plays video games Donkey Kong and Mario Brothers, his favorites, because he always has the right wrist under his arm.
Hill found a cure for his son, even a week after hospitalization, with Gillette therapy. Unable to move the top of his left arm, Quinton trains him to reach Legos and build with both hands. The muscles on the left side of his face remain weak, making it difficult to smile, blink and swallow.
The two children risk a complication called subluxation or dislocation of the arms if they do not move.
"Keep the left-hander involved with the right," say the therapists in Quinton.
Although it is the largest cluster to have been reported in Minnesota, this is not the first in the state. Minnesota had three cases in 2014 and only one case in recent years. Nationally, most cases were reported each year in September.
In addition to viruses, health officials suspect that the syndrome is linked to unknown genetic and environmental factors. Various treatments have been tried, including steroid medications and immunoglobulin infusions to strengthen the child's immune system.
Mr. Ehresmann explained that since the origins of the AFM were unclear, this is the best strategy, such as washing hands, coughing, staying home sick and keeping informed vaccinations.
(EDITORS: HISTORY CAN END HERE)
The CDC is working with researchers nationwide to understand the AFM, assess the number of cases occurring before 2014 and determine why the number of cases has increased significantly from this year.
The Ministry of Health has not revealed the identity of the people in the current group. Parents contacted the Star Tribune directly, hoping that media coverage would prompt parents to take precautions, as well as doctors and hospitals should identify the problem quickly when they met him.
Sophia, the daughter of 4-year-old Mehdi Ayouche, is still hospitalized at Children's in Minneapolis. Chanhassen fears that the loss of mobility in his neck and right arm will make his job difficult, such as swimming and drawing, through Tae Kwan Doe. He said he was relieved but confused that Sophia's twin brother and older sister did not contract the syndrome, despite the cold symptoms.
"We want to educate people," he said. "It's a rare condition. (When this happens), people may not know what to do next. "
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© 2018 Star Tribune (Minneapolis)
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PHOTO (for help with images, contact 312-222-4194): MED-CHILDREN-PARALYSIS
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