What you need to know about the polio-like disease that appears in the United States



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A rapidly evolving "polio-like" disease leaves children in many states paralyzed – and experts do not really know what's causing the disease.

The rare disease, called acute flaccid myelitis (AFM), causes an "inflammation of the spinal cord" that resembles polio cases of the twentieth century, told the Daily News Dr. John A. Hopardo, associate professor of neurology and pathology.

MFA cases have recently been reported in at least five states: Minnesota, Washington, Illinois, Colorado, and Pennsylvania.

The exact cause of the AFM is unknown – it may be a new virus that some children do not have sufficient immunity to fight and which, as a result, causes a bad reaction when the nervous system fails or the virus directly attacks the spinal cord.

"The CDC found evidence of enterovirus D68 in respiratory samples in approximately 20% of affected patients, and other viruses in 20% of cases, although a trigger was not identified in the majority of cases Dr. Kiran Thakur, expert in neuro-infectious diseases, told The News. "Most patients had acute febrile illness preceding the onset of weakness. So we think that an infection has triggered an MFA, although we often can not prove it by laboratory tests. "

The CDC estimates that there are fewer than one million cases of AFD per year and that 362 cases have been identified in the United States since 2014.

The time between the onset of symptoms and the loss of motor skills is short.

"This manifests itself as an infection of the upper respiratory tract with rapid onset of fever and paralysis," said Pardo.

The disease progresses rapidly within 24 hours. Patients may begin to feel weak and have difficulty breathing. Paralysis of the limbs begins to settle.

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10 subtle signs of disease that your feet can reveal

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Dry and scaly feet

It might be: Thyroid problems, especially if the moisturizer does not help. When the thyroid gland (the butterfly-shaped gland located at the base of your neck) gets in motion, it does not produce the correct thyroid hormones, which control the metabolic rate, blood pressure, tissue growth and development. of the skeletal and nervous system. "Thyroid problems cause severe skin dryness," says Marlene Reid, DPM, foot specialist in Naperville, Illinois. "When we see cracks on our feet or if the moisturizer does not improve the dryness in a few days, we usually refer patients to their GP to make sure their thyroid is OK." Brittle nails can also report thyroid complications. Do not miss these 13 other silent signs of a thyroid problem.

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Bald toes

It might be: Arterial disease. If the toe of your toes suddenly disappears, it may indicate poor circulation caused by peripheral arterial disease (PAD). "The signs of DPA may include decreased hair growth on the feet and ankles, purple toes, and thin or shiny skin," says Suzanne Fuchs, DPM, a podiatric surgeon at North Shore University Hospital in New York. Accumulation of plaque in the arteries of the legs, the PAD affects about 8 million Americans. The symptoms are subtle, but doctors can check the pulse of the foot or spot the PAD on an x-ray. "If I take a X-ray of a broken foot and I see a hardening of the arteries, 99% of the time, it happens the same thing in the blood vessels of the heart," says Gary A. Pichney, DPM, a pediatrician. surgeon at the Foot and Ankle Institute of the Mercy Medical Center. (These 11 tests detect silent heart disease.)

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Ulcers that do not heal

It might be: Diabetes. Uncontrolled blood sugar can damage the nerves and cause poor circulation. The blood does not reach the feet. When the blood does not reach a wound caused by, for example, irritating shoes, the skin does not heal properly. "Many people with diabetes are first diagnosed because of foot problems," says Reid. Other signs of diabetes may include tingling or numbness of the feet. Ask your doctor to have your blood glucose tested. Memorize these 12 foot care tips that you should follow if you are diabetic.

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Painful big toe

It might be: What you ate. Full of wine and steak? The painful consequences could be gout, a type of arthritis that usually affects the big toe joint. (Here are some natural remedies for pain and swelling.) Purity-rich foods, a chemical compound found in red meats, fish and some alcohols, can trigger an attack by increasing acid levels. uric in the body. Uric acid is normally excreted in the urine, but it is overproduced or under-excreted in some people. "You will notice the uric acid deposit in the joint, usually the big toe or ankle," said Bob Baravarian, DPM, a foot and ankle podiatry specialist at Providence Saint John's. s Center of Santa Monica, California. "The patient will wake up with a hard, red, swollen joint. It is extremely painful. A doctor may prescribe anti-inflammatories for short-term relief and suggest a low purine diet for long-term prevention. Whether you have gout or not, learn how pedicures prevent foot problems by wearing sandals.

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Tiny red lines under the nail

It might be: A heart infection. Red streaks under the fingernails or nails could be broken blood vessels called splinter haemorrhages. These occur when small blood clots damage the tiny capillaries under the nails. They can report endocarditis, an infection of the inner lining of the heart. People with existing heart disease, who have received a pacemaker or whose immune system is chronically inhibited (such as cancer patients receiving chemotherapy, HIV patients and diabetic patients) are at higher risk of developing endocarditis. The infection can lead to heart failure if it is not treated. If you notice splinter haemorrhages on your fingernails or nails and you have not had any recent trauma to the nail, check with your doctor to check your heart and blood circulation. Learn what your natural nail color says about your health.

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Clubbing

It might be: Lung cancer or heart disease. Another symptom that appears in both toes and fingers, clubbing is often associated with lung cancer, chronic lung infection, heart disease or intestinal disease. Lung cancer and heart disease reduce vascular resistance, which means that blood flow to the small arteries of the finger nails and fingertips will increase. The fabric swells and gives the appearance "clubbed" (fingers and toes rounder and wider). Although patients generally know that they are suffering from a disease that causes bludgeoning, it is best to be checked if you notice any abnormalities. Do not overlook these other silent signs of major health problems.

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Nails stitched

It might be: Psoriasis. If you find tiny holes, furrows, or ridges in your nails, you may have psoriasis. Although most people with nail psoriasis also have skin psoriasis (an autoimmune disease that makes the skin look uneven and irritated), 5% of people with nail psoriasis are not affected elsewhere. "If you have never been diagnosed with psoriasis, but your nails contain small bites, you should have them checked," says Pichney. Other symptoms include white spots and horizontal lines on the nails. To treat psoriasis, your doctor may prescribe topical creams or steroids to inject under the nail. Learn about skin care that routine dermatologists recommend for psoriasis.

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Nails with a spoon

It might be: Anemia or lupus. Do you have a depression in the nail deep enough to hold a drop of water? Also known as koilonychia, the spoon-shaped nails may indicate iron deficiency, as well as hemochromatosis (overproduction of iron), Raynaud's disease (which affects the blood supply to the fingers and toes) and sometimes lupus (an autoimmune disease). the body's immune system attacks cells, tissues and organs). Spoon nails sometimes appear in infants, but normalize in the first years of life. If you notice a spoon, contact your doctor, who will give you a blood test to identify the exact cause. Discover these other information revealed by your nails on your health.

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A straight line under your nails

It might be: Skin cancer. A dark vertical line under the nail could be acral lentiginous melanoma or hidden melanoma – a form of skin cancer that appears on dark parts of the body. (The other hidden melanomas include eye melanoma and oral melanoma.) "This will be a black line going from the base of your fingernail to the end of the nail," says Pichney. "It should be seen by a podiatrist or a dermatologist. You want to make sure that it is not a fungus, which is usually yellow-brown and sporadic all over the nail. Although only 5% of diagnosed melanoma cases are of the hidden type, hidden melanoma is the most common type in dark-skinned people. Here are other symptoms of skin cancer that are not on your skin.

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An arch suddenly high

It might be: Nerve damage. "Most feet with a high arch are associated with a form of underlying neuromuscular disorder," says Pichney. "If someone has thinned arch muscles, this could be an indication of a neurological condition called Charcot-Marie-Tooth (CMT)." An inherited disease that damages the peripheral nerves (outside the brain and spinal cord). CMT may also result in gait changes, numb feet, balancing difficulties, loss of lower leg muscles and, later, similar symptoms in the arms and hands. Consult your doctor if you notice any abnormalities. "For anything that is different or changing with regard to the foot, consult your podiatrist immediately," says Reid. Also watch out for those sneaky ways that your feet can disturb with your sleep.

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In a study conducted at Johns Hopkins, Pardo noted that some patients had lost sensation in all four limbs in less than six hours.

Parents should seek immediate medical attention if disturbing symptoms occur.

Patients often stay in intensive care for weeks after acquiring AFM and many will require mechanical ventilation.

"A small percentage is recovering, but patients remain with a severe neurological disability or paralysis," said Pardo.

Pardo has focused on the short time between the onset of symptoms and the need to immediately receive medical care. Patients may receive steroids or an intravenous infusion, but until now no proven treatment for the disease has been demonstrated.

"Early recognition of the disease is essential for us to provide care and support to the patient, including monitoring the symptoms of respiratory impairment. Early supportive treatment can save lives, "said Thakur.

Families of people with AFM can find resources and information from The Transverse Myelitis Association (TMA).

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