“Almost all the patients who meet the criteria for this condition had evidence of a preceding viral syndrome.” Kenneth Tyler, MD.
Two doctors from Colorado are in Atlanta this week as part of a taskforce assembled by the Centers for Disease Control and Prevention to address the possible causes for a third outbreak since 2014 of a rare but severe illness often likened to polio.
Acute Flaccid Myelitis, or AFM is described as a neurological illness of sudden onset that can cause permanent paralysis in one or more limbs and the middle 50% of patients are aged from 5 to 12 years old. Though the cause for this illness isn’t yet conclusively known, it inflames the grey matter within the spinal cord, creating pressure on vertebrae which drastically reduces muscle strength and/or control.
The condition generally presents itself in the immediate wake of a viral infection and according to Dr. Ken Tyler, from the Department of Neurology at the University of Colorado’s School of Medicine, a considerable number of AFM patients test positive for one of two separate enteroviruses, D68 and A71. Tyler said while the 2014 cases were most associated with D68, this year’s cases seem more aligned with A71, which he described as milder making full recovery more likely.
AFM was identified in 1962, but incidents of the condition spiked in 2014 to 120 cases in 34 states, at which time, the illness was placed under surveillance. The number of cases the following year dropped to below 1/5 of that, but clusters surfaced again in 2016 with 149 cases in 39 states. That pattern has held through these last two years with a significant drop in 2017, but 286 patients under investigation so far this year. 15 of the 116 confirmed cases so far this year are from Colorado.
This illness also has what’s called a seasonal nature that has a concentrated presence in the late summer to early fall. The condition has also been identified in international settings like Japan, Europe and Australia.
Joining Tyler in Atlanta is fellow taskforce member Kevin Messacar, a pediatric infectious disease specialist from the Children’s Hospital in Denver. The CDC expects to have a public meeting regarding AFM on Thursday.