NEW YORK (AP) – More children have been diagnosed with a mysterious paralysis the past few weeks, and US health…
The year’s worth could surpass the plates seen in similar outbreaks in 2014 and 2016, officials said. Fortunately, the disease is still rare: this year there have been 90 cases spread among 27 states, Centers for Disease Control and Prevention.
It is not clear what causes some children to lose the ability to move their face, neck, back, arms or legs. Symptoms tend to occur approximately one week after the children had fever and respiratory disease.
Health officials call the condition acute weak myelitis. Nobody has died of it this year, but CDC officials say that half of patients do not recover from paralysis and some have serious complications.
Polio and West Nile viruses have been ruled out. Doctors have suspected that the cause may be some type of enterovirus, which in most people causes cold symptoms. But CDC officials say it’s not clear.
The first mysterious wave of paralysis cases in 201
4 coincided with a larger nail in diseases associated with an enterovirus called EV-D68, said CDC officials. But there was no such nail during the waves of 2016 or this year.
There is also a lack of clinical evidence: CDC officials have checked the spinal cord fluid in about three quarters of the 90 patients and found the EV-68 only one. Another type of enterovirus called EV-A71 was found in only one other patient.
But there are also questions about it. If a virus is the cause, it is possible that the test is not good enough or that the bacterium left the spinal fluid when the test was taken, said CDC’s doctor Nancy Messonnier. It is also possible that the perpetrator hides elsewhere in the body.
Or perhaps the paralyzing diseases are caused by a new bacterium for which no laboratory test has been developed. Or, perhaps, there is some predisposition factor in some patients who get their immune system to respond so seriously to a bacterium or other trigger that the immune response causes paralysis, says CDC officials.
On Tuesday, Minnesota Senator Amy Klobuchar released the following letter sent to CDC Director Robert Redfield:
“Dear Director Redfield:”
“I am writing to express my continued concern over the continued increase in the number of children suffering from acute myelitis (AFM) and requesting an update at the Center for Disease Control and Prevention (CDC) progress in identifying AFM’s etiology and issuing updated clinical guidelines for treatment. “
“While I appreciate your response to my previous letter and willingness to provide staff information, important issues remain with regard to CDC’s efforts to address the 80 cases of AFM now confirmed in 25 states. I request a respectful response to the following additional questions: “
” 1. CDC has identified many possible causes of AFM. Is there a update whether the CDC has identified a common etiology for the confirmed cases of AFM? “
” 2. Which states have reported cases of AFM, and what is the breakdown of cases for each state? Do you have other information about the geographical areas affected by AFM? What is mandate reporting of potential AFM cases to CDC? Do these or other states only AFM reporting on a disease first be identified as an outbreak of state and local health departments or other government agencies? “
” 3. Concern has been raised that AFM may be under-reported. Does the CDC have an idea of whether incidents of AFM are currently under reporting? If so, what factors contribute to the potential occurrence of underreporting? “
” 4. Does the CDC work with scientific experts to consolidate existing research on AFM from different universities and other research institutes to provide the AFM and clinics affected with the most up-to-date information? “
]” and. When will CDC issue updated clinical guidance on treatment of AFM? “
” b. I understand that you recently expressed support for the creation of a working group to assess and respond to the recent increase in AFM cases. What would be the benefits of a workgroup like the one you described, and did CDC take steps to set up such a workgroup? If not, would CDC need additional authority, funding or resources to convene a workgroup? “
” 5. A child paralyzed by AFM recently underwent an innovative operation that established links between newly transmitted nerves and the affected muscles, enabling the child to go again. Has the CDC studied the safety and efficacy of the procedure for potential use in the treatment of other previous AFM cases? What diagnostics and other tools are CDCs and other agencies that explore to enable earlier detection of AFM and possibly minimize the impact of the state when detected? “
” 6. Does the CDC estimate the AFM’s overall financial burden for a family with a child developing the state and requiring long term healthcare services? “
” Thanks for your continued work to ensure that vulnerable young patients who fight AFM and their families have hope for the future. I look forward to your reply. “
Klobuchar previously sent a letter on this subject to the CDC in October and was later joined by colleagues Minnesota Senator Tina Smith and Iowa Senators Chuck Grassley and Joni Ernst to press for more information.
About 120 Cases of AFM were confirmed in 2014, the first time such a wave occurred. Another 149 was reported in 2016. In 2015 and 2017 the bills were much lower, and it is not clear why.
Diseases have spiked in September each year. wave and tailed off significantly in November, but it may take weeks to decide which cases will be counted in the outbreak. More than 160 cases are still being investigated, and some of them can join the bill, CDC officials said.