3rd Case Of Mysterious Polio-Like Illness Confirmed In PA

Authorities in Pennsylvania are warning residents after a third case of a rare but dangerous polio-like condition has been confirmed in the state. In addition to the three confirmed cases of acute flaccid myelitis in Pennsylvania this year, there has also been one suspected case, state officials said this week.

“Acute flaccid myelitis is a rare and potentially life-threatening disease that is affecting residents across the state," Secretary of Health Dr. Rachel Levine said in a warning released by Governor Tom Wolf's office. “At this time, the exact causes or source of this disease is unknown.”

The federal Centers for Disease Control and Prevention has received reports of 127 suspected cases of acute flaccid myelitis, or AFM, with 62 cases confirmed in 22 states.

The polio-like condition, which is primarily affecting children, impacts the central nervous system. Its symptoms mimic the cold or flu at first, but a sudden onset of limb weakness and loss of muscle tone and reflex is a signal that a child’s ailment may be far from ordinary.

Some with the illness may notice facial droop or weakness, difficulty moving eyes, drooping eyelids, or difficulty swallowing or slurred speech, according to the CDC. In some rare cases, AFM may cause numbness or tingling in the limbs, the inability to pass urine and breathing difficulties due to muscle weakness that require urgent ventilator support, the CDC said.

So far, officials haven’t found a common link among the reported illnesses, which can develop after a viral infection. The Pennsylvania Department of Health said it is working with the CDC to investigate the illness.

The CDC doesn’t list the additional states where AFM has been confirmed, but CNN's survey of state health departments revealed that it has also been confirmed in Arizona, Colorado, Georgia, Indiana, Iowa, Massachusetts, Minnesota, New Jersey, North Carolina, Ohio, Rhode Island, South Carolina, Texas and Wisconsin.

It’s unclear what is causing AFM, first recognized by the CDC in 2014. That year, there were seven confirmed cases in Pennsylvania. In 2015, there were no cases, but in 2016 there were seven more. In 2017, one case was confirmed in Pennsylvania.

Since 2014, the CDC has confirmed 362 cases, and the number of cases is growing every year, the CDC’s Dr. Nancy Messonnier told reporters in a conference call Tuesday.

“There is a lot we don't know about AFM,” Messonnier said. “I am frustrated that despite all of our efforts, we haven't been able to identify the cause of this mystery illness.”

Acute flaccid myelitis can be caused by a variety of germs, including several viruses, according to the CDC, including both polio and non-polio enteroviruses, West Nile virus and viruses in the same family, and adenoviruses. Environmental toxins and genetic disorders may also cause AFM, according to the CDC, which said AFM is only one of a number of conditions that can result in neurologic illness with limb weakness.

Oftentimes, however, a cause for AFM cannot be identified.

The average age of the children who have gotten sick this year is about 4. The cases the federal health agency has been studying since 2014 involved children 18 and younger, Messonnier said.

Messonnier said enterovirus has been detected in several of these individual cases, but none of the specimens has tested positive for polio virus. Polio, which seemed to randomly strike young children, became a global epidemic in the late 19th and early 20th centuries, but has been eradicated through vaccination in the United States and most of the world. It is still endemic in Pakistan, Afghanistan and Nigeria.

Messonnier said complications from AFM are “incredibly rare.”

“Overall, the rate of AFM since 2014 is less than one in a million,” she said. Still, it’s important to see a doctor right away if there are any symptoms of limb weakness.

“AFM is a rare condition. It's also a serious condition. So we want to encourage parents to seek medical care right away if you or you child develop symptoms of AFM such as sudden weakness or paralysis of the arms and legs,” Messonnier said.

There’s no specific treatment for AFM, and once it has attacked the nervous system, there’s no known medical intervention to reverse the effects, the CDC says. Patients can regain some limb function through physical therapy.

Health officials advised residents to take these steps to stay healthy but acknowledged that it is unknown if they can help prevent the spread of AFM:

• Washing your hands often with soap and water;
• Avoiding close contact with sick people;
• Cleaning surfaces with a disinfectant, especially surfaces that a sick person has touched.

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