South Carolina

Cases of rare illness that can paralyze children reported in North and South Carolina

What we know and don’t know about AFM

Acute flaccid myelitis (AFM) is a rare, serious condition that affects the nervous system. Cases of AFM have been on the rise since 2014. Fewer than 1 million people in the U.S. contract it each year, but not a lot is known about it.
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Acute flaccid myelitis (AFM) is a rare, serious condition that affects the nervous system. Cases of AFM have been on the rise since 2014. Fewer than 1 million people in the U.S. contract it each year, but not a lot is known about it.

Public health officials in both North and South Carolina confirmed cases of a rare condition that can paralyze children, according to local media reports.

In North Carolina, state officials say they confirmed one case of acute flaccid myelitis, AFM, and are investigating two others, according to WSOC. In South Carolina, the Post and Courier reports the state public health department confirmed a case there.

The Centers for Disease Control and Prevention says researchers do not know what causes AFM, but it can cause paralysis and polio-like symptoms, mostly in children. The CDC reports that it has seen 386 confirmed cases of AFM between August 2014 and September of this year.

The CDC likens the symptoms of AFM to complications from polio or West Nile virus, with sudden weakness in the arms and legs, difficulty moving eyes and trouble with swallowing or slurred speech. The illness most commonly impact children, the CDC says.

“The most severe symptom of AFM is respiratory failure that can happen when the muscles involved with breathing become weak,” the CDC explains.

Public health authorities do not know what causes AFM and are unsure how to treat it, the CDC notes, but most recover from the illness.

“There is no specific treatment for AFM, but a doctor who specializes in treating brain and spinal cord illnesses (neurologist) may recommend certain interventions on a case-by-case basis,” according to the CDC.

The CDC has named two viruses as potential links to AFM, EV-D68 and EV-A71, according to NBC News. The news network reports that both viruses “are distant relatives of polio.”

So far this year, the CDC reports, doctors have seen 62 cases of AFM in 22 states. Doctors in many states, including both North and South Carolina, are not required to report AFM cases to state health authorities. according to WSOC.

Even if doctor’s do not have to report the condition, CBS 17 in North Carolina reports that public health officials ask doctors and hospitals to report suspect cases in the state.

CBS 17 reports there have been seven confirmed cases of AFM in North Carolina reported to state officials since 2014.

And in South Carolina, state Department of Health and Environmental Control spokeswoman Laura Renwick told the Post and Courier, “Providers will often consult with DHEC when they suspect AFM as a complication of an infectious disease.”

The CDC says it saw a spike in AFM cases in 2014 with 120 cases and again in 2016 with 149 confirmed AFM cases.

“Surveillance has shown us that AFM cases generally peak in the months of September and October,” NBC News quoted from a the Nevada state health department bulletin.

The bulletin, according to NBC News, states, “A biennial pattern has been observed, with the majority of cases reported in 2014 and 2016, and smaller numbers reported in 2015 and 2017. If this pattern continues, we should expect to see an increase in AFM cases in 2018.”

Acute flaccid myelitis, or AFM, attacks the nervous system, particularly the spinal cord, and can lead to arm or leg weakness and loss of muscle reflexes. Most of the cases that CDC has learned about have been in children. There is no specific treatment for AFM. 2014 2015 2016 2017 2018* • Facial droop/weakness • Difficulty moving eyes • Drooping eyelids • Difficulty swallowing • Slurred speech Source: CDCGraphic: Staff, TNS *As of Sept. 30 Confirmed acute flaccid myelitis cases SYMPTOMS 120 22 33 38 149 Acute flaccid myelitis Some people, in addition to arm or leg weakness, will have:

Charles Duncan: 843-712-5297, @duncanreporting

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