CDC urges parents to look for symptoms of rare ‘polio-like’ illness in children - WDIV ClickOnDetroit
CDC urges parents to look for symptoms of rare ‘polio-like’ illness in children - WDIV ClickOnDetroit |
- CDC urges parents to look for symptoms of rare ‘polio-like’ illness in children - WDIV ClickOnDetroit
- To Your Good Health: Vaccines are OK for those who have had polio - Albany Democrat Herald
- What to Know About AFM: The Disease That Could Return This Fall - Healthline
- Polio-like illness that paralyzes children’s limbs due to return, but will COVID-19 precautions hold it off? - Loveland Reporter-Herald
| Posted: 06 Aug 2020 12:00 AM PDT :strip_exif(true):strip_icc(true):no_upscale(true):quality(65)/d1vhqlrjc8h82r.cloudfront.net/08-05-2020/t_9fbb396d154b400288e65233a3fe3a54_name_image.jpg) DETROIT – Just as parents are becoming increasingly concerned about the impact COVID-19 will have on the return to school, the CDC has issued a warning about another illness. The warning comes just one week after the Michigan Department of Health and Human Services reported the state's first confirmed case of acute flaccid myelitis (AFM), a rare condition that attacks the nervous system, specifically in children. READ: Michigan confirms first 2020 case of rare 'polio-like' illness in Macomb County child There are also two other suspected cases of AFM in Michigan -- here's what parents need to know: Cases of acute flaccid myelitis have been tracked in the United States since 2014 -- that year there were 120 cases in 34 states, including four in Michigan. 2015 saw a fall in cases to 22. In 2016, there was another resurgence to 153 cases with one in Michigan. The nationwide cases dropped to 38 in 2017 just before 2018 had the highest number of cases so far with 238 cases in 42 sates, including five cases in Michigan. Last year, the anticipated drop in cases every other year occurred with 48 cases nationwide. Every-other year peaks occur between August and November. The last increase was in 2018, making this year a concern. So far there have already been 16 cases nationally in 10 states. AFM is considered uncommon, but it is a potentially life threatening medical emergency that can lead to permanent paralysis. The peak age of occurrence is 5 years old, but can occur in babies and older children as well. The main symptom parents should be on the lookout for is sudden limb weakness or paralysis, often related to or following a respiratory illness with a fever. Arm weakness is more common than leg weakness. Other additional symptoms with the weakness include back pain, headache and difficulty walking. We do not definitively know what causes AFM, but it is thought to be related to a viral infection -- possibly an enterovirus, which is common in the summer and fall. The diagnosis is based on specific findings on MRI, a spinal tap is also done to look for other potential causes for the weakness. Unfortunately, there is still no specific treatment, but it's important to make an early diagnosis and provide supportive care because it can progress to respiratory failure. Among doctors, one serious concern is that because of COVID-19, there may be reluctance on the part of many people to seek medical care, especially in the ER. A diagnoses might be delayed leading to worse outcomes. I have the same advice, if you have an emergency you need to go to a hospital.  | ||||
| To Your Good Health: Vaccines are OK for those who have had polio - Albany Democrat Herald Posted: 21 Aug 2020 09:30 AM PDT  Return to homepage ×  Please subscribe to keep reading. You can cancel at any time. Already a subscriber? Loading&hellp; × Sign Up Today and Support Local Journalism Enjoy more articles from Albany's Most Trusted Information Source. Subscribers can log in for unlimited digital access DEAR DR. ROACH: I am a woman in my late 70s, a 1949 polio patient. For forever I have been told that because of poliomyelitis I cannot tolerate any preventive inoculations, including flu, pneumonia, shingles, etc. I was allowed to get flu shots when they first became available; however, when additives were included later on, I was instructed not to get it any longer. My concern is if I will be able to safely partake of the coronavirus inoculation when it becomes available. Most present-day doctors have no experience with polio, and often input is vague. — P.G. ANSWER: Poliomyelitis was, for many years, a terror that parents feared every summer. Until a vaccine became available in 1955, polio could strike without warning. Although the vast majority of people had only mild symptoms (90% to 95% of cases were asymptomatic), about 1 person per thousand with polio developed poliomyelitis, a serious complication of the nervous system that was sometimes fatal and two-thirds of the time led to permanent weakness. Why some people got terribly ill and died while others had no symptoms remains a mystery, although we know some risk factors for developing poliomyelitis, such as older age, excess exercise while infected and tonsillectomy. I am surprised to hear the recommendations against standard vaccines for you. I haven't read that before and I have taken care of quite a few polio survivors. Experts confirm that standard vaccines, including flu, pneumonia and shingles, are recommended for those with a history of poliomyelitis. There are no additives in the vaccines placing polio survivors at increased risk. It is too early to speculate on a coronavirus vaccine. Although many groups are working on a vaccine, efficacy and safety testing is extensive before a vaccine is approved and the process must not be rushed. However, I doubt that a history of polio will prevent you or the many other polio survivors from getting the vaccine when one is approved. There are many places for you to get more information: Post-polio.org is one I often use. It has reliable information from experts, which is increasingly important as the number of physicians who have taken care of polio survivors decreases. DEAR DR. ROACH: Will you please explain how a person who is not sick, or has no symptoms, tests positive for COVID-19? How do doctors know he has it? The symptoms they tell us are the same symptoms we knew made us sick when we were young. Our mother put us to bed, gave us some medicine, and we were good to go in a couple of days. Don't we carry a lot of germs? — L.J.T. ANSWER: The majority of COVID-19 infections have minimal or no symptoms. People without symptoms may be tested due to concerns about exposure or as part of a program to identify the prevalence in the population. The test is specific for the genetic material of the virus. It is true that for many people, the symptoms are similar to the common cold or another of the many germs (bacteria and viruses) we are exposed to. However, some people get terribly ill due to COVID-19. As of this writing, there have been over half a million deaths worldwide, and will be higher still when this is published. As in the above answer, why some people get ill and die while others have no symptoms is a mystery, although we know some risk factors for becoming seriously ill, such as older age, being male and a history of high blood pressure or diabetes. Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803. Get local news delivered to your inbox!  What to Know About AFM: The Disease That Could Return This Fall - Healthline Posted: 07 Aug 2020 12:00 AM PDT 
All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. The Centers for Disease Control and Prevention (CDC) warns 2020 could be a peak year for a dangerous condition that can have symptoms in common with COVID-19. It's called acute flaccid myelitis (AFM). In a new Vital Signs Report, CDC experts advise healthcare providers to look for signs of a potential outbreak beginning late summer and early fall 2020. "As we head into these critical next months, CDC is taking necessary steps to help clinicians better recognize signs and symptoms of AFM in children," CDC Director Dr. Robert Redfield said in a statement. "Recognition and early diagnosis are critical. CDC and public health partners have strengthened early disease detection systems, a vital step toward rapid treatment and rehabilitation for children with AFM," he said. This illness has spiked every 2 years since 2014, and the number of cases has grown with each outbreak, as has the number of states affected. AFM is an uncommon but serious neurological condition that affects the spinal cord, specifically an area called the gray matter, according to the CDC. It can affect reflexes, weaken muscles, and even cause paralysis. The CDC says its seen more cases of AFM, also called a "polio-like illness," since 2014, and more than 90 percent of cases have been seen in children. While the cause is still unknown, a recent study finds strong evidence that a type of virus called enterovirus D68 (EV-D68) causes it. Polio is also caused by a type of enterovirus. "The increase in AFM cases we saw in 2014 occurred during a national outbreak of children with enterovirus D68," Dr. Robert Glatter, emergency physician at Lenox Hill Hospital in New York City, told Healthline. "However, the CDC did not consistently detect EV-D68 in every child with confirmed AFM." "Since the outbreak in 2014, the CDC started surveillance. Since then, it has become a rare condition, happening one in a million times," said Dr. Alla Al-Habib, a neurologist at Texas Health Presbyterian Hospital in Plano, Texas. Al-Habib adds that while the condition is thought to be related to "non-polio enteroviruses," others think it might be connected with West Nile virus and sometimes "even genetics and poisons." Al-Habib is concerned that the current pandemic could delay treatment for those affected, as people try to avoid infection with the new coronavirus. "Now, in the middle of the COVID-19 pandemic, physicians and scientists are concerned that patients may not go to the hospitals for evaluation," Al-Habib said. "This can worsen the patient's condition and complicate or even delay the recovery process." "While there are no specific therapies for AFM, supportive care is very crucial with hospitalization for monitoring, mainly to monitor rapid weakness deterioration and respiratory failure," explained Al-Habib, since around 30 percent of patients "may need ventilatory support." A lack of treatments specifically for this disease doesn't mean that medical professionals are powerless to help. "As in many neurological conditions that we don't have specific treatment for, we try to treat with immune-modulating therapy like IVIG [intravenous immunoglobulin], plasmapheresis, and with steroids," Al-Habib said. However, "there's no indication that plasma exchange/IVIG or steroids should be either preferred or avoided in the treatment of AFM," Al-Habib continued, since there's no clear human evidence whether it's effective or not for AFM. Enteroviruses are typically spread by either contact with secretions, such as mucus, saliva, and feces, and "by larger droplets" from someone with an infection, explains Glatter. "A person with enterovirus is contagious for about 10 days after symptoms develop," he said. He emphasizes the importance of adhering to hygienic practices like handwashing, avoiding people who are sick and coughing into an elbow. With the rise of COVID-19, wearing a face mask may also help decrease risk of developing AFM. Additional steps to reduce the risk of AFM include staying up to date on vaccinations and taking precautions to reduce the risk of mosquito bites. There can be long-term effects if someone does develop AFM. "Unfortunately, there are no collective data or any systemic reviews, but most of the patients seem to end up with some persistent and residual symptoms," Al-Habib said. "Their recovery seems incomplete, most of the time. However, there are chances for improvement with rehabilitation." Glatter cautions that while some people do rapidly recover, others remain "paralyzed and require a high level of ongoing care to support their breathing and monitor for neurological deterioration." Glatter says the symptoms of AFM are "quite similar" to poliovirus, West Nile virus, and adenoviruses, so it's very difficult to diagnose the condition. However, symptoms can include:
"AFM can also affect the respiratory muscles, leading to difficulty breathing and the need for a ventilator in severe cases," Glatter advised. But there's no need to panic. "Parents should also understand that while there have been an uptick in cases since 2014, the disease is still quite rare," Glatter said, adding that EV-D68 can also "lead to a mild to severe respiratory illness or minimal to no symptoms at all." He says parents need to "remain vigilant for signs of muscular weakness or difficulty breathing that develop during and after recovery from an upper respiratory infection," because we don't yet have a clear picture of which children may be at risk for developing AFM. The CDC warns that we may soon experience a peak in cases of acute flaccid myelitis (AFM), a condition similar to polio that strikes the nervous system and primarily affects children. Experts say the condition shares symptoms in common with COVID-19 and other diseases, so diagnosis is difficult, but people must remain vigilant so they can treat it as quickly as possible. Experts emphasize that AFM is still a rare condition, but following precautions against enterovirus infection may reduce risk.  Posted: 19 Aug 2020 05:00 AM PDT  A rare syndrome that paralyzes children's limbs would normally return this fall, but it's still unknown whether precautions to stop the spread of COVID-19 could keep it in check. The Centers for Disease Control and Prevention sent out a message this month asking doctors to look out for cases of acute flaccid myelitis, which causes muscle weakness or paralysis. AFM, as it's known, has followed a two-year pattern since 2014, with a spike in cases from August to November in even years and relatively few cases in odd years. Most kids who developed AFM had a common respiratory virus roughly a week earlier, so it's not clear if precautions meant to prevent the spread of COVID-19 will reduce the number of cases, said Dr. Kevin Messacar, a pediatric infectious disease researcher and physician at Children's Hospital Colorado and University of Colorado. There's no sign the virus believed to cause AFM was circulating in Colorado as of the second week of August, he said. Still, it's important for parents to be on the lookout for symptoms, because once nerves die, the damage can't be repaired, Messacar said. About 75% of kids they followed at Children's Hospital Colorado have some long-term muscle weakness, though physical therapy to strengthen surrounding muscles can help, he said. Symptoms to watch for include:
The disease isn't fully understood. The CDC believes enterovirus D68 is a major cause, though other common viruses could be behind some cases. Enteroviruses are a family that includes poliovirus, but EV-D68 typically causes cold-like symptoms. EV-D68 was first identified in the 1960s, but didn't attract much attention until the 2000s, when more kids started showing up with difficulty breathing, and later with muscle weakness, Messacar said. It's not clear why it started making kids sicker in recent years, he said. Even in years with more cases than usual, AFM is rare. The CDC recorded 238 cases in 2018, with most in the late summer or fall. About half of patients were admitted to an intensive care unit, and almost a quarter needed a ventilator to breathe. Most were young children, though cases have been reported in teens and adults. The reason for the two-year pattern isn't known with certainty, but common respiratory viruses do tend to follow a cycle, dipping after significant numbers of people were infected and coming back later, Messacar said. With EV-D68, it could reflect many children getting infected in school or daycare, so that the virus only gains a foothold again after enough younger, unexposed kids start attending. "There just needs to be enough susceptible people out there," he said. Parents don't need to be alarmed about common cold symptoms, but they should seek help immediately if a child is struggling to breathe or shows signs of muscle weakness, Messacar said. Weakness, in this sense, doesn't mean the general wiped-out feeling when you're sick, but difficulty with basic functions like walking, talking or swallowing, he said. "This is a child who wakes up and can no longer lift their arm," he said. Studies in mice show the virus can attack the spinal cord, but patients also tend to have substantial inflammation from the immune system's response, Messacar said. Researchers are still studying which is the culprit in paralysis cases, so they know whether it's better to treat patients with antiviral or anti-inflammatory drugs, he said. Work on a potential vaccine also is ongoing. Many people get EV-D68, and very few develop AFM. Still, it's important to study vaccines and treatments, in case it becomes a more common syndrome, Messacar said. That happened with polio, which has existed for thousands of years but only began causing large outbreaks in the 20th century, he said. "The goal is to study diseases while they're still uncommon and rare, so if they do become common, you have tools in your toolbox," he said. Subscribe to bi-weekly newsletter to get health news sent straight to your inbox. 
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