Wednesday, October 10, 2018

Illinois & Texas Also Reporting Cases Of Acute Flaccid Myelitis


On Monday we learned of an outbreak of AFM in Minnesota (n=6), and earlier today, in More Reports Of Acute Flaccid Myelitis Around The Country, I reported on recent cases reported in Colorado (n=14), Pennsylvania (n=3), and Chicago (n=1).
For a more detailed discussion of AFM, and its possible causes, please refer this morning's blog.
Since then at least two more states have announced cases, including 9 cases reported today by the Illinois Department of Public Health.

Statement On Acute Flaccid Myelitis

10th Oct, 2018

SPRINGFIELD – The Illinois Department of Public Health (IDPH) has received recent reports from health care providers of nine sporadic, clinically diagnosed cases of acute flaccid myelitis (AFM).  IDPH is working with the health care providers to collect necessary information to send to the Centers for Disease Control and Prevention (CDC).  The CDC reviews medical information on all reported clinical cases to confirm the diagnosis. The case reports are from individuals younger than 18 years of age and from northern Illinois.  Specific location information is not available.  The CDC will make the final determination on diagnoses and numbers are subject to change.

In September, IDPH issued an alert to health care providers about AFM, including information about reporting this clinical syndrome and submitting specimens.  Illinois has monitored this syndrome since 2014 when it was first described by CDC.  Since 2015, four cases reviewed by CDC experts have been counted in Illinois.  IDPH continues to work closely with the CDC to monitor reports of AFM. 

AFM is a serious, but uncommon condition.  It affects a person’s nervous system, specifically the spinal cord.  AFM or neurologic conditions like it have a variety of causes, including viruses, environmental toxins, and genetic disorders.  The viruses can include:

  • enteroviruses (polio and non-polio)
  • West Nile virus and viruses in the same family
  • adenoviruses
Much is still unknown about AFM and often, a cause for AFM cannot be identified.  Symptoms can include:
  • sudden onset of limb weakness and loss of muscle tone and reflexes
  • facial droop/weakness
  • difficulty moving the eyes
  • drooping eyelids
  • difficulty with swallowing or slurred speech
If you or your child develops any of these symptoms, you should seek medical care right away.

There is no specific treatment for AFM, but a doctor who specializes in treating brain and spinal cord illnesses may recommend certain interventions on a case-by-case basis.

Although we are still learning about AFM and its causes, being up to date on all recommended vaccinations, including poliovirus, is one way to protect yourself and your family from diseases that can cause AFM.  You can also protect yourself from mosquito-borne viruses such as West Nile virus—another known cause of AFM.

While we don’t know if it is effective in preventing AFM, steps you can take to help stay healthy include:

  • washing your hands often with soap and water
  • avoiding close contact with sick people
  • leaning surfaces with a disinfectant, especially surfaces that a sick person has touched
For more information on acute flaccid myelitis, visit
Media outlets in Texas are reporting on 3 cases there as well (see North Texas Children Among Those With Rare Polio-Like Illness).
It is too soon to know how this fall's uptick will compare to those reported in 2014 and 2016, or for that matter, what is driving these cases.
While the CDC continues to investigate, there are still more questions than answers, as highlighted on their AFM Investigation website:
What We Don’t Know
Among the people who were diagnosed with AFM since August 2014:
  • The cause of most of the AFM cases remains unknown.
  • We don’t know what caused the increase in AFM cases starting in 2014.
  • We have not yet determined who is at higher risk for developing AFM, or the reasons why they may be at higher risk.
  • We do not yet know the long-term effects of AFM. We know that some patients diagnosed with AFM have recovered quickly, and some continue to have paralysis and require ongoing care.
See prevention for information about how to protect your family from viruses that may cause AFM.

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