The words and phrases being tossed around are dire: Serious childhood illness. Polio. Paralysis. Unknown origin. And worst of all, this combination: spiking in occurrence, with no clear treatment protocol.
Federal health officials have warned of a small surge in cases of a rare and mysterious condition affecting mainly children across the US. The condition, called acute flaccid myelitis or AFM, that mimics polio, has potentially sickened more than 250 people, according to the Centers for Disease Control and Prevention. Of these cases, 90 have been confirmed — and there appear to be no geographic clusters in the outbreak so far. Cases have been reported in nearly every state.
Most of the patients are children under the age of 18, with an average age of 4. The most common symptoms include sudden weakness and loss of muscle tone in arms or legs, as well as difficulty swallowing, facial or eyelid drooping, and slurred speech. Some children have required ventilators in order to breathe.
Medical care for affected children tends to be supportive (helping them eat, breathe and move) since at this point, doctors don’t have one firm treatment protocol in place. In many instances, patients are able to leave the hospital, significantly improved, after approximately two weeks. But it’s not always the case. Some children remain significantly weakened and in 2017, one AFM-related death was reported.
The illness is devastating to families and confounding to researchers who have not been able to tie it to one specific virus. For example, a strain of a respiratory virus called enterovirus has been detected in several cases.The poliovirus and the West Nile virus have also been detected in some patients – but not every time and not in every patient. And while many of the symptoms are similar to polio, not one of the patients has tested positive for polio. It isn't a disease that has been traced to any one nationality or country (except for the U.S.), meaning there is no reason to think it was brought into the U.S. from international sources.
Those are all the knowns – and unfortunately, there aren’t many of them. What is known is enough to make parents nervous, particularly those whose children will be traveling for tournaments. What should sports event planners be prepared to do in order to help allay parents’ fears?
While the CDC has not been able to identify a clear cause for the illness, they have outlined some basic precautions individuals can take (and which parents can pass along to their children).
Individuals can protect themselves and their children from poliovirus by getting vaccinated. Polio vaccine contains inactivated (not live) virus and protects against poliovirus. This vaccine does not protect against other viruses that may cause AFM. (However, making sure all vaccines are updated is never a bad idea).
Protect against bites from mosquitoes, which can carry West Nile virus, by using mosquito repellent, staying indoors at dusk and dawn (when bites are more common), and removing standing or stagnant water (where mosquitoes can breed).
Guard against becoming infected with enteroviruses (and other communicable illnesses) by washing hands often with soap and water, avoiding close contact with people who are sick, and cleaning and disinfecting frequently touched surfaces, including toys and shared sports equipment.
See a doctor at the first sign of symptoms of any respiratory illness – without waiting for it to worsen.
The last major uptick in AFM cases happened in 2014 and coincided with an outbreak of the enterovirus, which by and large had flu-like symptoms — but in some cases, could also lead to sudden paralysis and infections in the heart and brain.
Since the CDC began tracking AFM in 2014, they’ve detected between 22 and 149 cases every year. But this year’s AFM outbreak is notable because there’s already a spike in cases — and the year is not yet over. The current number is also significantly higher than the 33 cases confirmed last year, and the CDC hasn’t been able to figure out what’s driving the uptick.
For more information on research, and on any information the CDC has uncovered, see the AFM Investigation page.
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