The Centers for Disease Control and Prevention anticipates 2020 will be another peak year for cases of acute flaccid myelitis, or AFM, the mysterious polio-like illness that causes paralysis in children.
The agency attributes this increase in cases to enteroviruses, particularly EV-D68, according to the CDC Vital Signs report released Tuesday. It’s the most common virus identified among patients with AFM.
Researchers had pinpointed enteroviruses in the past, suggesting the devastating disease could be caused by this strain of respiratory virus. Results of a fall study were published by the University of California, San Francisco in the peer-reviewed journal Nature Medicine in October 2019.
The CDC said the disease has peaked every two years between August and November in the United States since 2014, when the CDC first began AFM surveillance.
Fewer than 1 in 1 million children are affected by AFM, but cases have grown over the years.
While other countries have reported cases, including Canada, France, Britain and Norway, the size and pattern of the U.S. outbreaks have been more pronounced. More than 550 Americans have been struck this decade. The oldest was 32. More than 90% were children, most around 4, 5 or 6 years old.
AFM cases are still exceedingly rare, but the results are devastating. It can paralyze a child’s arms and legs. Some need ventilators to breathe. It can also cause muscle weakness, slurred speech and difficulty moving eyes and swallowing.
What parents should know: About the polio-like paralyzing disease the CDC is warning about
Many families say their children have regained at least some movement in affected limbs, but stories of complete recovery are unusual.
While symptoms of the disease resemble polio, the CDC said all AFM patients tested negative for the poliovirus.
The agency also reported 35% of patients weren’t hospitalized until two or more days after limb weakness in 2018, delaying care that could be vital to patient treatment.
“Recognition and early diagnosis are critical,” said CDC director Dr. Robert Redfield. “CDC and public health partners have strengthened early disease detection systems, a vital step toward rapid treatment and rehabilitation for children with AFM.”
Dr. Thomas Clark, deputy director of the CDC’s division of viral diseases, says the COVID-19 pandemic may require clinicians to perform evaluations by phone or telemedicine. However, he urges doctors not to delay hospitalization when they suspect AFM.
Dr. Robert Glatter, emergency physician at Lenox Hill Hospital in New York City, said there has been a sharp decrease in emergency room visits not related to COVID-19.
He predicts the pandemic's impact on the health care system and access to medical care will "most likely have an adverse effect on our ability to detect, refer and rapidly evaluate patients with AFM."
"While we recognize that parents are concerned about the risks of COVID-19 when making a visit to the ER, the greater risks of permanent paralysis and mechanical ventilation resulting from AFM should take precedence," he said.
Common early symptoms of AFM include difficulty walking, neck or back pain, fever and limb pain. There is currently no specific test, proven treatment or prevention method for AFM.
Contributing: Mike Stobbe, Associated Press. Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
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This article originally appeared on USA TODAY: Acute flaccid myelitis: CDC anticipates AFM case increase in 2020