Increasingly mysterious polio-like diseases in the United States

Puzzling polio-like illness causes uncertainty in the US
US health officials report an increase in the occurrence of polio-like illness, which may be associated with paralysis in the extremities and, in the worst case, respiratory failure. According to the Centers for Disease Control and Prevention (CDC), 50 people have been diagnosed with Acute Flavid Myelitis (AFM) by the end of August 2016. This is more than twice as many diseases as in the previous year. What causes the disease is still unclear, according to the CDC.

The occurrence of polio-like paralysis in children and adolescents is still a mystery to the CDC. After 2014, a total of 120 people were affected by AFM, the symptoms appeared to be significantly less important in 2015 (21 cases). But currently, the numbers have increased again. The search for possible triggers of acute inflammation in the spinal cord is in full swing, but so far without clear results.

Acute Sagittal Myelitis (AFM), with its polio-like symptoms in the United States, causes uncertainty, especially as the cause remains unclear. (Image: didesign / fotolia.com)

So far no trend recognizable
While it is still difficult to determine a trend in AFM diagnostics, reporting started in 2014 and is voluntary in most US states. But the disease remains in any case. The symptoms are similar to the symptoms of infections with certain viruses, such as the poliovirus, other enteroviruses, adenoviruses or the West Nile virus. As a possible trigger, therefore, especially these viruses are considered.

What are the AFM symptoms??
Symptoms of AFM include pain in the extremities, inability to urinate, and worst-case respiratory failure (respiratory insufficiency) associated with respiratory muscle involvement. According to the CDC, the latter symptom may require urgent artificial respiration. A targeted therapy does not exist so far, but there is usually a treatment based on the respective symptoms.

Cause of the disease remains unclear
Despite extensive testing, the cause of AFM cases is still unclear. The obvious suspicion of the enterovirus D68, which caused numerous respiratory infections in the USA in 2014, could not be confirmed in 2015 and 2016. And the mechanism of the disease remains a mystery. What causes the disruption of the signals from the nervous system to the muscles in the arms and legs, could not be deciphered so far.

Search for the triggers of AFM cases
The CDC claims to actively investigate all AFM cases and monitor their distribution. For example, various samples including stool, blood, respiratory and CSF samples are analyzed in the laboratory. It also works closely with healthcare providers, as well as state and local health agencies to raise awareness and improve reporting, the CDC reports. (Fp)