Saint Paul, Minnesota, USA : Health investigators are trying to figure out how some Minnesota children contracted a rare illness with polio-like symptoms that has left them partially paralyzed. At least six children in Minnesota have been diagnosed and hospitalized with acute flaccid myelitis (or AFM) since September 20. On average, the Minnesota Department of Health sees only about one case per year
Quinton Hill, 7, spent two weeks in a hospital undergoing a range of tests, according to his parents, before he was finally diagnosed with acute flaccid myelitis, also known as AFM, a rare and serious condition that typically strikes children and affects the nervous system resulting in muscle and nerve weakness.
“He started just complaining of just really bad neck stiffness. He couldn’t move his neck and then his left arm,” Quinton’s father, James Hill, told reporters. “We thought it was a ‘dead arm,’ like he was laying on it funny so we didn’t think much of it at first…Couple hours into not being able to move his arm, we started getting more concerned.”
The Minnesota Department of Health said that six pediatric cases of AFM have been reported since mid-September.
“It can be a complication following a viral infection, but environmental and genetic factors may also contribute to its development,” the health department said Friday in a press release.
Patients experienced weakness in one or more of their limbs, and all cases of AFM have been hospitalized, according to the Minnesota Health Department. Two cases required treatment in the intensive care unit for respiratory support, and all cases involved children younger than 10 years old from the Twin Cities area or central and northeastern Minnesota.
The Minnesota health department issued an alert last Thursday, urging hospitals and clinics to be on the lookout for any symptoms associated with the rare disease.
The Centers for Disease Control and Prevention, which said AFM presents like polio or West Nile virus, estimates that fewer than one in a million people in the U.S. will get AFM each year. Symptoms include weakness, loss of muscle tone, facial droop, difficulty swallowing, slurred speech and in severe cases, paralysis.
However, there has been a national uptick in cases of AFM since 2014, with 362 cases recorded between 2014 and 2018, according to the CDC and the Minnesota Department of Health.
The Minnesota Department of Health said that the state had three cases of AFM in 2014. Since then, however, the Minnesota Department of Health said it has seen an AFM case about once a year.
While there are a variety of possible causes for the disease, there is no known cure.
“It starts off with a cold, cough, runny nose, congestion and then before you know it, you have weakness and paralysis of your arms and your legs,” Dr. Janette Nesheiwat, a family physician, said.
After a frightening few weeks, Quinton is starting to get his strength back, his father said. In the meantime Quinton is adapting to live without the use of his left arm.
For one Minneapolis boy, he started to have trouble moving as he recovered from a cold. Elaine and Michael Young said that soon after their now-four-year-old son Orville developed a fever in July, he started losing mobility in his right arm.
“I said, ‘Hey, buddy, can you lift your right arm?’ And he goes, ‘I can’t,'” said Elaine.
The Youngs say doctors ran several tests, but only got closer to a diagnosis after a second MRI. “The results come back that he had an abnormality through his entire spinal cord,” said Elaine.
Orville was diagnosed with acute flaccid myelitis, or AFM, and spent six days in the hospital. At his worst, the Youngs say, Orville was unable to move the upper part of his right arm and had difficulty moving his legs and sitting up.
Michael Young said, “I just felt so sad for him that this thing that we didn’t know about and couldn’t protect him from had happened and had taken a lot away from him.”
The Youngs say Orville has regained most of his muscle function, except in his upper right arm. They don’t know if he’ll be able to move it again.
A reporter asked, “How confusing is this to him?”
“You know, he’s a trouper,” said Elaine Young.
Michael added, “He’s remarkably, like, able to wrap his head around this as it’s going on. He’s kind of like, one day at a time, whereas we’re worried about the whole rest of his life.”
Orville is in therapy and faces possible surgery.
Since 2014, more than 360 cases of AFM have been reported in the U.S. There’s still a lot doctors don’t know about it, and there aren’t specific treatments available.
Avoiding germs could help lower the risk of getting the disease, including washing your hands or staying up-to-date on vaccinations.
Image : Quinton Hill, 7, spent two weeks in a Minnesota hospital undergoing a range of tests before he was finally diagnosed with acute flaccid myelitis or AFM.
Below is the advisory issued by the Minnesota Department of Health (MDH):
Statement on cases of acute flaccid myelitis
The Minnesota Department of Health (MDH) issued the following statement today regarding reported cases of acute flaccid myelitis (AFM) in six children around the state over the last few weeks. AFM is a rare but potentially severe condition that can arise following an infection, and in some cases it can lead to death, paralysis or other long-term health impacts.
The Minnesota Department of Health (MDH) is investigating six cases of a rare condition called acute flaccid myelitis (AFM) that occurred since mid-September in Minnesota children.
AFM is a rare but serious condition that affects the nervous system, causing muscles to weaken. It can be a complication following a viral infection, but environmental and genetic factors may also contribute to its development. AFM symptoms include sudden muscle weakness in the arms or legs, sometimes following a respiratory illness. Other symptoms may include:
Neck weakness or stiffness
Drooping eyelids or a facial droop.
Difficulty swallowing or slurred speech.
MDH disease investigators are working aggressively with health care providers to gather information about the cases. The department is also in contact with the Centers for Disease Control and Prevention (CDC) to share information.
For reasons not fully understood, AFM affects mainly children. All recent Minnesota cases have been in children under 10 years old and all were hospitalized. Cases have been reported from the Twin Cities, central Minnesota and northeastern Minnesota.
There was a national uptick in AFM cases in 2014. Disease investigators believe this was linked to an outbreak of a respiratory illness in children that was caused by a virus known as enterovirus D 68 (EVD68). Minnesota saw three AFM cases that year. Since then, we have typically seen less than one case a year.
Since AFM can develop as a result of a viral infection, MDH recommends parents and children take basic steps to avoid infections and stay healthy:
Wash your hands frequently to limit your exposure to germs.
Cover your cough or sneeze.
Stay home if you are sick.
Stay up to date on vaccinations.
Protect yourself and children from mosquito bites if you’re spending time outside.
If parents see potential symptoms of AFM in their child, (for example, if he or she is not using an arm) they should contact their health care provider as soon as possible. AFM can be diagnosed by examining a person’s nervous system, taking an MRI scan and testing the cerebral spinal fluid. It is important that tests are done as soon as possible after someone develops symptoms. While there is no specific treatment for AFM, doctors may recommend certain interventions on a case-by-case basis.