Polio-like Virus Versus Polio

Acute flaccid myelitis (AFM) is the correct name for the polio-like virus that is spreading slowly and often reported on the news. There are only 90 cases so far in 2018, found in 27 states, but another 162 patients are being investigated. While this number seems small, it is growing each year since 2014, according to the CDC. AFM has occurred in 46 states and in Washington DC in past years.

Even though the number is small the effects of this disease are very serious for many people. AFM typically affects children with an age range from 5 to 20 years, and most of the time this disease occurs in the late summer of early fall of the year.

AFM affects the nervous system, which can cause paralysis. The gray matter of the spinal cord is specifically affected, and that will cause muscles and the reflexes in the body to weaken. There are some particular enteroviruses that can cause AFM, including enterovirus A71 (EV-A71 and EV-D68) and the West Nile virus.

Over 90% of patients with AFM begin with a mild respiratory disease, diarrhea or a fever that is consistent with a viral infection before the AFM symptoms begin. Most people recover from this illness, but the ones that do not recover have life-altering symptoms. There has been one death.

The actual symptoms of AFM include:

• Most patients will have sudden onset of limb impairment
• Extremity weakness
• Some patients have both upper and lower motor neuron involvement
• Drooping eyelids
• Facial droop/weakness
• Difficulty moving the eyes,
• Difficulty with swallowing and slurred speech
• Rare symptoms include numbness or tingling in the extremities or being
• Unable to pass urine
• Difficulty with breathing has happened in rare cases due to muscle weakness, which may require a ventilator

A neurologist uses a case by case basis to diagnose AFM and determine testing and treatment. Diagnosis is made with a careful exam of the spinal cord and nervous system, plus specific areas of muscle weakness. An MRI will show lesions on the spinal cord. Some blood work is ordered, a spinal tap to check the fluid around the brain and spinal cord, nerve reflexes will be checked and a nerve conduction may be ordered.

This disease has affected those who have not been vaccinated for polio, so the polio vaccination is not causing this disease. No true cause is known.

Treatments obviously must be determined on an individual basis. The data for determining treatment is insufficient, but scientist are researching this disease. There is an AFM task force established to collaborate with the CDC to try and prevent and treat AFM.

Acute treatment includes IV steroids in high doses, IVIg and plasma exchange. The CDC has recommended that caregivers of children should discuss these treatments with their doctor. The goal is to reduce inflammation in the spinal cord.

Some Other treatment include:

1. Intensive physical therapy
2. Occupational therapy

While there is really no way to prevent AMF, the CDC recommended preventative measures:

1. Get the polio vaccine
2. Washing hands frequently
3. Prevent mosquito bites by using a repellent for West Nile virus

Polio is caused by the poliovirus, and a horrible, disabling disease. It has been completely eradicated in 80% of the world. People with polio have entered the US, but rarely, however, one traveler with polio can cause infection in a person that has not been vaccinated.

Polio is potentially deadly, causing lifelong paralysis with some people ending up in an iron lung. Polio is a very communicable disease among children, and it invades the brain and spinal cord. In the1950s, it was a very feared disease. Swimming pools were closed and windows sealed shut in the summer. Dr. Jonas Salk discovered a vaccine in 1951, then Dr. Albert Sabin discovered an oral vaccine in 1957.

The inactivated polio vaccine (IPV) has been given in the US since 2000. Albert Sabin and Jonas Salk could each rightfully claim credit for the near-eradication of polio as a one of the greatest accomplishments in the 20th century.

Even though the number of people with long term effects from acute flaccid myelitis are low, the seriousness of this disease needs to be respected. The number of patients could increase, and the fact that no one is not really sure what causes the disease is important. Hopefully, a cure will be in the near future.

• https://www.cdc.gov/acute-flaccid-myelitis/downloads/fs-acute-flaccid-myelitis.pdf
• https://qz.com/1426337/what-is-acute-flaccid-myelitis-a-polio-like-disease-is-spreading-across-the-us-according-to-the-cdc/
• https://www.cdc.gov/vaccines/vpd/polio/index.html
• https://vaxopedia.org/2018/10/03/do-vaccines-cause-acute-flaccid-myelitis/
• https://myelitis.org/living-with-myelitis/disease-information/afm/
• https://www.npr.org/sections/health.../wiping-out-polio-how-the-u-s-snuffed-out-a-killer
• https://www.smithsonianmag.com/history/salk-sabin-and-the-race-against-polio-169813703/#rKsGKP49I3rUWGzO.99
• https://en.wikipedia.org/wiki/Cold_War_tensions_and_the_polio_vaccine
• https://www.smithsonianmag.com/history/salk-sabin-and-the-race-against-polio-169813703/#rKsGKP49I3rUWGzO.99

• https://www.cdc.gov/acute-flaccid-myelitis/afm-surveillance.html