Minnesota grapples with outbreak of acute flaccid myelitis

Rare illness leaves 3-year-old boy paralyzed

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Minnesota health officials have reported 6 children have been diagnosed [since September] with a rare disease known as Acute flaccid myelitis or AFM.

Sen. Amy Klobuchar, D-Minn., urged the CDC to investigate the national uptick of acute flaccid myelitis infections among children in an October 9 letter to CDC Director Robert Redfield, MD.

The condition, which affects mainly children, attacks the nervous system, causing muscles to weaken. Minnesota saw three AFM cases that year. An investigation is underway to determine what caused these specific cases of AFM.

The CDC recommends people follow normal disease prevention steps to avoid AFM, including staying current on vaccines, washing hands and avoiding mosquito bites.

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Melaney Arnold of the Illinois Department of Public Health says health care providers in the state have reported nine cases of AFM.

In 2014, doctors believed the cases might be linked to infection with enterovirus 68, a respiratory virus, according to a New York Times article. All of the cases have been reported on the west side of the state with two children in King County and one child in Pierce County, Lewis County and Snohomish County.

Some affected by AFM may also be unable to pass urine, and have difficulty breathing, requiring urgent ventricular support.

The condition is not new, but officials started to see a rise in cases in 2014.

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"It is very rare and it is certainly something we're taking very seriously", said Kris Ehresmann, who directs the Health Department's infectious disease section. Symptoms can include sudden arm and leg weakness, drooping eyelids, facial weakness, difficulty moving the eyes and slurred speech/difficulty swallowing. The CDC has not identified a germ that has been consistently found in every case of AFM, according to its website.

However, 11 of the Colorado cases of AFM have tested positive for EV A71, a rare type of enterovirus not usually seen in the US but instead in Asia and other parts of the world, according to Dr. Rachel Herlihy, the Colorado state epidemiologist. However, doctors who specialize in treating brain and spinal cord illnesses may recommend certain interventions on a case-by-case basis.

"We don't yet have any effective treatment for the virus or for the condition", Messacar said.

The disease usually presents itself at the end of a cold and then causes muscle weakness. And there are other diseases that mimic the symptoms, such as West Nile virus and Guillain Barre syndrome. It is sometimes caused by a viral infection, although environmental factors and genetic disorders may also contribute to its development.

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