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Doctor looks into more about cause, spread of AFM

April 18, 2019 06:24 PM

A doctor at University of Minnesota Medical School is revealing new insight about a rare disease that has been leaving children throughout the country suddenly paralyzed.

Acute flaccid myelitis, commonly known as AFM, is a condition that causes severe muscle weakness and loss of muscle tone in one or more parts of the body. 

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It’s caused by inflammation of the spinal cord.

There was a spike in AFM in 2018, with 228 cases reported nationwide. Ten of those came in Minnesota, the largest cluster of cases ever identified in the state.

“It is scary, and I think the biggest scare is uncertainty,” said Dr. Heidi Moline, the chief resident of pediatrics at the UMN Medical School.

Moline has been working with experts from the Centers for Disease Control and Prevention and the Minnesota Department of Health over the past few months to better understand the course of the illness and what may be causing it.

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The findings are being released in the CDC’s Morbidity and Mortality Weekly Report.

Moline looked at the first six AFM patients in Minnesota in 2018, examining their cases for commonalities. She found the kids lived in different counties and ranged in age from 16 months to nine years. She reported all six experienced fever and upper respiratory symptoms - such as a cough - an average of eight days before developing muscle weakness. 

“They were better for about a week," she said. "They went to bed feeling well, and woke up in the morning maybe having difficulty raising their arm to brush their hair or could no longer raise a spoonful of cereal to their mouth."

AFM is believed to be caused by certain viral infections that attack the spinal cord. Some of the viruses are relatively common, but only a small fraction of patients go on to develop AFM.

“That's been the challenge here with our recent outbreaks - that we haven’t been able to identify a specific virus in the spinal fluid,” Moline said.

But in Moline’s report, something specific was found in the brain fluid of one of the Minnesota patients - Enterovirus-D68.

“It's the first time in the United States (that) we found indisputable evidence of EV-D68 in the cerebrospinal fluid during an outbreak period,” Moline said. “So it's reassuring that we know a little bit more now about another virus that could be part of that group that is known to cause AFM.”

Moline admits more work needs to be done to figure out why some cases of Enterovirus-D68 develop into AFM, while others don't.

"We don’t have all the answers yet so we need to continue to explore more about this illness,” she said.


 

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Alex Jokich

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