Five things to know about the poliolike condition that has hospitalized two Chicago-area children

October 12, 2018 by Elvia Malagon, Chicago Tribune

At least two children who have been diagnosed with a rare but serious condition that weakens muscles and limits mobility are being treated in Chicago, according to Lurie Children's Hospital.

The parents of a Batavia 2-year-old, Julia Payne, went public in hopes of raising awareness for acute flaccid myelitis, or AFM, which causes inflammation in the spinal cord area that directly affects a person's muscles. Now the downtown Chicago hospital says a second child is being treated there, but the family in the second case did not want to be identified.

The two children are among nine recent cases of AFM—all involving minors—reported across the state, according to the Illinois Department of Public Health. Just last month, the department issued an alert to medical providers about AFM and how to properly report it. The federal Centers for Disease Control and Prevention, which has been tracking cases in the United States, says the condition isn't new but reports that nationwide saw an uptick in cases starting in 2014.

It has been compared with polio because the condition can lead to paralysis. The causes of AFM vary from viruses to environmental toxins to genetic disorders, according to the state health department. The CDC has not identified a germ that has been found in every case of AFM, according to its website.

Here are five things to know about AFM:

-How many children have been diagnosed with AFM?

Since the CDC began tracking AFM cases four years ago, at least 362 cases have been logged nationwide, according to the agency's website. This year alone there have been 38 people diagnosed with the disease across 16 states.

-What are the symptoms?

Like many children, Julia, the toddler at Lurie, started to show signs of weakness and problems breathing on her own after a prolonged cold, said Dr. Marcelo Malakooti, the medical director for Lurie's pediatric intensive care unit. But those aren't the only signs: Other symptoms can include eyelid or facial drooping, difficulty moving the eyes, difficulty swallowing and slurred speech, according to the state health department.

-What's the treatment?

There is no known cure for AFM, but doctors can provide supportive care to patients. There isn't a vaccine that could prevent AFM and there isn't a vaccine that causes the condition, medical experts said. A medical report detailing the case of a 12-year-old boy who had been diagnosed with AFM noted that caring for patients with the condition often means involving an infectious disease physician, a neurologist, an orthotist, a physical therapist and a speech therapist.

For Julia, doctors did a type of dialysis to clear out her blood, and she has a ventilator to help her breathe. She soon will be transferred from the hospital to a rehabilitation center where she will continue physical therapy.

-Do patients make a full recovery?

Answering that question is complicated, said Mark Schleiss, a professor of pediatrics at the University of Minnesota Medical School. He was among those who treated a 12-year-old boy diagnosed last month with AFM at a Minneapolis hospital. The child was hospitalized for five days and given intensive outpatient physical therapy, according to the report.

The condition targets the spinal cord area that directly affects a person's muscles. The cells that are killed during the illness don't regenerate and the damage to the cells is irreversible, Schleiss explained. However, the patients can regain functionality of the muscles through . Another medical expert said surgery was an option in severe cases.

-Is it contagious? Any prevention tips?

While AFM itself isn't contagious, the viruses that may lead to AFM are. In Chicago, doctors say Julia had an enterovirus that caused the AFM. On its website, the CDC explains that nonpolio enteroviruses, which normally don't make people sick and if they do, it's often the common cold, can cause AFM.

"Scientifically, we don't understand why only some children will go on to develop AFM," Schleiss said. "Most kids just have a fever for a couple of days and maybe a rash or diarrhea."

Experts say good hygiene and making sure little ones are washing their hands can prevent the spread of viruses and germs.

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