This year, more than half of all U.S. states have had confirmed or possible cases of acute flaccid myelitis, the polio-like illness that can cause paralysis and mostly affects children, according to an exclusive CNN analysis.
A sharp spike in cases of pediatric acute flaccid myelitis, or AFM, is raising red flags with health officials, who despite concerted efforts, haven't identified a cause.
"We understand that people particularly parents are concerned", Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, said in a here media briefing on Tuesday.
When AFM strikes, patients experience sudden weakness, as well as loss of muscle tone and reflexes in the arms and legs.
AFM may be caused by other viruses, including enterovirus, environmental toxins and a condition in which the body's immune system attacks and destroys tissue that it mistakes for foreign material, Messonnier said: "This is a mystery so far, and we haven't solved it yet, so we have to be thinking broadly".
Here is what is known about the disease that has had 127 confirmed or suspected cases in 22 states as of Tuesday, including Pennsylvania. Then two years later, when we had another outbreak in 2016, there was much less of an association with enterovirus D68, so we came to the conclusion that we can't definitively prove that there's a direct causal relation to anything right now.
Boston Children's Hospital has evaluated all of the confirmed and suspected AFM cases that occurred in MA this year.
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Data collected since the establishment of standardized surveillance helped with the identification of another increase in reports nationally during 2016 and has provided additional valuable information on the clinical presentation to help better characterize the clinical features, epidemiology, and short-term outcomes of cases of AFM.
It's too early to know whether the total for 2018 will surpass those previous years.
MA has seen a total of 16 confirmed cases in children since 2014, plus one probable case in an adult.
While AFM is incredibly rare, the current rate is less than one case for every 1 million Americans, Messonnier urged parents and health care providers to be on the lookout for symptoms. Those officials are probing another 65 illnesses in those states.
The CDC has tested many different specimens from patients with this condition for a wide variety of pathogens, or germs, that can cause AFM. The illness has been compared to the polio and West Nile viruses. We don't know who may be at higher risk for developing AFM or the reasons why they may be at higher risk.
There is no treatment specifically for AFM, but affected children can undergo physical and occupational therapy to maximize their strength and adapt to their limitations. The average age was 4. But some states have previously announced clusters, including Minnesota, Illinois, Colorado, New York and Washington. A spokeswoman for hospital said they have notified the health department and are working with the CDC to learn more about the illness.
The CDC is not saying how many states have patients under investigation, only that it's more than 22.