Health Alert for Child Patients

"The way that it presents in children is with a pretty sudden weakness or paralysis of one or more of their limbs. So maybe an arm or maybe a leg or maybe an arm and a leg, and in this particular acute flaccid myelitis, it's usually on one side [that is affected]."
"Even with the spike of cases that we have at the moment, it's still an incredibly rare condition."
"When you think about how many kids will get a viral infection at this time of year, you're literally talking about huge numbers. So a tiny, tiny percentage seems to go on to get AFM [acute flaccid myelitis]."
"So there does seem like there's more to this than just the virus infection and there has to be some sort of genetic setup that makes these children vulnerable to that particular virus."
"We know from past experience that the prognosis and long-term effects of AFP [acute flaccid paralysis] can vary: Some patients recover fully and others experience a spectrum of long-term and even permanent effects."
"[The risk of a child developing the condition] is still incredibly low. But that said, because we are seeing quite a few more cases than we would normally see, we certainly want our colleagues … to be aware of what to look for."
"The message I would send out is there’s no cause for alarm." Dr. Jeremy Friedman, pediatrician-in-chief, Hospital for Sick Children, Toronto

Toronto Sick Kids Hospital in Toronto. Doctors at the hospital are unsure what is causing a spike in polio-like paralysis targeting kids. (Doug Ives/Canadian Press)

"This year, more than half of all US 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."

"CNN reached out to health departments in every state; 48 states responded, plus the District of Columbia. Of those, 30 states said they had cases that were confirmed, suspected or being investigated -- including 15 states that said they had confirmed cases in 2018."

"In total, CNN found 47 confirmed cases and 49 more that were suspected or being investigated, for a total of 96."

"The US Centers for Disease Control and Prevention, which releases only confirmed numbers, says 16 states had 38 cases as of September 30. It does not identify the states."

CNN, October 18, 2018

Four-year-old Orville Young, right, is is believed to be one of the first patients in the Minnesota cluster of acute flaccid myelitis patients.  Business Insider

 

 

 

An alarm has been raised by Dr. Friedman of Toronto's Hospital for Sick Children of unusual instances in an admittedly rare, but dangerous polio-like condition affecting the health of some Canadian children. A condition called acute flaccid myelitis (AFM) which causes muscle weakness and which typically manifests after a viral infection has doctors concerned and vigilant, even though it is rarely seen to affect children, and its onset mechanism is not quite understood, though it is thought that those affected have a genetic predisposition.

According to Dr. Friedman, staff physicians at Sick Kids have diagnosed fewer than twenty cases of limb-based paralysis since September, and of that number a dozen have been confirmed as acute flaccid myelitis. Canada is certainly not alone in discovering that this rare condition has suddenly begun to crop up in greater numbers than what is considered normal. Dozens of reports have been surfacing out of the United States within that same time period; early September to the present.

Although the condition is still considered rare, a vanishingly minuscule number of children being affected, even with this perceived 'outbreak' -- to place the matter in perspective -- Sick Kids sees a mere two cases of AFM annually, accounting for an annual incidence risk of about one case per million children, for the condition. What it is that triggers the onset of AFM remains unknown, however, other than that it follows a viral infection.

MRI imagining does disclose that children with AFM have an inflammatory abnormality in an area of the spinal cord called the anterior horn cell. The U.S. Centers for Disease Control last week reported over 60 confirmed cases in 22 U.S. states in the last several weeks. In total, since the beginning of 2018, 127 cases of AFM have been reported in the United States, with one death occurring related to the condition.



Those seen with AFM at Sick Kids are all children under 14; though the average age of affected children is four, most onsets tend to appear with children of pre-school age. Some of the affected children at Sick Kids were treated in the ICU (intensive care unit) but fortunately, no deaths have resulted from the outbreak. According to a spokesperson for the Public Health Agency of Canada, current surveillance data have not detected any surge in such cases recently.