Mystery Child Virus Stirs Fresh U.S. Concern on Possible Return

(Bloomberg) -- Government health officials are urging U.S. doctors to be on the lookout for a mysterious condition that has begun to re-emerge in late summer and early fall, targeting healthy young children and leaving them paralyzed.

The first sign of what scientists are calling acute flaccid myelitis, or AFM, occurred in 2014, amid an outbreak of a severe respiratory infection caused by the EV-D68 virus. Most of the affected children were healthy until an infection caused fever or cold symptoms about a week before they started losing muscle strength, said officials with the U.S. Centers for Disease Control and Prevention. There have been about 570 cases to date.

Many of the children had friends and siblings that seemed to clear the virus without any problem, the researchers said, and it’s still not clear if the EV-D68 virus is to blame. There is no known way to prevent or treat it, and doctors are still unable to predict which children will develop paralysis. For those who do, the paralysis and weakness can last for months and it’s unclear how many will fully recover.

“We want clinicians and parents to be ready for a possible significant outbreak this year,” Anne Schuchat, principal deputy director of the CDC, said on a conference call with reporters. “One of the reasons we are reporting these results right now in July is because it’s every August that we start to see the uptick.”

Identifying potential patients early in the course of the disease is critical since the condition can quickly spiral from limb weakness to full-blown respiratory failure that requires intensive medical care, according to the CDC. Children who get the condition tend to be about 5 years old.

Researchers from the agency analyzed 233 cases that occurred across 41 states in 2018, which marked the biggest outbreak, to better understand how the disease behaves. Almost all the patients were hospitalized, 60% were admitted to the intensive-care unit and 27% required machines to help them breathe, said Tom Clark, a pediatrician and deputy director of the CDC’s division of viral diseases.

Previous work found more than 70% of patients still had limb weakness months after the disease first took hold.

“We really do think that early and aggressive physical therapy and rehabilitation holds good promise to help kids strengthen the function that they have after AFM,” Clark said. “Unfortunately, we don’t have good evidence for the benefits of any of those treatments. This is an important question for us and why we are working to identify every case.”

The illness typically hit hardest every other year. There have been 11 reported cases thus far in 2019, mimicking lower levels seen in odd-numbered years, Schuchat said.

The CDC is telling doctors to quickly report any suspected cases to their state health department. The agency is investigating every case, and an early alert gives its disease detectives a better chance to understand what is happening. In 2018, it took 18 to 36 days before cases were reported to the CDC, a lag the agency hopes to slash.

“We ask for your help with early recognition of patients with AFM symptoms,” Schuchat said. When doctors diagnose, collect samples and report cases earlier, “we have a better chance of understanding the causes of AFM, these recurrent outbreaks and developing a diagnostic test. Rapid reporting also helps us to identify and respond to outbreaks early and alert other clinicians and the public.”

To contact the reporters on this story: Michelle Fay Cortez in Minneapolis at mcortez@bloomberg.net;Myah Ward in New York at mward174@bloomberg.net

To contact the editors responsible for this story: Drew Armstrong at darmstrong17@bloomberg.net, Mark Schoifet

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