OLYMPIA – The Washington State Department of Health and four local public health agencies are investigating reports of five children hospitalized for sudden onset of paralysis of one or more limbs. The Department of Health is working with experts in neurology from the Centers for Disease Control and Prevention (CDC) for confirmation of acute flaccid myelitis (AFM).
All cases are among infants and children under age six who all reportedly had symptoms of a respiratory illness in the week prior to developing symptoms of AFM. Four of the five had fever of 100.4 F or greater. The children are residents of King County (2), Pierce County (1), Lewis County (1), and Snohomish County (1).
The children are being evaluated for AFM, a rare condition that affects the nervous system, specifically the spinal cord. Symptoms typically include sudden weakness in one or more arms or legs, along with loss of muscle tone and decreased or absent reflexes. AFM can cause a range of types and severity of symptoms, but the commonality among them is a loss of strength or movement in one or more arms or legs. The cause of any individual case of AFM can be hard to determine, and often, no cause is found. CDC specialists will make the final determination if these cases are AFM.
“At this point there isn’t evidence that would point to a single source of illness among these cases,” said Dr. Scott Lindquist, state infectious disease epidemiologist at the Department of Health. “We’re working closely with medical providers and public health agencies. We’ll continue to investigate and share information when we have it.”
Some viruses and germs have been linked to AFM, including common germs that can cause colds and sore throats, and respiratory infections. It can also be caused by poliovirus and non-polio enteroviruses, mosquito-borne viruses (such as West Nile virus or Zika virus) and possibly by non-infectious conditions.
While there are no specific recommendations for avoiding AFM, you can help protect yourself from some of its known causes by: washing your hands often with soap and water, avoiding close contact with sick people, and cleaning surfaces with a disinfectant, especially those that a sick person has touched. Staying updated on recommended immunizations is also important to avoiding vaccine preventable illnesses.
The Department of Health sent a notice to public health departments for distribution to healthcare providers across the state to be alert for other suspected AFM cases.
In 2016 there was a cluster of nine cases of AFM case in Washington state. In 2017 there were three cases, and since the beginning of 2018 there has been one case in the state.