KAILUA-KONA — Hawaii health officials said Thursday the state has yet to confirm a case of acute flaccid myelitis — a polio-like illness that’s infected dozens of people, most frequently children, across the nation.
Some 38 cases of acute flaccid myelitis, or AFM, have been confirmed in 16 states across the nation through Sept. 30, according to the Centers for Disease Control and Prevention, which has been monitoring and investigating an increasing number of cases of AFM since 2014. States reporting cases include Illinois, Washington, Colorado, Minnesota and Texas.
Anna Koethe, public health information coordinator for the Hawaii Department of Health, told West Hawaii Today on Thursday that the department had “not received any verified reports” of AFM in Hawaii so far in 2018.
“For now, DOH is staying up-to-date with the latest guidance shared with states by the US Centers for Disease Control and Prevention (CDC) regarding diagnosis and management of acute flaccid myelitis and continuing to monitor for any such cases,” she said.
Acute flaccid myelitis is a rare condition that affects a person’s nervous system, specifically the spinal cord, according to the CDC. A virus, a genetic disorder, and environmental toxins can cause it.
Symptoms, health officials say, can be similar to those associated with poliovirus and West Nile and include facial and eyelid drooping, facial weakness, difficulty moving the eyes, difficulty swallowing, slurred speech, sudden limb weakness and loss of muscle tone and reflexes in the arms or legs. Poliovirus and West Nile virus may sometimes lead to AFM.
There is no specific treatment for AFM, but a neurologist, a doctor who specializes in treating brain and spinal cord illnesses, may recommend interventions on a case-by-case basis. Though long-term effects are not yet fully understood, the CDC said some patients have recovered quickly while others continue to suffer paralysis and require ongoing care.
Health officials have also yet to confirm the cause of the illness, despite testing many different specimens from patients for a wide range of pathogens that case AFM. It’s also not known who may be at a higher risk.
“To date, no pathogen (germ) has been consistently detected in the patients’ spinal fluid; a pathogen detected in the spinal fluid would be good evidence to indicate the cause of AFM since this condition affects the spinal cord,” CDC officials wrote in an Oct. 5 update.
The CDC has determined, however, that based on the 362 cases the CDC has received verified from August 2014 to August 2018, most of the cases occur in children.
Acute flaccid myelitis is not new, but the CDC has seen an increase in cases nationwide since late summer 2014. From August to December that year, 120 people in 34 states were confirmed to have acute flaccid myelitis.
The number dropped in 2015, when the CDC confirmed 22 people in 17 states had AFM. It again increased in 2016, with 149 cases confirmed in 38 states and the District of Columbia. Last year, in 2017, there were 33 confirmed cases in 16 states.
Hawaii had no verified reports from 2014 through Thursday, Koethe said.
“We had a couple investigations of suspect cases in Hawaii, but no confirmed cases,” she said.
Preventing AFM can start by protecting yourself and children from poliovirus by getting vaccinated, according to the CDC. Another preventative measure is protecting oneself from mosquito bites, which can carry West Nile virus, by using repellent, reducing outdoor time at dusk and dawn and removing areas of standing or stagnant water.
“While we don’t know if it is effective in preventing AFM, washing your hands often with soap and water is one of the best ways to avoid getting sick and spreading germs to other people,” the CDC advised.