Doctors may soon have a better understanding of a rare and mysterious illness that has been causing paralysis in children. Researchers said they have pinpointed a link between the condition known as acute flaccid myelitis, or AFM, and a common virus.
Acute Flaccid Myelitis
AFM affects the nervous system, particularly the area of the spinal cord known as gray matter. The condition has symptoms similar to that of polio. It weakens the muscles and reflexes of the body.
Researchers do not know what causes or triggers most AFM cases, albeit they think that viruses have a role.
In recent cases, most patients had mild respiratory illness or fever, which are often caused by a viral infection, before they got AFM.
AFM And Viral Infection
It appears that there is indeed a link between viral infection and the illness. University of Minnesota's chief pediatrics resident Heidi Moline and colleagues said that AFM is being caused by the presence of Enterovirus-D68.
The researchers said they found E-D68 in the spinal fluid of one of the six Minnesota children who were hospitalized between Sept. 19 and Oct. 1, 2018, due to the polio-like illness. The patients had headaches and flu symptoms that devolved into paralysis.
Five children improved after treatment, but a 7-year-old girl suffered rapid paralysis that did not improve. Researchers said she lost all voluntary limb movements but still remains cognitively intact.
Researchers found E-D68 in the spinal fluid of this girl and in a mouth swab of another of the patients, which suggest the virus could be behind the onset of AFM in all six children.
"EV-D68 in the CSF of patient B is considered the cause of AFM in this patient. Detection of a pathogen in the CSF might be related to the severity and prolonged nature of illness in this patient; however, host or other factors contributing to illness severity are unknown," Moline and colleagues wrote in a report published in the Morbidity and Mortality Weekly Report on Friday.
First Confirmation Of Link Between Enterovirus-D68 And AFM
E-D68 was previously found in the spinal fluid of a child in California. Unfortunately, contamination of the fluid tainted the results. The researchers said their findings offers proof of the role of EV-D68 in the development of AFM.
"The fact that we were able to definitively identify the EV-D68 virus as the cause of paralysis in one of our Minnesota patients does suggest this virus as a probable cause in our other recent AFM cases," Moline said. "This is the first true confirmation that we've had."