6 children treated for sudden onset paralysis in Washington state

SEATTLE — Six children in Washington state have experienced the sudden onset of paralysis of one or more of their limbs, Washington State Department of Health officials said Thursday.

The latest case was reported to the DOH on Thursday afternoon and came out of Skagit County.

Now the cases in Western Washington are: King County (2), Pierce County (1), Lewis County (1), and Snohomish County (1), and Skagit County (1).

All six of the infants and children are younger than 6 years old.

Health department officials are working with the CDC to confirm whether the children have acute flaccid myelitis (AFM).

AFM is a rare condition that exhibits polio-like symptoms. It affects the nervous system, especially the spinal cord, health officials said.

“Symptoms are a weakness or paralysis and inability to use one or more arms or legs. And you also might see weakness in the face, trouble speaking,” said Michelle Holshue, a nurse epidemiologist at the WA Department of Health in Shoreline.

Holshue was appointed by the CDC to the WA’s health department to track outbreaks like AFM.

Experts don’t know what causes it.

They have noticed outbreaks typically happen in the fall, and in most cases -- including all the cases in Washington state this year -- it developed in kids a week or two after they got sick.

“Many of the cases, or the suspected cases we’ve seen, have had cold and flu symptoms before the onset of the symptoms of AFM,” Holshue said.

The case Thursday afternoon was reported after the child was also discovered to have partial paralysis.

“Every news story I read makes my heart break,” said Heather Werdal.

She’s a Bremerton mom whose son was diagnosed with AFM in the 2014 Washington outbreak.

There are currently outbreaks popping up around the country.

Nine cases in Illinois, 14 cases in Colorado, and six in Minnesota, according to CNN.

“The CDC is tracking cases and they’ve actually reported cases in 16 states,” Holeshue said.

Werdal’s son, Hayden, was 13 years old when he was diagnosed with AFM.

Now, he’s still mostly paralyzed, but can speak and has movement in his right arm and hand.

“It’s the scariest thing I’ve ever done. We spent three weeks in a pediatric intensive care unit. He was monitored 24/7 on life support,” Werdal said.

Hayden is now 17 and said when he hears about the new outbreaks, it concerns him.

“I’m just worried because I don’t want anyone else to have to deal what I’ve had to deal with,” he said.

There’s little health officials can recommend to parents in terms of prevention, other than try your best to avoid catching the common cold or flu.

“Things like washing your hands, staying away from people that are sick, and being up to date on your vaccinations to make sure everyone in the family stays as healthy as possible,” Holshue said.

And if someone does get sick, both health officials and parents who’ve had experience with AFM say keep a close eye on your kids.

“Just keep an eye. And if they complain about anything, my legs are tired, my arm, I’m too tired to lift my arm, that requires a trip to the ER,” Werdal said.

On Oct. 8, our sister station WSBTV reported an uptick in the illness impacting children.

It is raising serious red flags with the Centers for Disease Control and Prevention researchers.

The rare disease is similar to polio.

In 2016, there were nine cases of AFM in Washington state, health officials said. In 2017 there were three cases, and since the beginning of 2018 there has been one case in the state.

“Symptoms (of AFM) typically include sudden weakness in one or more arms or legs, along with loss of muscle tone and decreased or absent reflexes,” health officials said. “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 (new Washington state) cases are AFM.”

The reporting below on AFM comes from WSBTV:

The CDC has tested many different specimens from AFM patients for a wide range of pathogens (germs) that can cause the disease.

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.

What CDC Doesn't Know

Among the people who were diagnosed with AFM since August 2014:

The cause of most of the AFM cases remains unknown.
We don't know what caused the increase in AFM cases starting in 2014.
We have not yet determined who is at higher risk for developing AFM, or the reasons why they may be at higher risk.
We do not yet know the long-term effects of AFM. We know that some patients diagnosed with AFM have recovered quickly, and some continue to have paralysis and require ongoing care.

What CDC Is Doing

CDC is actively investigating AFM cases and monitoring disease activity.
We are working closely with healthcare providers and state and local health departments to increase awareness for AFM.
We are encouraging healthcare providers to recognize and report suspected cases of AFM to their health departments, and for health departments to send this information to CDC to help us understand the nationwide burden of AFM. CDC is also actively looking for risk factors and possible causes of this condition.

CDC activities include:

Urging healthcare providers to be vigilant for AFM among their patients, and to send information about suspected cases to their health departments
Verifying clinical information of suspected AFM cases submitted by health departments, and working with health departments and neurologists to classify cases using a case definition adopted by the Council of State and Territorial Epidemiologists (CSTE)
Testing specimens, including stool, blood, and cerebrospinal fluid, from suspected AFM cases
Working with healthcare providers, experts, and state and local health departments to investigate and better understand the AFM cases, including potential causes and how often the condition occurs
Providing new and updated information to healthcare providers, health departments, policymakers, the public, and partners in various formats, such as scientific journals and meetings, and CDC's AFM website and social media
Using multiple research methods to further explore the potential association of AFM with possible causes as well as risk factors for AFM. This includes collaborating with experts to review MRI scans of people from the past 10 years to determine how many AFM cases occurred before 2014, updating treatment and management protocols, and engaging with several academic centers to conduct active surveillance simultaneously for both AFM and respiratory viruses.

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