Doctors rule out AFM in 1 of 3 children recently hospitalized for disease

Seattle Children's Hospital file photo

Lab results are in for a child hospitalized for symptoms of a rare-polio like disease in King County.

Doctors have ruled out AFM - or Acute Flaccid Myelitis.

The child was one of three hospitalized this week in Washington State because of similar symptoms. The three children are between 3 and 14 years old.

The Washington State Department of Health said the Centers for Disease Control and Prevention confirmed eight cases of AFM in Washington, a rare condition that affects the nervous system.

Results for the two other children are still pending.

Below are common questions and answers provided by the State Department of Health:

<strong>Q: How common is AFM?</strong>

<strong>A:</strong> AFM is quite rare. Last year, Washington state had no cases, and in 2014 there were only two, so this number of suspected cases within about a six-week time span is unusual. Clusters similar in size to the one we are currently seeing have happened elsewhere in the US, for example, in Colorado and Arizona.

Even with an increase in cases in 2016, AFM remains a very rare disease. Less than one in a million people will ever develop it.

<strong>Q: What causes AFM?</strong>

<strong>A:</strong> AFM can be caused by a variety of germs, such as enteroviruses, which typically cause milder illness in children such as respiratory infections. Other causes may be West Nile Virus, autoimmune disease or environmental toxins. For most reported cases across the US, the cause has not been identified.

It can also be mistaken for conditions that cause inflammation of the nerves such as transverse myelitis and Guillain-Barré syndrome.

However, when enteroviruses get into the central nervous system, they can cause more serious illnesses like inflammation of the brain. Polio virus, which is not being considered as the cause of these children's illnesses, is a cause of AFM that is rare now in the US due to vaccination.

<strong>Q: Are these cases connected to each other?</strong>

<strong>A: </strong>At this point we don't know if these cases are connected in any way.

They came from four different counties (Whatcom, King, Pierce and Franklin).

Their age ranges between 3 to age 14.

And while we can't discuss specific cases, some have unique symptoms from the others.

<strong>Q: Could this be something else?</strong>

<strong>A:</strong> AFM is one of a number of conditions that can result in neurologic illness with limb weakness. Such illnesses can result from a variety of causes, including viral infections, environmental toxins, genetic disorders, and an abnormal immune response that attacks the body's nerves.

<strong>Q: How is AFM diagnosed?</strong>

<strong>A:</strong> AFM is difficult to diagnose because it can look nearly identical to other conditions or syndromes. It is diagnosed based on a combination of symptoms and a type of imaging test called an MRI or laboratory results.

A doctor can rule out other neurological disease by careful examination, for example, looking at the location of muscle weakness, muscle tone, and reflexes. An MRI is essential to diagnose AFM.

<strong>Q: Can Adults Get It?</strong>

<strong>A:</strong> Yes, but it may be more likely to affect children, perhaps because they typically haven't built up as much immunity to germs as adults.

<strong>Q: Is there a treatment?</strong>

<strong>A:</strong> There is no specific treatment for acute flaccid myelitis, other than what doctors call supportive care, treating symptoms. A doctor who specializes in treating brain and spinal cord illnesses (neurologist) may recommend certain interventions on a case-by-case basis.

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