Acute flaccid paralysis: mystery surge in polio-like disease

Medical experts are trying to understand why more and more children in the UK and US are being paralysed by a rare polio-like disease.

So far there have been 28 confirmed cases of acute flaccid paralysis (AFP) in England this year, the majority of them affecting children.

“Officials would usually expect fewer than 10 cases a year,” says The Independent.

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The neurological condition attacks the nervous system, causing weakness in the limbs, slurred speech and drooping facial muscles. Although physical rehabilitation is often effective in milder cases, for some patients the nerve damage can be permanent.

AFP is rare and often requires specialist procedures such as an MRI scan or lumbar puncture to diagnose, meaning the true number of those affected could be even higher.

Adding to the mystery is evidence of a similar phenomenon in the US, where it has affected children across the country.

“By the end of November 2018, the condition had been confirmed in 116 children from 31 US states,” said virologists at the University of New South Wales in a paper published in the British Medical Journal earlier this week.

That represents “an increase of 250% from 2017, when 33 confirmed cases were recorded”.

The condition usually occurs after the patient has contracted an enterovirus, an intestinal infection affecting the central nervous system.

“While the largely eradicated polio virus is one cause, it can also be triggered by the wider family of enteroviruses which usually only have mild cold-like symptoms,” says the Independent.

According to the US-based Center for Disease Control, which recently launched a special task force to monitor the outbreak, “since 2014, most patients (more than 90%) had a mild respiratory illness or fever consistent with a viral infection before they developed AFM [acute flaccid myelitis, a type of AFP]”.

Public Health England’s head of immunisations Dr Mary Ramsay stressed that, despite the surge in numbers, the disease is still “very rare”.

“However, if you or your child develops weakness in any limb you should seek medical care immediately so that appropriate testing and care can be given.”