|Patients Under Investigation in Illinois*||Confirmed AFM Cases**||Probable AFM Cases**||Not Cases**|
The nationwide concern over the polio-like illness “acute flaccid myelitis” is magnified here in the state of Illinois, where 17 patients are now under investigation and eight cases of the paralyzing condition have been confirmed.
As of Monday (Nov. 26, 2018), the Illinois Department of Public Health is reporting those 25 cases as well as two additional cases categorized as “probable.”
“IDPH is working with the health care providers to collect necessary information to send to the Centers for Disease Control and Prevention for AFM case classification,” the state of Illinois organization says on its website. “The case reports are from northern and central Illinois, and all but one patient is under 18. Specific location information is not available.”
A total of 116 cases have been confirmed across the country, according to the Centers For Disease Control. More than 90 percent of patients affected by AFM are children.
The CDC makes the final determination on AFM classifications and the IDPH updates numbers at 2 p.m. every Monday.
As recently as Oct. 16, the number of suspected cases in Illinois was at 10. In all of 2016, there were just two confirmed cases of AFM reported in Illinois.
The condition is described as “rare,” but it has received national attention in recent weeks, in part because the numbers have climbed quickly, in part because it is a condition that primarily affects children and in part because there are so many possible causes, including viruses, toxins, and genetic disorders.
What are the signs and symptoms?
Most patients will have sudden onset of limb weakness and loss of muscle tone and reflexes. Some patients also will experience:
- facial droop/weakness,
- difficulty moving the eyes,
- drooping eyelids, or
- difficulty with swallowing or slurred speech.
Numbness or tingling is rare in patients with AFM, though some patients have pain in their arms or legs. Some patients with AFM may be unable to pass urine. The most severe symptom of AFM is respiratory failure that can happen when the muscles involved with breathing become weak. This can require urgent ventilator support (breathing machines).
If you or your child develops any of these symptoms, you should seek medical care right away.
What causes AFM?
Acute flaccid myelitis can be caused by a variety of pathogens, including several viruses:
- enteroviruses (polio and non-polio),
- West Nile virus and viruses in the same family as WNV, specifically Japanese encephalitis virus and Saint Louis encephalitis virus, and
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 Guillain-Barre syndrome, a neurologic disorder caused by an abnormal immune response that attacks the body’s nerves. Oftentimes, however, despite extensive laboratory testing, a cause for AFM is unable to be identified.
How is AFM treated?
According to the CDC, there is no specific treatment for AFM, but a neurologist may recommend certain interventions on a case-by-case basis.
How To Report AFM
Clinicians suspecting AFM in patients meeting the probable or confirmed case definition (irrespective of laboratory testing results) are asked to report these cases to the local health department governing the jurisdiction where the patient lives, or to the Illinois Department of Public Health Communicable Disease Control Section at 217-782-2016.
Clinicians should complete the patient summary form and submit it to their LHD as early as possible. Clinicians or infection control practitioners that have access to enter reportable diseases into the Illinois National Electronic Disease Surveillance System (I-NEDSS) should also enter the case’s information into the system’s AFM module.