Question: Seeing the news about that polio-like disease is frightening. Are there cases here?
Answer: No, Hawaii is not among the 22 states with confirmed cases in 2018 of acute flaccid myelitis, a paralyzing neurological condition that mainly strikes children; the average age of patients this year is 4.
The disease affects the central nervous system, specifically the spinal cord, causing symptoms such as sudden weakness and loss of muscle tone in the arms and legs. Anyone with such symptoms needs immediate medical attention, according to the U.S. Centers for Disease Control and Prevention. Although often compared to polio, all AFM cases have tested negative for poliovirus, it said.
The federal agency began tracking the disease nationwide amid a spike in late 2014, relying on local and state health officials to report cases. Since then there have been 386 cases confirmed nationwide, including 62 this year, the CDC reported Tuesday. None were in Hawaii, according to the state Department of Health.
“The Hawaii Department of Health has not received any verified reports of acute flaccid myelitis (AFM) here in Hawaii and has not seen any verified reports since 2014. Note that 2014 was when AFM related to enterovirus infections was first recognized nationally as a potential issue. We had a couple of investigations over the years of suspect cases in Hawaii, but no confirmed cases,” said Anna Koethe, a department spokeswoman.
The department is staying current with the latest guidance from the CDC and continues to monitor for any cases in Hawaii, she said.
Along with the 62 confirmed cases, another 65 suspected cases nationwide have been reported to the CDC as of Tuesday, some of which it is still investigating. So the number of U.S. cases this year is likely to rise.
The CDC did not name the 22 states, citing privacy concerns. However, media outlets throughout the country have been reporting on young patients with the mysterious disease, which in some cases may be a rare complication of a common virus. Multiple cases have been reported in Colorado, Texas and Minnesota, to name just a few affected states.
Q: Do they know what causes it?
A: No, CDC investigators have been unable to determine the cause in most cases. They know that it is not caused by poliovirus. They believe that it could be a rare complication of a number of common viruses, which in most people cause mild illness, or be caused by environmental toxins or genetic disorders. The spike in 2014 coincided with a national outbreak of severe respiratory illness caused by enterovirus D68 (EV-D68), but further testing showed that EV-D68 was not consistently detected among patients confirmed to have AFM. Amid the uncertainty, the CDC states on its website, “While we don’t know the cause of most of the AFM cases, it’s always important to practice disease- prevention steps, such as staying up-to-date on vaccines, washing your hands and protecting yourself from mosquito bites.”
Q: Do the kids get better?
A: Outcomes vary. Last year one child with AFM died. Some patients recover quickly, while others remain paralyzed and require ongoing care and intensive physical therapy. Read more at the CDC website, 808ne.ws/cdcafm.
Mahalo
On Monday I took TheBus (No. 17) to Kaiser Permanente (Honolulu Clinic), and in a rush, I left behind my black folding carry-on bag. After my appointment I caught the same bus and asked the driver, Emma, if an “honest person” had turned in my bag. “Yes,” Emma told me, “it was Uncle Daniel.” Mahalo to Uncle Daniel for being honest. — Bus rider Gail
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