THE DANGEROUS VIRUS OR THE GENETIC DISORDER?
At the moment when little Carter Roberts was hit by sudden Polio-like illness, the US doctors had no clue what is happening with the body of this 3-year-old boy. He was hospitalized for months at Kennedy Krieger Institute in Baltimore, Maryland while they were trying to catch up what is going on with him. That was just the beginning of the worst health nightmare recently that has targeted American children and their parents.
The CDC defined the disease with the odd name: acute flaccid myelitis (AFM). According to their study, myelitis is inflammation of the spinal cord, caused by different indicators that could vary from dangerous germs via biological toxins to the genetic disorders:” Most patients will have sudden onset of limb weakness and loss of muscle tone and reflexes. Some patients, in addition to the limb weakness, 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).”
That is simply the disease that affects the nervous system and damages the vital muscles to work properly. The outbreak started silently after some children experienced the paralysis as the next stage of the virus called enterovirus or EV-D68. The virus itself produced breathing problems for the patients but some ended up paralyzed. Within five months of hysteria, based on the unknown factor of paralysis of children and teenagers in the USA, the medical reports have written the shocking evidences of the real epidemics at the end of 2014. We are talking about thousand ( 1, 153) severe cases of EV-D68 in 49 states and 14 deaths as well as about 120 known cases of confirmed AFM children paralysis in 34 US states. In 2015, were just 21 but later in 2016, there were reported 138 cases in 24 different states.
The main problem here in this case is lack of reliable information regarding the disease. Doctors are not required to report the cases and the CDC does not do much to inform the public that has suffered from this illness more than from the cocktail of Ebola, Zika and Rabies together. This is unspoken and well covered. The families have no clue what is really AFM, since the medical experts do not share crucial knowledge or they do not have significant progress in treatment. Some of the affected groups have organized the supporting pages on the social media but there is still a big, screaming gap.
AFM is still very rare disease but when it occurs, it occurs with horrible outcomes. The viruses are definitely in the background of this paralysis, from EVs, EV-A71 and flaviviruses to the Japanese encephalitis and West Nile virus. However, in recent time, it seems that EV-D68 has a leading role in the AFM outbreaks, especially in the USA and Canada.
The scientists are giving efforts to match the causes and consequences and to solve the medical puzzle of the year. The renaissance of mutated polio illness would be devastating for the American public that dealt back in 1952 with the worst polio ever and 3,145 killed and 21,269 paralyzed Americans at the end.
Could the AFM be a new plague of the 21st century? It has started shy but it does not give up in bringing fear to the parents that their children will be paralyzed after they catch some mysterious virus. Nevertheless, it is not the rule that AFM comes always with the certain viruses or toxins. That is why the acute flaccid myelitis is rare if we compare with the other diseases. Let us look at the statistic of American epidemic book and millions of infected with EV-D68. Only few actually came down with the paralysis. Numbers speak for themselves. AFM is dangerous because of the unknown clinical facts and bad outcomes but it cannot be labeled as new Ebola. Many children get the mentioned virus but not the AFM, at the end of the day. How is that possible? The answer is in human and virus biology. In the dark ages of black plague, some people survived the dangerous disease and it was a miracle. Even now, there are patients that successfully experienced Ebola virus. In the case of AFM, there are children that develop paralysis while the medical experts research the genesis of that rare paralysis.
On one side, these phenomena should convince people in the importance of polio-vaccines in spite of the controversial stories. On the other side, the people are getting concerned for the health future of their youngest through the framework of unknown cause of the scary paralysis. It could come with the infection but it could also escape the one patient and hit the second. There are no simple rules to follow. Everything is so unclear and still not enough presented so the stressed public could be ensured that American medicine is trying to solve the mystery of emerged polio-like outbreak. The most prominent doctors are discussing this hot issue with their colleagues from abroad, collecting the different opinions and research lines.
The good physician is able to recognize the symptoms of AFM or any other similar disease and to redirect the affected patient to the responsible institution. The medical response must be urgent even the treatment does not mean the absolute recovery. There are evidences that children with AFM are never capable to get back to the previous state of nervous system since the spinal cord is really damaged.
It is better to prevent the possibilities for this disease than to cure it. The science recommends to people with small children to avoid the public places with the potential of infections and to apply the hygienically standards after any staying in the red zones. Nobody can say if those measures really help or not at all but the AFM is still a big enigma for the progressed humankind. The diseases like this should not be unveiled by media silence but rather exposed as the global health challenge, risk and threat. Unfortunately, it is just a matter of time…when the silent disease will become the loud messengers of new global health chaos.
SARAH MAX RESEARCH 
There are those who choose not to get their children immunized out of unfounded fears of complications. Some do not pursue regular childhood immunizations due to perceived cost, despite available assistance programs. Others may avoid routine healthcare due to concerns regarding their immigration status. The possibilities above can lead to a loss of national safety due to diminished protection from herd immunity. This is setting up the US for a naturally occurring or man made epidemic. Compounding this problem, the newer generation of front line healthcare providers may be unprepared to identify diseases long thought to be eradicated in the U.S. The ease of rapid global travel could then lead to a pandemic.
Thank you for the informative article. Let us hope that it’s message gets disseminated faster than the next viral attack.
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Sarah’s invaluable and informative article should be read by all parents with small children; especially, in so-called First World states where we are witnessing the process of underfunding and understaffing in public health systems more and more, which is resulting in more and more preventable contagions and infections among patients and their respective visitors, etc. Mostly, it is down to public education, in the context of hygiene and protocol of sterile environments in medical facilities and private domiciles.
As Sarah notes, Enterovirus 68 is a member of the Picornaviridae family. First isolated in California in 1962, and once considered rare, it has been on a worldwide upswing in the 21st century. It has been implicated in cases of the polio-like disorder Acute Flaccid Myelitis.
In 1897, foot-and-mouth disease virus (FMDV), the first animal virus, was discovered. FMDV is the prototypic member of the Aphthovirus genus in the Picornaviridae family. The plaque assay was developed using poliovirus; the discovery of viral replication in culture was with poliovirus in 1949. This was the first time that infection virus had been produced from molecular building blocks in the cells.
Enteroviruses are a genus of positive-sense single-stranded RNA viruses associated with several human and mammalian diseases. Enteroviruses affect millions of people worldwide each year, and are often found in the respiratory secretions (e.g. saliva, sputum or nasal mucus) and stool of an infected person. There are 64 non-polio enteroviruses that can cause disease in humans.
Sarah’s brilliant and well-written article brought to mind the case of Lorenzo Michael Murphy Odone (1978-2008), a child afflicted with the illness adrenoleukodystrophy (ALD): the film ‘Lorenzo’s Oil’ (1992) was based upon the factual history.
Despite research dead-ends, the horror of watching their son’s health decline, and being surrounded by skeptics, they persisted until they finally hit upon a therapy involving adding a certain kind of oil (actually, containing two specific long chain fatty acids, isolated from rapeseed oil and olive oil) to their son’s diet. The oil (erucic acid) proved successful in normalizing the accumulation of the very long chain fatty acids in the brain that had been causing their son’s steady decline; thereby, halting the progression of the disease. There was still a great deal of neurological damage remaining which could not be reversed; unless, new treatments could be found to regenerate the myelin sheath (a lipid insulator) around the nerves. The father took on the new challenge of organizing biomedical efforts to heal myelin damage in patients.
As Sarah exclaims ‘It is better to prevent the possibilities of these diseases than to cure them’. Parents can involve themselves in scientific R & D that is associated with specific diseases afflicting their respective children. There needs to more widespread and open communication between parents, governments and pharmaceutical corporations, etc. Also, the monetary incentive of medical R & D needs to be replaced by ethics and morality.
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Thank you, Sarah, for exposing and discussing this critical disease !
For so many years, I have been astonished at and baffled by how much money is spent on wars instead of on medical research ! It is so saddening to see that “humans” are more interested in killing one another and destroying lives rather than saving lives !
It’s time humanity progressed and moved away from wars and killing and paid attention to AFM and all other incurable diseases !
Thank you again, Sarah, for this excellent research !
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