Covid-19 measures like social distancing, hand hygiene may reduce polio-like illness among kids in 2020: CDC
The year 2020 was supposed to see an upsurge in cases of a polio-like condition called the acute flaccid myelitis (AFM) in American children, but only 13 have been confirmed so far. If new cases stay below limits for the rest of the year, it could mean one thing: Covid-19 control measures such as social distancing and hand hygiene may have worked for AFM too, experts from Centers for Disease Control and Prevention (CDC) said at a meeting.
AFM cases have been increasing in the US in the recent past. "We have seen increases in AFM cases, mostly in young children, every two years," according to the CDC. In 2014, the CDC reported 120 cases in 34 states, prompting CDC to keep a tab on the disease prevalence. Since then, they have confirmed 630 cases.
The condition, which weakens the muscles of the body, could be triggered by a common virus. It affects the nervous system, specifically the area of the spinal cord called the gray matter, which causes the muscles and reflexes in the body to become weak, the CDC said. The common symptoms of AFM include difficulty in moving the eye and swallowing, facial droop or weakness, pain in arms, legs, neck, or back. It could turn life-threatening when children experience respiratory failure. Under those conditions, they are hooked to a ventilator to support breathing. It could also cause permanent paralysis. AFM has no treatment. But doctors may recommend physical or occupational therapy to help with arm or leg weakness.
The symptoms are similar to polio, leading experts to suspect its role. But all the stool specimens from AFM patients did not contain traces of poliovirus, according to the CDC. Evidence suggests that the culprit behind AFM is enterovirus D68 or EV-D68. Typically, enteroviruses do not cause severe complications: some do not get sick, while others develop a common cold. But scientists are unsure whether the virus or the body's immune response causes the condition.
"There is a great deal we don't yet know," Dr Anne Schuchat, principal deputy director of the CDC, said at the Grand Rounds meeting. "We want to do everything possible to learn more about recognizing, treating, and preventing AFM and helping families to heal. AFM is a CDC priority," Schuchat added. Scientists are trying to understand the factors driving the spike since 2014.
At the briefing, the CDC said that they expect a reduced number of AFM cases this year due to Covid-19 control measures such as social distancing and improved hand hygiene practices, Dr Janell Routh, medical officer, and lead for the CDC's AFM and Domestic Poliovirus Team, said. "These practices may result in a decease circulation of other viruses, including enteroviruses and, therefore, either decrease or delay AFM this year," she added.
However, there are still some uncertainties. "We don't know if the Covid-19 epidemic will complicate detection and management, nor do we know if the social distancing efforts will reduce the risks of occurrence. But we do know we need to be ready," Schuchat explained.