child with thermometer in their mouth, infection and celiac disease

Dr. Anthony Fauci is head of the National Institute of Allergy and Infectious Diseases. He is one of the world’s foremost authorities on HIV/AIDS. He has won some of the most prestigious awards in medicine including the Lasker Award. Dr. Fauci is the go-to expert when it comes to infectious diseases. That’s why his article about acute flaccid myelitis (AFM) in mBio (April 2, 2019) is so disturbing. Perhaps you have heard of the polio-like illness that has been cropping up across the country. Dr. Fauci and his colleagues suggest that AFM may be evolving. The trajectory of this epidemic is somewhat reminiscent of the early days of the polio epidemic that went on to terrorize the world during the 1940s and 1950s.

A Short History of Polio:

If people think about polio at all these days, it is from the perspective of the rear-view mirror. That’s because the disease has almost been eradicated. Epidemiologists report that there are only three countries left in the world where polio is still a problem—Afghanistan, Nigeria and Pakistan. The World Health Organization reports that there were 350,000 cases of polio in 1988. By 2017 that number had fallen to 22. 

Although most people think of polio as a disease of the 20th century, it has actually plagued humans for centuries. Archeologists point to ancient Egyptian artwork depicting people with limb deformities as signs of early polio-like disease. There are reports in the medical literature of cases in the 18th century. But it wasn’t until the early 1900s that epidemics of polio were registered. At the peak of the polio epidemic, more than 500,000 people were infected each year.

The point is that polio kind of limped along for centuries without much notice. There would be periodic outbreaks in various communities, but it was not a disease that panicked people. That changed in 1916 when a polio epidemic led to over 6,000 deaths.

Fast Forward to 2010: Acute Flaccid Myelitis (AFM)

Acute flaccid myelitis causes symptoms that are suggestive of a polio-like illness. The CDC warns parents to be on the alert for:

AFM Symptoms:

“• weakness and loss of muscle tone and reflexes in the arms or legs
• facial droop or weakness
• difficulty moving the eyes
• drooping eyelids
• difficulty swallowing
• slurred speech”

Will acute flaccid myelitis evolve into a polio-like illness that becomes widespread? No one yet knows, but 2018 was not a good year.

According to Dr. Fauci and his colleagues (mBio, April 2, 2019): 

“AFM was first recognized around 2010 as a seemingly novel condition and quickly grew into an alarming and important disease threat, with the first large outbreak occurring in 2014. Since then, seasonal waves have occurred every other year in the United States, the largest occurring in 2018.”

Dr. Fauci told Mike Stobbe of The Associated Press (USA Today, April 3, 2019) that AFM: 

“…may  may bear similarities to polio, which smoldered among humans for centuries before it exploded into fearsome epidemics in the 19th and 20th centuries.”

““Don’t assume that it’s going to stay at a couple of hundred cases every other year.”

What Lies Ahead for This Polio-like Disease?

In their scientific article, Dr. Fauci and his colleagues summarize the trajectory of acute flaccid myelitis (AFM):

“Although sporadic AFM is not rare, its sudden appearance in epidemic form is unprecedented. Beginning in the summer and fall of 2012, California and other locales began to detect small, unexpected upticks in AFM cases featuring influenza-like respiratory prodromes and associated with various NPEVs (nonpolio enteroviruses).

“By 2014 to 2015, large AFM epidemics began to appear across the United States and globally; again, such outbreaks typically occurred in temporal association with EV-D68 [enterovirus D68] epidemics. The EV-D68/AFM epidemiological association has since become unmistakable.”

Dr. Fauci points out that the viruses thought to be responsible for acute flaccid myelitis “have been neglected for decades.” He and his colleagues go on to conclude:

“Watching healthy children become permanently paralyzed virtually overnight by a seemingly random, lightning-strike disease is as heartbreaking today as it was in the polio era. The trajectory of AFM over the past 5 years suggests that the problem is getting worse, and so it is critical that we galvanize our efforts to learn more about, and respond adequately to, this ubiquitous, often crippling, continually reemerging group of viruses.”

You can read more about AFM and which states have been affected at this link:

Should You Be Worried About Polio-Like Illness?

Share your own thoughts about AFM in the comment section below.

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  1. John
    New York
    Reply

    Does no one study ecology anymore? Remember the bit about a vacant niche–like the one formerly occupied by poliovirus–being eventually filled by a another species. I’d reckon EBV, Coxsackie, or some other nonpolio enterovirus would make a dandy hypothesis to start testing.

  2. Larry
    Raleigh, nC
    Reply

    Margaret,

    I suffered the same kind of illness back in July 2017. It started with weakness in my left arm but then over about a month fully exploded into leg/arm weakness/tingling and extreme soreness. Afterwards it progressed into numbness in my hands and feet and extreme tiredness for several months. I’m better now but still not back to where I was two years ago.

  3. Robert
    Home
    Reply

    Will polio vaccine prevent AFM?

  4. Margaret
    Somis, CA
    Reply

    I recently heard about ACM and the devastating effects it has had on children. But, I haven’t heard anything specifically about how it might affect adults. And I am wondering whether this virus may be responsible for symptoms my husband and at least 2 of his employees experienced in early 2018.

    My husband and 2 of his employees had what appeared to be some kind of flu virus back in December of 2017. Within a month of that all 3 developed strange neurological symptoms. One (aged 55) suddenly could not move her right arm. She went to bed figuring it would be better in the morning and it was not. She went to the ER and they found no obvious reasons. She slowly regained function of that arm over several weeks. Another (age 48) found that she was just exhausted and had what she described as “wobbly leg syndrome”. She became very weak in her legs. If she tried to run she had to concentrate and think “push off of my toes” to keep from gradually sinking toward the ground. She said she was exhausted and slept a lot during this period and eventually recovered. My husband (age 68 at the time) experienced the same “wobbly leg syndrome” but also lost the feeling of temperature and pain on his left side from the waist down. He also developed weakness in his arms. He was extremely busy with work and did not allow himself the rest he needed (I believe) to fully recover. He very slowly has regained muscle strength over this last year, but he still has the neuropathy issue on his left side.

    I am curious to know if others have experienced anything similar and if there is information as to how this virus affects adults.

  5. Chris W.
    Andrew, IA
    Reply

    Sounds like a vaccine needs to be worked on right away!!

  6. Cypress
    Texas
    Reply

    I had polio in 1949 at the age of 2 and was left with permanent limb damage and weakness. Please ask your medical professionals to study up on AFM and to report suspected cases to the CDC. More research needs to be done before an outbreak occurs.

  7. George
    75217
    Reply

    Could this be a form of EVD68?

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