Virus linked to rare paralysis on the rise, Pa. reports; pediatrician shares warning signs

• By Lucy Albright/LNP | LancasterOnline

The Pennsylvania Department of Health is concerned about an apparent increase in a virus linked to a rare form of paralysis in children, and a local pediatrician said that while parents shouldn’t panic, knowing the warning signs is key.

The department released an advisory about acute flaccid myelitis (AFM) on Nov. 7, warning of an increase in detection of one of the viruses that can cause the illness. As of Sept. 3, there have been no cases of AFM in the state this year — though there have been eight confirmed cases nationwide.

The condition can develop after a respiratory or gastrointestinal illness with a fever — illnesses that are common during this time of year.

“Parents do not need to panic about this, they just need to understand it. And if they see any signs of muscle weakness in their children, they should be evaluated immediately,” said Dr. Pia Fenimore, a pediatrician at Lancaster Pediatric Associates and vice chair of pediatrics of Penn Medicine Lancaster General Health.

AFM is a serious but rare disease that causes paralysis, typically in children, the advisory said. It can be caused by a number of viruses, such as non-polio enteroviruses, herpesviruses and West Nile virus  — the latter of which reached a 20-year high in Lancaster County this year.

Parents should look out for limb weakness, such as in the arms and legs, which can occur on one or both sides of the body. If a child has this symptom, they should seek care right away, either with a primary care doctor or at the emergency department, Fenimore said.

EV-D68, the virus most commonly found in AFM patients, has recently increased in wastewater at Pennsylvania’s treatment plants, paving the way for a possible increase in AFM cases, according to the advisory.

While it’s possible that cases could appear in Lancaster County, it’s very unlikely, Fenimore said. She herself has never seen a case of AFM before, and there are only around 50 cases a year on average in the United States.

Most people with AFM will experience sudden weakness in their arms or legs and loss of muscle tone and reflexes, the U.S. Centers for Disease Control and Prevention said. Other less common symptoms include difficulty moving the eyes, drooping eyelids, facial droop or weakness, trouble swallowing, slurred speech, pain in the limbs and pain in the neck or back. The illness can also cause headaches, a stiff neck, numbness or tingling in the affected limb or a hoarse or weak cry, according to the advisory.

AFM has an average age of onset 4 to 6 years old, but adults can be affected, too, the advisory said.

In severe cases, AFM can cause respiratory failure and neurologic symptoms like body temperature changes and blood pressure instability, which can be life threatening, the CDC said.

AFM typically comes one to two weeks after a respiratory or gastrointestinal illness, and onset of the symptoms is quick, within a few hours or days, the advisory said. AFM usually spikes between late summer and early fall, but the U.S. has seen cases year round, with annual increases in 2014, 2016 and 2018, the advisory said.

During the initial cold or stomach virus, there won’t be any specific signs to indicate that AFM might develop, Fenimore said. It’s not well understood why many people get sick with viruses like EV-D68 and yet don’t ever develop AFM symptoms.

Fenimore said it’s important to take precautions to prevent illnesses, especially during this time of year. She recommends handwashing, staying home when sick, getting enough sleep, spending time outside and eating healthily.

“These things all help to boost our immune system and keep us healthy from all types of viruses, including this one,” Fenimore said.