Polio-Like Illness Baffles Experts


Experts continue to be baffled by a mysterious illness that has stricken a reported 25 children in the San Francisco Bay area of California. The obscure illness mimics polio-like symptoms and has affected children between ages 2 to 16. The perplexing illness has the medical community concerned due to the inability to isolate a common cause. Tests have been conducted on 15 of the reported cases thus far. The investigation into this matter is ongoing. One determination doctors have been able to reach is that the elusive illness is not in fact polio. The children who are affected by the illness have been immunized against and tested negative for presence of the disease.

Polio or poliomyelitis is a highly infectious viral disease that spreads by direct person-to-person contact. It invades the central nervous system and results in paralysis within hours. The disease usually strikes children under five. All U.S. children are required to receive four polio vaccinations starting at 2 months of age. Polio is part of the Picornaviridae family, which also includes enteroviruses and rhinoviruses. Well-known enteroviruses and rhinoviruses are the common cold and hand, foot and mouth disease. Most forms of non-polio enteroviruses and rhinoviruses are very common and infect 10 to 15 million people a year. Most of these infections are usually mild and often even asymptomatic, but they all carry varying degrees of risk . However, in the case of this unknown ailment, there is a possibility of a new infectious polio-like syndrome present in California.

The polio-like illness that continues to baffle medical experts has presented with common characteristics in all 25 reported cases. All the children affected have experienced sudden or acute flaccid paralysis, which involves weakness of muscle tone resulting from disease or injury of nerves responsible for movement, and MRIs have confirmed injury to the central portion of the spinal cord in each case.  The prognosis remains grim in terms of regaining use of the affected limbs. The first case linked to this mystery ailment in California is a 4-year-old girl named Sofia Jarvis. Her sudden onset occurred two years ago with flu-like symptoms, trouble breathing, and soon discovered she could not move her left arm. An MRI later confirmed the presence of a spinal lesion that was causing the paralysis.

Medical experts speculate the undetermined illness might stem from a rare form of enterovirus, a family of viral diseases among which polio is classified. However, there are also more than 200 forms of non-polio enteroviruses that exist. Two of the children thoroughly examined have tested positive for enterovirus-68, which has previously been linked with polio-like symptoms in children overseas in countries like Asia and Australia. However, the other children who have been thoroughly tested so far have tested negative for that strain. The other complication involved in this matter is that some of the cases have gone unreported for long periods of time and only came to light following recent events. There is a possibility whatever strain of enterovirus might have infected the children is no longer active in their systems.

Thanks to Dr. Jonas Salk’s polio vaccine developed in April 1955, the disease has been eradicated from most countries in the global community. There are only three countries in the world in which it remains an active, widespread threat–Nigeria, Pakistan, and Afghanistan. It has been eradicated from the United States for more than 30 years. However, pockets of polio-like illness continue to appear every few years in various parts of the world.

The polio-like illness that continues to mystify experts appears to be a very rare occurrence and the cases are seemingly unlinked from what doctors have been able to determined. It appears there has been no direct contact between patients and experts say there is no apparent clustering of the disease. The findings on five of the early known cases will be presented in April 2014 at the American Academy of Neurology’s annual meeting by Dr. Keith Van Haren, a pediatric neurologist at Lucile Packard Children’s Hospital Stanford, who has treated and reviewed several of the cases linked to the polio-like ailment. Doctors are hopeful that going public with these cases will help bring more suspected cases forward. The faster parents seek treatment for children affected by this undetermined illness, the better the prospects for minimizing impairment. Additionally, the more information doctors can gather in the ongoing investigation regarding the illness will foster treatment protocols and help identify the cause of the mystery ailment.

By Leigh Haugh

The Washington Post
NBC News
Los Angeles Times

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