Reports have surfaced that up to 25 children in California have been stricken by an illness with polio-like symptoms, spurring some concerns about a new disease cropping up in the United States. Doctors assure that the condition is definitively not resurgence of polio, a highly infections, paralyzing disease of days gone by now essentially an artifact in the Western hemisphere thanks to the work of Jonas Salk, but the new illness may fall within the same category.
For starters, there is no need for panic as the cases are very rare and have only been reported in California to date, according to research by the Centers for Disease Control and Prevention. In the same vein, it is worth being aware of what is happening and to note if the infection spreads, as the prognosis is not good and there are currently no treatments available.
The first case was reported in 2012 when 2-year old Sofia Jarvis (now 4 years old) experienced wheezing and difficulty breathing that led to a hospitalization and a diagnosis of asthma. Subsequent to her hospital stay, Sofia was reaching for toy at a follow-up visit and, according to her mother Jessica Tomei, Sofia’s arm went limp in mid-reach, paralyzed. None of the cocktail of drugs that the little girl has received since has improved the condition. She still has some shortness of breath, paralysis in her left arm and weakness in her left leg.
Neurologists scouring data in California’s Neurologic and Surveillance Testing program identified four other cases between July 2012 and August 2013 of children that presented in similar fashion to Sofia, with paralysis developing in each case. Keith Van Haren, a pediatric neurologist at Lucile Packard Children's Hospital in Palo Alto, California and neurology professor at the Stanford University of Medicine, says that there is not a final case count yet, but he thinks it’s around 25 currently. He also believes that there could be more cases, except doctors simply don’t know to look for it at this point because it’s so rare.
The onset of the illness, which is believed to be viral, has some of the hallmarks of polio, with generally being asymptomatic or accompanied by very mild symptoms followed by sudden paralysis in one or more limbs.
The initial culprit seems to be enterovirus, a family of pathogens that includes polio, which can cause severe neurological complications, mostly in children. Apropos, the median age of the five children diagnosed with the new malady is 12 and all five children had been immunized for polio. Once a disease that was crippling about 25,000 Americans annually during the late 1940s and early 1950’s, the advent of the Salk vaccine in 1954 has extirpated the disease, without a case of polio being reported in the U.S. since 1979.
Enterovirus has been responsible for several outbreaks in the Asia-Pacific region in recent decades. Enterovirus 71, which causes hand, foot and mouth disease amongst other sicknesses, has been linked to fatal brain inflammation (broadly called encephalitis) and paralysis. “These five new cases, highlight the possibility of an emerging infectious polio-like syndrome in California,” said Van Haren in media reports.
Two of the five children in California have tested positive for enterovirus 68, a virus that shares biological traits of both enteroviruses and rhinoviruses. It is generally associated with respiratory tract infections, but also has been linked to polio-like conditions as well. Originally isolated in California in 1962, reports of enterovirus 68 have been very rare in the last half-century.
The case series is slated to be presented at the American Academy of Neurology’s annual meeting in April in Philadelphia by Emmanuelle Waubant and her colleagues at the University of California, San Francisco.
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