Following a record 186 cases of polio-like disease, acute flaccid myelitis (AFM) in 2018, the peak has passed and it is expected that the cases will continue to decline by 2020.
I do not know why, but the infection, which apparently attacks the spinal cord and causes temporary – and occasionally permanent – paralysis mainly in young children, seems to wane in all other waves of the other year.
The first known outbreak of unknown cause or origin occurred in 2014. AFM reappeared in 2016 and hit 149 people. In 2018, it came again to a comeback of the disease. This year, 186 cases were confirmed.
So far it seems that AFM outbreaks occur every other year ̵
Six-year-old Alex Bustamante is one of 186 people – almost all children – affected by acute flaccid myelitis in 2018. This has been the worst year for the disease so far, and if this continues, 2020 will Bringing More Cases
One thing is becoming clearer: we can now expect an approximately 14-month break at AFM.
During this time, the Centers for Disease Control and Prevention (CDC) are determined to do whatever it takes to solve the puzzle.
The CDC has put together a special task force for this purpose.
Members include parents, neurologists, epidemiologists working on disease, virologists and pathologists who are investigating potential infectious agents for the disease, physicians who study the immune system, and those who study risk factors for genetic and environmental conditions.
For the Task Force and the world in general, however, far more than unknown is known about AFM.
The very first cases appeared in 2012 with a string of 10-year-old children concentrated mainly in California.
In 2014, the disease was more prominent with clusters in Colorado and Utah.
Between August and December, a total of 120 cases occurred in 34 states.
WHAT IS ACUTE FLACCID MYELITIS (AFM)?
The term "myelitis" means inflammation of the spinal cord.
Transverse myelitis is the common name of the disorder, and there are several subtypes.
It is a neurological disease that inflates the spinal cord across its entire width ("across") and destroys the fatty substance that protects the nerve cells.
This can lead to paralysis.
AFM is an unusual subtype of transverse myelitis.
Patients start with the same spinal inflammation, but their symptoms are different and the disease develops differently.
The main difference is that AFM patients are weak and flaccid, while patients with general transverse myelitis tend to be rigid.
Most AFM patients begin to struggle with limb, face, tongue, and eye movements.
You then lose control of a limb or sometimes the whole body – although many have control of sensory organs, intestines and intestines have bladder functions.  Unlike myelitis, which has been around for years through doctors, doctors still do not know exactly why and how AFM manifests itself.
And then, just as quickly as it had come, AFM dispersed again.
In both first and sporadic cases from 2012, the doctors were able to find common ground.
These outbreaks coincided with another virus that caused respiratory infection caused by an error called EV-D68.
But the discovery was a dead end.
Although about 90 percent of people with AFM recently had a cold that affected their respiratory organs, traces of EV-D68 and other enteroviruses were found in the spinal fluid of only four out of 512 people who had polio-like disease has been since 2014.
This leaves the majority of cases unclear.
The vast majority of those affected are toddlers, and they present themselves not unlike polio.
Most limb muscle strength and muscle control first and paralysis spreads from there.
In rare cases, freezing may spread to the respiratory tract and make the disease life threatening.
For many older, frightened parents, AFM initially looked like polio effectively eradicated by vaccines.
However, so far no positive text for the devastating disease has been written at AFM.
It seems clear that anything underlying the AFM has to attack the spinal cord, as paralysis is the main symptom.
However, spinal fluid tests on AFM children were often negative for suspected viruses.
Looking ahead to 2020, scientists hope to find out what genetic and environmental factors make some children vulnerable, while others are safe.
relied on a wheelchair, since Sebastian Bottomley only five Was years old when the AFM beat him in 2016. The seven-year-old (pictured) has been relying on a wheelchair since 1965
They also investigate how a pathogen can infect other cell types than before, for example: For example, the muscle cells themselves, or whether infection could trigger inflammation and an autoimmune response.
In addition, they intend to introduce a science stud [ies] to find out which biennial "seasons" or cycles drive the disease. Nonetheless, scientists can do little to predict the future, especially in the case of AFM.
"It's impossible to say if we have real answers … because this is a complex public health challenge," said CDC scientist Dr. Thomas Clark, an epidemiologist, the Dallas Morning News.
And that leaves the parents in the frightening position of simply hoping for the best for their vulnerable children.
"Until we fully understand the causes of AFM, we can not help protect people from it."
Currently, epidemiologists like him have little to do except the patterns we've observed since 2014.
And if these are signs, we can only expect more sickly children in winter or 2020.