What Is Acute Flaccid Myelitis?

The U.S. Centers for Disease Control and Prevention (CDC) has received an unusually large number of reports of polio-like illnesses in people—mostly children—across the United States in recent months, according to an agency telebriefing held yesterday. So far in 2018, 62 cases of the rare disease, called acute flaccid myelitis (AFM), have been confirmed in 22 states, with an additional 65 reports currently under investigation.

AFM is a serious condition that affects the nervous system, causing sudden weakness, and sometimes pain or paralysis, in the arms and legs. It can also cause drooping eyelids, slurred speech, and difficulty swallowing. In recent weeks, news reports and home videos of children afflicted with these symptoms have circulating online, adding to the country’s growing concern.

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“We know this can be frightening for parents,” said Nancy Messonnier, MD, director of the CDC’s National Center for Immunization and Respiratory Diseases, in the briefing yesterday. “I know many parents want to know what the signs and symptoms are that they should be looking for in their child.” Here are a few takeaways from yesterday’s briefing about AFM, including what to look for and how worried experts really are.

AFM has been on the rise since 2014

In yesterday’s telebriefing, Dr. Messonnier said that the CDC has been testing for and monitoring reports of AFM since 2014, when an increase in cases was first noted. Since that time, most confirmed AFM cases have been among children.

Among AFM patients confirmed so far this year, the average age is 4. More than 90% of cases have been in patients 18 and younger. Often, patients experience a mild illness—which can include a fever, headache, and stiff neck—before developing a sudden onset of muscle weakness.

Most cases occur around this time of year

Based on previous years’ reporting, AFM strikes most patients in late summer and fall. This year is no different: “The data we are reporting today is a substantially larger number than in previous months this year,” said Dr. Messonnier, due to an increase in reports of patients whose symptoms started in August and September.

That doesn’t mean that we’re in the midst of an unprecedented outbreak, however. “The number of cases reported in this time period in 2018 is similar to what was reported in the fall of 2014 and 2016,” Dr. Messonnier said, although she added later that it’s still too early to know how this year will ultimately measure up. It’s not unheard of for a number of cases to be reported all at once, either: In 2016, eight children were diagnosed with the condition in Washington State within the same week.

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The cause is unknown, but it’s definitely not polio

The CDC has tested stool samples from every confirmed AMF patient, and none have tested positive for poliovirus. Other viruses (like enterovirus, rhinovirus, and West Nile virus) and environmental toxins can cause AFM, but so far the CDC has not been able to identify a cause for most of the cases diagnosed this year. “[I]f you are having the peaks of disease every late summer and early fall, you would think we are finding a single agent,” Dr. Messionnier explained. “That is what we are not finding.”

Dr. Messonnier also said that she’s frustrated “that despite all of our efforts we haven’t been able to identify the cause of this mystery illness.” The CDC is continuing to investigate these illnesses, she added, to better understand its risk factors and possible causes of the increase in recent years.  

Some patients recover quickly, while others have long-term damage

“We don’t fully understand the long-term consequences of AFM,” Dr. Messonnier said. “We know that some patients diagnosed with AFM have recovered quickly and some continue to have paralysis and require ongoing care.” In the most serious cases of AFM, patients can experience respiratory failure when the muscles that affect breathing become weakened. In 2017, one child died from AFM.

There is no specific treatment for AFM, but doctors may prescribe immunosuppressant drugs, steroids, and blood-replacement procedures. They may also recommend physical or occupational therapy to help patients get their strength and mobility back after experiencing muscle weakness or paralysis.

Parents shouldn’t freak out—but they should take basic precautions

“Parents need to know that AFM is very rare, even with the increase in cases that we are seeing now,” said Dr. Messonnier. (Overall, since 2014, the risk of developing the illness is less than one in a million.) Nevertheless, she added, “we recommend seeking medical care right away if you or your child develop sudden weakness of the arms or legs.”

Until more is understood about what’s causing these cases, Dr. Messonnier said that parents can help protect their children from pathogens by washing their hands, staying up to date on vaccines, and using insect repellent to prevent mosquito bites. “While I am concerned about the increase in cases,” she added, “I want folks to know this work is core to CDC’s mission to protect America from health threats.”

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Family’s Moving Obituary for Mom Who Died of Opioid Addiction: The ‘Disease Wouldn’t Let Her Go’

A poignant obituary for a young mother is starting conversations about opioid addiction, as the woman’s family struggles to come to terms with her death.

Madelyn Linsenmeir died unexpectedly on Oct. 7 surrounded by her family. Now, in a moving obituary, Linsenmeir’s relatives wrote candidly about her years-long struggle with the addiction that ultimately took her life.

“We loved her more than you can imagine, and are heartbroken at her passing,” Linsenmeir’s sister, Maura O’Neill, tells PEOPLE.

Linsenmeir’s obituary has made its way around the Internet, prompting social media users everywhere to send messages of comfort to the family, think differently about drug abuse and even to share their own stories of addiction. But for the family, they were simply honoring the 30-year-old that they remembered as a loving mother who was “warm, and fearless.”

“It is impossible to capture a person in an obituary, and especially someone whose adult life was largely defined by drug addiction. To some, Maddie was just a junkie — when they saw her addiction, they stopped seeing her. And what a loss for them,” the family wrote in the obituary.

“Though we would have paid any ransom to have her back, any price in the world, this disease would not let her go until she was gone.”

Linsenmeir first began using opioids when she was 16 years old, the family wrote. She tried OxyContin for the first time at a high school party after her family moved from Vermont to Florida and “so began a relationship with opiates that would dominate the rest of her life.”

Linsenmeir struggled with sobriety several times during her life and, with the birth of her son Ayden in 2014, she worked even harder to transform her life.

“Maddie loved her family and the world. But more than anyone else, she loved her son, Ayden…” the family wrote. “Every afternoon in all kinds of weather, she would put him in a backpack and take him for a walk … she so loved to snuggle him up, surrounding him with her love.”

Ultimately, Linsenmeir relapsed and lost custody of the little boy and the family described the loss as “unbearable” for her. According to her relatives, the past two years have been the hardest for Linsenmeir as the “darkness” of the disease led to “pain and shame.”

However, the family has held onto one of their last good memories, the 12 days Linsenmeir spent with her family over the summer.

“For those 12 wonderful days, full of swimming and Disney movies and family dinners, we believed as we always did that she would overcome her disease and make the life for herself we knew she deserved,” the obituary states. “We believed this until the moment she took her last breath. But her addiction stalked her and stole her once again.”

Concluding the candid obituary, Linsenmeir’s family offered encouragement to those suffering from the disease, and urged readers to educate themselves about the addiction.

“If you are reading this with judgment, educate yourself about this disease, because that is what it is. It is not a choice or a weakness,” they wrote. The family added: “If you yourself are struggling from addiction, know that every breath is a fresh start … It is never too late.”

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