Dr. Stan Sack “The Barefoot Doctor” explains a “new” pediatric illness


If you’ve lived in the Keys for a while, you’ve been through a hurricane or three. And on the epidemic front, you might have seen the effect on our town of the early years of HIV. Events like these, especially in the early stages, have quite a lot in common—particularly the questions that you might ask. Is this serious? Will I be affected? What can or should I do to protect myself? And, not insignificantly: should I panic?

When a new, potentially significant problem lurks in the shadows, professionals and public officials ask the same questions and do their best to find the answers. Sometimes finding the answers takes a little time. This appears to be the case with an emerging illness known as acute flaccid myelitis (AFM), which has people talking.

AFM is a disease that mainly affects infants and young children. An affected child can start out with symptoms that look like an ordinary cold. Subsequently, however, AFM causes changes in the spinal cord, that structure in our backs which connects the brain with the body’s nerves. The result is that patients become weak, especially in the legs and/or arms, and have difficulty moving. Speech, swallowing and breathing can be affected as well.

Currently there’s no definitive treatment, though many remedies have been proposed; physical therapy and watchful waiting are about it. Patients recover slowly and, at times, not completely, and serious complications may result.

Technically, AFM is not a “new” disease. The reason we’re more concerned about it now is that the number of children with it has skyrocketed. While still quite rare, there have been over 550 cases in the US since August of 2014 — a dramatic increase. Just last year, there were 228 cases.

We don’t know why this sudden spike has occurred, but in cases like this, experts usually look to either a new infection or something in the environment. In the cases of Legionnaire’s disease and AIDS, two “new” illnesses in past years, similar questions were asked and infections were ultimately found to be the cause. AFM is currently most likely thought to be the result of a virus. One possibility is that it’s from a type of enterovirus, a family of germs which causes several childhood diseases (hand-foot-mouth is an enteroviral disease). However, there’s much more work to be done before we know more.

Until we do have more knowledge, we can’t really answer those questions posed at the start of this column. However, most experts would offer a few guidelines here, similar to what’s offered up with any new illness. I’ve never been fond of overusing mnemonics, which one finds all the time in medicine. But like my favorite foods, everything seems to gravitate toward the letter “P”

Don’t Panic. Few cases of AFM appear to have developed in Florida, and Dr. Mark Whiteside, medical director at the Monroe County Department of Public Health, tells me that he hasn’t yet seen any here.

Prepare yourself with knowledge about the disease. Information is always being updated; doctors at the National Institute of Allergy and Infectious Diseases published a new report just last week. A great user-friendly source of information is the website of The Centers for Disease Control: www.cdc.gov/acute-flaccid-myelitis

Always talk to your Pediatric Provider about any concerning symptoms in your child, such as increased difficulty moving, eating or talking.

· This is a good time to do a little cheerleading for the Polio vaccine. While AFM is NOT polio, the diseases share some traits, and the polio virus is also an enterovirus. Let’s take care of what we do know how to Prevent!


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