Sofia Jarvis, 4, of Berkeley, Calif., was struck by a polio-like illness when she was 2. It left her with a paralyzed arm.(Photo: Jessica Tomei)
(USA TODAY) -- California doctors investigating cases of polio-like illnesses in
children have been "flooded" with calls but are no closer to knowing
what is behind the illnesses.
"We're working with the California
Department of Public Health to go through the cases, to look for a cause
and to figure out how many patients are affected," said Keith Van
Haren, a pediatric neurologist at Lucile Packard Children's Hospital in
Palo Alto, Calif.
He will present the cases of five of the
children at the American Academy of Neurology's upcoming annual meeting
The initial report about the cases was released
on Sunday and since then doctors and patients from around the country
have contacted the hospital and the state's department of public health.
See Also: Mysterious polio-like illness affects kids in California
and public health officials who have encountered similar illnesses have
submitted 20 reports to California Department of Public Health, and
CDPH has conducted preliminary tests on 15 of these specimens," said Gil
Chavez, California's state epidemiologist.
All the cases are in
children. Sofia Jarvis, 4, was the first case of acute flaccid
paralysis, as the syndrome is called, that the Stanford doctors came
So far no common causes have been found to suggest that the cases are linked, but "investigation is ongoing," Chavez said.
Centers for Disease Control and Prevention has not received reports
from any other states, said Danny Feikin, epidemiological branch chief
in CDC's division of viral diseases. The CDC is working with the
California Department of Public Health to study the illnesses.
cases have several things in common. They come on suddenly, they result
in paralysis of one or more limbs and an MRI of the spine shows an
injury to the central part of the spinal cord, said Van Haren. There is
no known cause and no prospect of regaining use of limbs.
has enhanced its surveillance for acute flaccid paralysis and will
continue to seek, test and review specimens and information to help
protect public health, he said.
What they're seeing is "likely to be a very rare manifestation from a rare virus," said Van Haren.
The numbers are no higher than would be expected by normal background cases, said Feikin.
According to the World Health Organization, about one in 100,000 children experience acute flaccid paralysis (AFP) each year.
is a description of a syndrome, not a disease itself, said Feikin. Just
as pneumonia can be caused by many different pathogens, AFP can have
Given those numbers, the CDC would expect to see about 78 cases of acute flaccid paralysis in the United States each year.
while the cases are devastating for the children and their families,
they do not constitute an outbreak or a cluster, Feikin said.
pediatric neurologists on the front lines in California are concerned
they might be seeing something different. "This is not something we're
used to seeing in the pediatric population," he said.
The initial concern was that the children might have polio, but testing quickly ruled that out, Feikin said.
haven't had polio in the United States for decades. Today it is only
endemic in three countries: Pakistan, Afghanistan and Nigeria."
doctors who first described the cases, at Stanford University Medical
School, believe it might be caused by a virus but can't say for certain.
Testing found one type of enterovirus in two of the affected children,
but not others.
Polio is one of more than 200 enteroviruses in the
Picorna family, Feikin said. These viruses also cause hand, foot and
mouth disease, a common childhood ailment, as well as the common cold.
general these viruses are asymptomatic. You don't even know you have
them. Sometimes they cause mild illnesses, sometimes a rash," Feikin
It is estimated that there are between 10 million and 15
million cases of symptomatic enterovirus in the United States each year,
"almost all of them just mild, cold-like illnesses," Feikin said.
virus in the family, enterovirus 71, was responsible for several
outbreaks of disease in California in the 1960s and later Bulgaria,
Hungary. In the 1990s it sickened tens of thousands of children in
Malaysia, Taiwan and China. Some victims developed a similar polio-like
None of the recent California cases tested positive for enterovirus 71, Van Haren said.
and doctors are doing their job as guardians of public health when they
bring attention to possible illnesses so that outbreaks can be spotted
early, said Feikin.
In this instance, it doesn't appear to be an outbreak, Feikin said.
"We're not trying to minimize, but there's no evidence right now that there is an outbreak or clusters," Feikin said.
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