DENVER — Fourteen cases of a rare polio-like condition that mostly affects children have been reported in Colorado, according to the Colorado Department of Health and Environment.

So far in 2018, there have been 38 confirmed cases of Acute Flaccid Myelitis (AFM) in 16 states across the country, according to the Centers for Disease Control and Prevention. Those numbers are through Sept. 30 and include six cases in Minnesota.

AFM is a rare condition that affects a person’s nervous system, specifically the spinal cord, according to the CDC. AFM, or neurologic conditions, like it have a variety of causes such as viruses, environmental toxins and genetic disorders.

Of the 14 AFM patients in Colorado, 11 tested positive for enterovirus A71, one tested positive for enterovirus D68, and two tested negative for enteroviruses, the Colorado Health Department said.

While all the patients were hospitalized, nearly all have fully recovered, the state health department said in a news release. There have been no deaths in Colorado.

Colorado has experienced previous outbreaks of less-common enteroviruses. In 2014, enterovirus D68 caused an outbreak of respiratory illness in Colorado children and was associated with 11 cases of acute flaccid myelitis. In 2003 and 2005, enterovirus A71 caused outbreaks similar to what Colorado is experiencing now, with eight cases of central nervous system infections occurring in each of those years.

Between August of 2014 and August of this year, the CDC recorded 362 cases. In 2017, 33 cases, and in 2016, when there was a spike in cases, 149 were reported.

The CDC has compiled the following list of facts about AFM:

  • Most patients are children
  • The patients’ symptoms have been most similar to complications of infection with certain viruses, including poliovirus, non-polio enteroviruses, adenoviruses, and West Nile virus.
  • Enteroviruses most commonly cause mild illness. They can also cause neurologic illness, such as meningitis, encephalitis, and AFM, but these are rare.
  • CDC has tested many different specimens from AFM patients for a wide range of pathogens (germs) that can cause AFM. To date, no pathogen (germ) has been consistently detected in the patients’ spinal fluid; a pathogen detected in the spinal fluid would be good evidence to indicate the cause of AFM since this condition affects the spinal cord.

The increase in AFM cases in 2014 coincided with a national outbreak of severe respiratory illness among people caused by enterovirus D68 (EV-D68). Among the people confirmed with AFM, CDC did not consistently detect EV-D68 in every patient.

During 2015, CDC did not receive information about large EV-D68 outbreaks in the United States, and laboratories reported only limited EV-D68 detections to CDC’s National Enterovirus Surveillance System (NESS). During 2016, CDC was informed of a few localized clusters in the United States.

Symptoms of enterovirus complications or acute flaccid myelitis

The Colorado Health Department said parents and guardians should contact a healthcare provider if they or their children have any of the following symptoms.

  • Severe symptoms such as sudden weakness in arms and legs, trouble breathing, unsteady walking, severe headache, stiff neck or seizures.
  • Dizziness, wobbliness, or abnormal, jerking movements that are worse at night.
  • Fever along with any other concerning symptoms.

To protect yourself and others from enteroviruses:

  • Wash your hands often with soap and water for at least 20 seconds.
  • Be especially careful to wash your hands after using the toilet and changing diapers.
  • Avoid close contact with people who are sick, and don’t share cups and eating utensils.
  • Clean and disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
  • Cover your coughs and sneezes.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Stay home when you’re sick, and keep children home from school or daycare for 24 hours after fever ends or if they are drooling uncontrollably and have mouth sores.
  • Colorado has experienced previous outbreaks of less-common enteroviruses. In 2014, enterovirus D68 caused an outbreak of respiratory illness in Colorado children and was associated with 11 cases of acute flaccid myelitis. In 2003 and 2005, enterovirus A71 caused outbreaks similar to what Colorado is experiencing now, with eight cases of central nervous system infections occurring in each of those years.