Rare, polio-like illness has now reached Children's Hospital, LHSC says

CBC News has learned that three cases of a rare, polio-like disease have presented at the London Health Sciences Centre's (LHSC) Children's Hospital in 2018, allsince early September.

There wereno cases of the illnessin 2017, a spokesperson said in an email.

The disease, acute flaccid myelitis (AFM) is a sub-type of anotherrare but serious neurological illness called acute flaccid paralysis (AFP), according toDr. AdamKassam,a senior resident physician inphysical medicine and rehabilitation at Western University.

Over time, AFMcan causemuscle weakness, trouble swallowingand, in severe cases, respiratory failure, he said.

"It's still a vastly rare presentation of illness, but it does provoke some concern based on the frequency, relatively soon over the past couple of months," said Dr.Kassam.

A spokesperson forLHSCsaid over email that, due to privacy reasons, it cannot disclosethe status of those three patients.

Incidents of the disease haveincreased in the U.S. this year, with more than 60 cases confirmedand another 65 currently under investigation, according to the Centers for Disease Control and Prevention.

Since September, the Hospital for Sick Children in Toronto has also seen an increase in patients with symptoms typical of AFP, namely muscle weakness and a preceding viral illness, according to associate pediatrician-in-chiefDr. Jeremy Friedman.

The Middlesex-London Health Unit says there have been no reports of AFM in London or MiddlesexCounty, which means the patients would likely have come from other public health jurisdictions.

The health unit considers AFPa disease of public health significance, andconfirmed or suspected cases of the illness must be reported as soon as possible.

'Rare but serious'

Doctors don't know what causes AFM, but Kassam said it may be related to class of viruses known as enteroviruses, which also causes polio. Althoughinfectious diseases that target the motor nerves and spinal cord can, in theory, affect anyone, Kassam said AFM has a particular "predilection" for children.

"This is something that's relatively rare, but affects children, and so this is something we should be concerned about as a community," he said.

Kassamsaid parents should watch out for symptomsincluding sudden weaknessand an inability to move a limb. AFMusually presents in just one side of the body, and tends to target the legs more so than the arms, he said.

There is no specific treatment for the illness, and kids who get AFMare primarily helped throughphysical therapy and adaptive solutions like wheelchairs or crutches once they're medically stable,Kassamsaid.

An email sent out to Ontario pediatricians by Dr. Friedman of the Hospital for Sick Children saidtreatmentmay include IV steroids, IVIG and/or plasmapheresis, on a case by case basis.

"If [parents] do have a suspicion about their child suffering from weakness that is unexplained, orit happened suddenly, then they should go to their doctor or go to their emergency room as soon as they can," he said.