Posted in children, Health, news

US Braces for New Wave of Polio-Like Illness

As August approaches, the CDC is asking health care professionals to be on the lookout and report any suspected cases of AFM (Acute Flaccid Myelitis), a paralyzing illness resembling polio, as cases may peak during this time.

Last year a total of 233 cases were confirmed in 41 states.  This year 11 have been reported and an additional 57 cases are being investigated.  Cases have been reported in California, Maryland, Nebraska, North Carolina, Pennsylvania, Texas, Utah and West Virginia this year.

 

afm-state-map.png

Image above from CDC

Last year, California, Colorado and Texas appeared to be the worst hit with 15, 16 and 31  cases respectively.  Experts are urging states to report any cases of suspected AFM as the above map could be an under-representation of true numbers.

On their website, the CDC reports the following:

  • Most of the patients with AFM (more than 90%) had a mild respiratory illness or fever consistent with a viral infection before they developed AFM.
    • Viral infections such as from enteroviruses are common, especially in children, and most people recover. We don’t know why a small number of people develop AFM, while most others recover. We are continuing to investigate this.
  • These AFM cases are not caused by poliovirus; all the stool specimens from AFM patients that we received tested negative for poliovirus.
  • We detected coxsackievirus A16, EV-A71, and EV-D68 in the spinal fluid of four of 570 confirmed cases of AFM since 2014, which points to the cause of those patients’ AFM. For all other patients, no pathogen (germ) has been detected in their spinal fluid to confirm a cause.
  • Most patients had onset of AFM between August and October, with increases in AFM cases every two years since 2014. At this same time of year, many viruses commonly circulate, including enteroviruses, and will be temporally associated with AFM.
  • Most AFM cases are children (over 90%) and have occurred in 48 states and DC.

 

The “48 states” refers to cases since 2014.   90% of the cases occurred in children under the age of 4.

The age range of children affected appear to be 3-14.  A 6-year-old boy in Washington State died in 2016 and was the first death to be linked to this mysterious illness.  His parents reported he had felt ill, became dizzy and within hours suffered swelling in the brain and paralysis.  Despite medical efforts, he passed.

In 2018 parents of two children who died from AFM accused the CDC of hiding their deaths.

Although the exact cause of AFM is unknown, health experts are considering a variety of possibilities. They have actually been investigating this since 2014 when reports of AFM began to surface across the United States.

What is AFM?

AFM stands for Acute Flaccid Myelitis.  It’s a condition that occurs suddenly, causing inflammation of the brain and spinal cord, causing loss of muscle tone and reflexes.  Although limb weakness is the primary symptom, patients could also exhibit slurred speech, facial drooping, and in serious cases inability to breath due to paralysis of the respiratory muscles.  Mild cases appear to resolve but serious cases can cause residual paralysis or death. Children appear to be more affected than adults.

What causes AFM?

Although health officials do not know for certain, due to its rapid onset, a pathogen such as a virus seems highly likely.  With the 2013-2014 outbreak, some of the cases tested positive for enterovirus (EV-D68), but it is not conclusive whether this was the exact cause or just coincidentally found in the patients tested.

Some postulate a combination of viruses may be a factor or an autoimmune disease.  Although Guillain-Barre syndrome causes acute limb weakness and paralysis when the immune system begins attacking the nervous system, the report that many individuals feel feverish or ill prior, seem to point to a pathogen as the primary cause although the latter is not being ruled out.  Virus families such as enterovirus (including polio and nonpolio enterovirus), adenovirus (causing respiratory and GI illness) cocksackieviruses and flaviviruses (including West Nile) have been suspected.

How common is AFM?

Per the CDC, acute flaccid myelitis is rare (less than 1 in a million cases) however currently they report 570 cases have been confirmed since the outbreak began in August 2014.

How is it diagnosed?

Medical professionals look at a variety of factors.

History: how the paralysis/loss of muscle tone began and which limbs did it affect first

Laboratory tests and CSF (cerebrospinal fluid) testing: to look for signs of infection

MRI of the brain: which may show gray matter involvement in a case of AFM.

Is there a treatment?

There is no standard treatment that has been proven effective, however depending on the severity of the symptoms, health professionals can consider a variety of options including steroids, IVIG, interferon, antivirals and supportive measures.  Some physicians are using “nerve transfers”, similar to a transplant, to help children regain control of their limbs.

Is there a vaccine?

No.  Until they can identify the exact cause, or causes, health officials cannot create a vaccine.

How does one avoid getting AFM?

If we assume it’s a pathogen causing the illness, avoiding contact with sick individuals, being up-to-date on one’s vaccines and good hand-washing are imperative.  Although we do not know if AFM is caused by a mosquito-born illness, avoiding mosquitoes would be wise as well.   More therefore needs to be researched to determine why and how those individuals with AFM were infected.

 

spanish book

Learning Medical Spanish is Easy!!!

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

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Posted in children, Health, news, teens

Teens May Fake Being Abducted in the Latest “48-Hour Challenge”

Earlier this month police warned that some teens may be participating in the 48- Hour Challenge.  This latest feat involves the child running away from home and accruing “likes” on social media.

However, this week we learned of two Houston 6th grade girls who had gone missing, with their parents scared out of their minds. Both the girl’s cell phones had been turned off and the parents were obviously hoping they weren’t truly abducted.

KHOU reports that Mary Tran Le, 13, and Tianny Granja, 12, left their homes around 7:30 a.m. Tuesday with their backpacks and never made it to class, days after they spoke to one of their mothers about the challenge.

Fortunately the girls have been found and returned to their families.

When reports of the social media game surfaced, whose mission is to score many likes while you’re “missing”, it could not be confirmed. Yet the average child who hears of these rumors may think it’s an actual challenge and turn rumor into reality.

Police are already stretched thin and image the “Boy Who Cried Wolf” scenario if this challenge goes viral.

What other dangerous challenges are out there?

Last year we learned of the “Boiling Water Challenge” in which kids drink boiling water from a straw or have it poured all over their body. Then they topped it off with a more dangerous challenge, the “Fire Challenge.”

The Fire Challenge is executed by pouring rubbing alcohol on one’s body and then setting oneself on fire.  A video records the victim running into a tub or shower to wash it off, and this trend has gone viral.

Unfortunately it’s one of the most dangerous.  A 12 year-old girl from Detroit who participated in this challenge is undergoing multiple surgeries to repair burns afflicting close to 50% of her body.

Multiple cases of the “Fire Challenge” have been reported over the years, including a 12 year-old boy from Georgia.

One would think children, especially teens, innately know that fire is dangerous but maybe the younger generation has been so protected that they haven’t experienced the basic concepts of danger and inadvertently underestimate its force.

 

fire-challenge

Challenges that involve dangerous stunts have been around for some time.  The Choking Challenge induced children to suffocate themselves for the high of feeling asphyxiated.  The Tide Pod Challenge tempted kids to put colorful cleaning packets in their mouths, hoping they wouldn’t burst.

 

download.jpeg.

The Cinnamon Challenge sparked thousands to inhale the common kitchen spice and cough till they puked.  Then the Condom Challenge offered two options where one dropped a condom filled with water on a friends face, or snorted one through the nose.

 

condom-snorting_fef3836eae7396a0afa3cb633b709bb4

We adults can’t for the life of us figure out what the reward is in performing these challenges, but presume its fame and awe among friends and social media followers.  But these challenges prove dangerous and in some cases deadly.  Unfortunately the YouTube Clips never show the after effects of these pranks…maybe they should.

 

IMG_1781

The Baby Boomer’s Guide to Online Dating

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

 

Posted in children, Health, news

“Aquaman” Treatment for Burns, A Hit With Kids

Image above from Reuters

Earlier this year we learned of burn specialists experimenting with fish skin to treat damaged skin that had sustained severe burns.  Now we learn that due to a shortage of pig and human skin tissue samples, Brazilian doctors are turning to the scaly looking bandages.

Kids, who idolize DC Comic’s Aquaman, appear to like the treatment.

 

Aquaman-Character-Posters-Featured.jpg

 

Tilapia skin, according to researchers, provide the collagen proteins needed to regenerate new tissue.

 

tilapia fish.jpg

 

When one is burned, the loss of tissue can expose one to infection and water loss.

 

burn.jpg

 

Burnt skin needs to be kept moist and covered, hence conventional treatment requires frequent dressing changes.

The fish skin is sterilized prior to use and then kept on for one week before being removed.  Fresh tilapia bandages may be refrigerated for up to two years.

 

tilapia.jpg

 

Preliminary studies are demonstrating Tilapia skin grafts allow quicker healing and less pain, and since they are relatively inexpensive, this treatment could revolutionize burn care.

 

 

dw sketch.jpg

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

Posted in children, Entertainment, Health, Millennials, news, smart devices, Social Media

What Are They Saying? Your Guide to Teen Slang

Once we became accustomed to words like “dope,” “word,” and “sick”, a new generation introduced their vernacular.

Social media has changed the way we talk.  Words need to be abbreviated, and many times one word must assume a whole phrase.

Generation Y’s (Millennials) and Z’s (those born after 1995) have learned to be concise, descriptive, and to the point as technology and social media encourage less characters/keys being used to get one’s point across.

So here’s a guide to what the young ‘uns are saying:

  • GOAT: Greatest Of All Time (you may see pics of goats in Tom Brady jerseys…..”
  • BAE: one’s love, or babe.  Stands for “Before Anyone Else”
  • Lit:  Cool or Awesome!
  • Woke: aware of social issues
  • Gucci:  Good or cool
  • Hundo P – Short for “I’m 100% positive/certain”
  • Squad/Fam: Group of close friends
  • Throw Shade:  Make fun of/criticize, give a nasty look at someone
  • Curve: To reject someone romantically
  • Salty: Bitter about something or someone
  • Ghost: To ignore someone
  • Skurt: to leave, tell someone to go away
  • Sip Tea: mind your own business
  • Ship: relationship
  • Troll:  Those who say nasty things online

Netsanity provides this breakdown:

TeenSlangInfographic

 

And for those of you who need some help translating your kids’ texts:

 

text-message

And we can’t forget the emoji’s. These allow a visual, pictoral way to get one’s message across:

emojis

With building and maintaining strong relationships, communication is key.  For us old dogs, we might need to learn some new tricks.

 

dw sketch.jpg

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

 

Posted in children, Health, news

AFM Polio-Like Illness Reported in Multiple States

31 states have reported recent cases of AFM (Acute Flaccid Myelitis), a paralyzing illness resembling polio.  This week the CDC reported a rise in the number of cases to 116.  170 more cases are currently being investigated.

 

cdc

Colorado and Texas appear to be the worst hit with 15 and 14 cases respectively.  Experts are urging states to report any cases of suspected AFM as the above map could be an underrepresentation of true numbers.

On their website the CDC reports the following:
  • Most of the patients with AFM (more than 90%) had a mild respiratory illness or fever consistent with a viral infection before they developed AFM.
    • Viral infections such as from enteroviruses are common, especially in children, and most people recover. We don’t know why a small number of people develop AFM, while most others recover. We are continuing to investigate this.
  • These AFM cases are not caused by poliovirus; all the stool specimens from AFM patients that we received tested negative for poliovirus.
  • We detected coxsackievirus A16, EV-A71, and EV-D68 in the spinal fluid of four of 440 confirmed cases of AFM since 2014, which points to the cause of their AFM. For all other patients, no pathogen (germ) has been detected in their spinal fluid to confirm a cause.
  • Most patients had onset of AFM between August and October, with increases in AFM cases every two years since 2014. At this same time of year, many viruses commonly circulate, including enteroviruses, and will be temporally associated with AFM.
  • Most AFM cases are children (over 90%) and have occurred in 46 states and DC.

The “46 states” refers to cases since 2014.   90% of the cases occurred in children under the age of 4.

The age range of children affected appear to be 3-14.  A 6-year-old boy in Washington State died in 2016 and was the first death to be linked to this mysterious illness.  His parents reported he had felt ill, became dizzy and within hours suffered swelling in the brain and paralysis.  Despite medical efforts, he passed.

Earlier this month parents of two children who died from AFM accused the CDC of hiding their deaths.

Although the exact cause of AFM is unknown, health experts are considering a variety of possibilities. They have actually been investigating this since 2014 when reports of AFM began to surface across the United States.

What is AFM?

AFM stands for Acute Flaccid Myelitis.  It’s a condition that occurs suddenly, causing inflammation of the brain and spinal cord, causing loss of muscle tone and reflexes.  Although limb weakness is the primary symptom, patients could also exhibit slurred speech, facial drooping, and in serious cases inability to breath due to paralysis of the respiratory muscles.  Mild cases appear to resolve but serious cases can cause residual paralysis or death. Children appear to be more affected than adults.

What causes AFM?

Although health officials do not know for certain, due to its rapid onset, a pathogen such as a virus seems highly likely.  With the 2013-2014 outbreak, some of the cases tested positive for enterovirus (EV-D68), but it is not conclusive whether this was the exact cause or just coincidentally found in the patients tested.

Some postulate a combination of viruses may be a factor or an autoimmune disease.  Although Guillain-Barre syndrome causes acute limb weakness and paralysis when the immune system begins attacking the nervous system, the report that many individuals feel feverish or ill prior, seem to point to a pathogen as the primary cause although the latter is not being ruled out.  Virus families such as enterovirus (including polio and nonpolio enterovirus), adenovirus (causing respiratory and GI illness) and flaviviruses (including West Nile) have been suspected.

How common is AFM?

Per the CDC, acute flaccid myelitis is rare (less than 1 in a million cases) however currently they report 386 cases have been confirmed since the outbreak began in August 2014.

How is it diagnosed?

Medical professionals look at a variety of factors.

History: how the paralysis/loss of muscle tone began and which limbs did it affect first

Laboratory tests and CSF (cerebrospinal fluid) testing: to look for signs of infection

MRI of the brain: which may show gray matter involvement in a case of AFM.

Is there a treatment?

There is no standard treatment that has been proven effective, however depending on the severity of the symptoms, health professionals can consider a variety of options including steroids, IVIG, interferon, antivirals and supportive measures.  Some physicians are using “nerve transfers”, similar to a transplant, to help children regain control of their limbs.

Is there a vaccine?

No.  Until they can identify the exact cause, or causes, health officials cannot create a vaccine.

How does one avoid getting AFM?

If we assume it’s a pathogen causing the illness, avoiding contact with sick individuals, being up-to-date on one’s vaccines and good hand-washing are imperative.  Although we do not know if AFM is caused by a mosquito-born illness, avoiding mosquitoes would be wise as well.   More therefore needs to be researched to determine why and how those individuals with AFM were infected.

 

dw sketch.jpg

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada