The Centers for Disease Control and Prevention (CDC) is facing mounting criticism for its handling of the growing number of cases of acute flaccid myelitis (AFM), also referred to as acute flaccid paralysis (AFP). The federal health agency has been accused by some doctors of moving too slowly to identify a virus as the cause of AFM, despite the fact that there is no hard evidence the condition is the result of a viral infection.1 2
The CDC also has been accused by parents of attempting to hide the deaths of children who suffered from AFM. At least two children diagnosed with AFM have reportedly died in the United States—including six-year-old Alex Bustamante in May 2018 and five-year-old Carter Roberts in September 2018.3
Some physicians note that the CDC has been dealing with reported cases of AFM since 2014 and that public health officials have had plenty of time to come up with an understanding of the cause of the outbreak and to provide guidelines to pediatricians on how to diagnose and treat patients afflicted with the polio-like illness. “This is the CDC’s job. This is what they’re supposed to do well,” said neurologist Kenneth Tyler, MD of the University of Colorado School of Medicine. “And it’s a source of frustration to many of us that they’re apparently not doing these things.”2
The central point of contention between doctors appears to be an argument about how to interpret the science regarding AFM. While some physicians are convinced that an enterovirus, specifically Enterovirus D68 (E-68), is the likely cause of AFM, the CDC has been reluctant to commit to this theory. “The CDC really seems to be out of sync with the conclusions that most scientists are coming to. We feel like we’re not being listened to,” complained Keith Van Haren, MD of Stanford University School of Medicine. “We don’t understand how the CDC has arrived at the place where they’re at.”2
Some doctors like Mark Siegel, MD of New York University Langone Medical Center, however, view the criticism of the CDC as being unfair. In a recent opinion piece, Dr. Siegel wrote that the “lack of proof of cause and effect from a culprit virus has helped engender the unfair criticism.” Although, he added, “Identifying a culprit strain (or strains) could lead to earlier diagnosis and possibly a vaccine.”4
That appears to be what the majority of the medical establishment wants to hear: AFM is caused by a virus. The answer, of course, to preventing AFM would be to quickly develop a vaccine that would be given to every child.
The CDC’s perspective so far has been “science doesn’t give us an answer” for what is behind the emergence of AFM.5 However, the health agency’s cautious approach may be changing.
On Nov. 13, 2018, the CDC released a report that suggests federal health officials may be more inclined to get in sync with critics. According to CDC researchers, “Clinical, laboratory, and epidemiologic evidence to date suggest a viral association.”6
Dr. Van Haren commented, “I’m breathing a sigh of relief that they’ve acknowledged this,” and added, “It’s great.”1
1 Cohen E, Goldschmidt D. As more cases confirmed, CDC says evidence suggests ‘viral association’ for AFM. CNN Nov. 13, 2018
2 Cohen E. CDC’s handling of polio-like illness criticized by its own advisers. CNN Nov. 2, 2018.
3 Cohen E. Parents accuse CDC of not reporting children’s deaths from polio-like AFM. CNN Nov. 13, 2018.
4 Siegel M. Dr. Marc Siegel: Stop criticizing the CDC on mystery muscle-weakening disease. Fox News Nov. 14, 2018.
5 Poole S. CDC still perplexed over cause of rare polio-like illness. The Atlanta Journal Constitution Nov. 13, 2018.
6 McKay SL, Lee AD, Lopez AS, Nix WA, Dooling KL, Keaton AA, Spence-Davizon E, Herlihy R, Clark TA, Hopkins SE, Pastula DM, Sejvar J, Oberste MS, Pallansch MA, Patel M, Routh JA, Increase in Acute Flaccid Myelitis — United States, 2018. Morbidity and Mortality Weekly Report Nov. 13, 2018.
7 Strauss EM, Phorn B. Officials investigating 252 possible cases of polio-like illness AFM. ABC News Nov. 13, 2018.
8 Cáceres M. AFM Not Transmissible from Human to Human Says CDC. The Vaccine Reaction Nov. 7, 2018.