rare disease afm

Mysterious Illness Spreading, But Still Very Rare

Your concierge family practice doctors in Jupiter, Florida, at MD 2.0., have been hearing concerns from our patients about the recent publicized increases of a rare polio-like disease occurring mainly in children. The Centers for Disease Control and Prevention (CDC) is investigating as many as 127 cases of acute flaccid myelitis (AFM) in at least 22 states this year. Some news outlets place the number of states affected closer to 30, because reporting cases to the CDC is voluntary, and this information may not have reached the CDC yet.

The symptoms of AFM are very similar to polio, a disease that was eradicated in the U.S. through the use of universal immunization. AFM affects a person’s nervous system, specifically the spinal cord, causing weakness in one or more limbs. It tends to begin about a week after a slight fever or respiratory illness, but can suddenly appear as weakness in the arms and legs. Other symptoms can include slurred speech or difficulty swallowing, or a “drooping” appearance in the face. Many patients recover quickly, while others continue to have paralysis requiring ongoing care.

More than 90 percent of the cases the CDC has confirmed have occurred in children under age 18; the average age is four. Although one death from AFM was reported last year, no deaths have been associated with the illness so far this year.

Cause still unknown

AFM was even rarer prior to its first major U.S. outbreak in 2014 when 120 cases were confirmed. The illness seemed to slack off in 2015 with only 22 confirmed cases, then spiked again in 2016 (149 cases), dropped in 2017 (33 cases), and now in 2018, we have 62 confirmed cases so far with an additional 65 suspected cases being investigated by the CDC. So not only do the cases seem to be rising then declining from year to year for reasons that are still unclear, but they also seem to cluster in the fall months. There are no state clusters, however, suggesting the illness is not spread from person to person but arises spontaneously.

The most frightening thing about AFM is that scientists have been unable to pinpoint a cause. All the confirmed AFM patients have been tested for poliovirus, and have definitively tested negative. The CDC has also tested every case for evidence of a wide range of known pathogens (germs) or viruses and has been unable to detect a consistent pattern among those affected.

What is known

Scientists continue to look for a common thread. Given the persistent controversy over vaccinations, it should be noted that those affected have differing histories on vaccinations: Some of the patients were vaccinated, some were not. (Incidentally, in October an unvaccinated child in Florida became the first person to die from this year’s flu.)

Unless it can be found that all those who contracted the illness share a common trait, such as being or not being vaccinated or contracting the same type of cold or flu, or having traveled to a certain place or having come in contact with some pollutant, the cause of the syndrome will remain a mystery.

What is also known is that the chances of developing AFM is less than one in a million, according to the CDC.

Should you worry?

The likelihood of you or your child developing this distressing illness is miniscule, but there is a chance, especially since this is a year in which the cases are spiking. But we believe there is little cause for concern. As a parent, you should take the typical precautions you always do to ensure your child stays healthy: obtaining the recommended vaccinations, ensuring they wash their hands regularly and practice accepted hygiene methods, eating well, exercising, and getting enough sleep.

Just be aware that AMF strikes with little warning, and watch your child for any signs of the symptoms described above. If you have any concerns or questions, please don’t hesitate to contact us immediately.

lyme disease outbreak

Lyme Disease Now Found In All 50 States

In case you thought we here in Florida didn’t have to concern ourselves with Lyme disease because it’s been confined to the Northeast U.S., new data demonstrate that’s no longer the case. Your concierge family practice doctors in Jupiter want to warn you that living here is no longer protection from this tick-borne disease, and to outline the steps you need to take to protect yourself and your family.

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Happy 100th Birthday Mr. Arbree

Joseph Arbree, to quote the adage, was slightly ahead of his time. A patriotic American, Joe graduated from bombardier school on September 11th, but many decades before that date was forever etched into the nation’s memory. It was 1943, shortly after the US entered War II. Then Lt. Arbree, of Tenafly, New Jersey was training to become one the nations newest bombardiers during an extremely dark period in US history. And he had just landed a very dangerous job.

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Salmonella e. coli guidelines

Recent Cases of Food Poisoning Highlight Need for Caution

Although the United States’ food system has never been safer in the history of the country, cases of widespread food poisoning continue to surface. This is to be expected given our industrialized food manufacturing and distribution processes, but since our focus at our Jupiter concierge family practice is our patients, we would like to take the occasion of the two most recent outbreaks to review steps you can follow to minimize your risk.

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prevent-cold-and-flu-image

Facts and Fallacies About the Flu

Last week’s Center for Disease Control and Prevention (CDC) report on this year’s influenza outbreak was not positive: 49 states reporting widespread flu activity for the third week in a row; 37 children dead so far (the CDC does not track adult deaths); the highest level of activity reported since the 2009 H1N1 pandemic.

The Florida Department of health reports this week that flu activity throughout the state is high and continues to increase.

Your concierge doctors, in Jupiter, Florida, at MD. 2.0 have become concerned about the various flu-related myths that have been spreading like a virus. Here’s a quick quiz on some of the facts and misconceptions many have about the flu.

  1. You can get the flu from the flu shot

    False. You may get the flu even after you receive the shot because: (a) you became infected before you got the shot (it takes about two weeks to take effect); (b) you got a strain of influenza that wasn’t protected against in the shot; (c) the shot wasn’t effective for you. But studies have shown that even if you get the flu after getting the shot, the symptoms will likely be less severe.

  2. Pregnant women shouldn’t get it

    False. The flu shot is not only safe for pregnant women, it may also confer a measure of immunity to the baby for several months after birth.

  3. If you’ve already had the flu, you don’t need a shot

    False. There are several types of flu virus circulating, and you can still catch a type you haven’t already had. In addition, your immune system may be stressed from fighting off the first flu, so you may be more susceptible to attack from other viruses.

  4. You’re only contagious in the first 48 hours

    False. People can catch the flu from you a full day before you are experiencing any symptoms, and for up to a week after your symptoms subside. If you have the flu, stay home and sleep alone. If someone in your home has the flu, change and wash their bedding frequently, and disinfect the phone, remote controls, and other surfaces after they touch them.

  5. You can catch flu from breathing

    True. Yes, it’s important to wash your hands frequently with soap and water for at least 20 seconds, to use hand sanitizer when you can’t, and to avoid touching your eyes, nose, and mouth, the portals for the flu virus into your body. But it’s also the case that you can catch it simply from breathing the air from anyone within six feet of you who is sick. That’s why it’s vital that flu sufferers stay home.

  6. It’s not too late to get the flu shot

    True. Since no one can say for sure when this current outbreak will end, you can obtain a measure of immunity within two weeks. Although the typical flu season normally ends by the February-March timeframe, it can last as long as May. The current flu shot is at least 30% effective, and we believe 30% coverage is better than none at all.

  7. Getting a second shot will boost your immunity.

    False. The first shot will stimulate your immune system to fight off the virus. A second shot, which will contain the same strains as the first shot, will do nothing to boost your immunity further.

  8. The “stomach flu” is not really the flu

    True. Except in children, nausea, vomiting, and diarrhea-often called “stomach flu”-are not associated with influenza. Symptoms of the flu include: fever over 100.4 degrees; aching muscles; headache; a dry, persistent cough; chills and sweats; fatigue and weakness; and nasal congestion.

  9. Antibiotics will help once you get sick

    False. Antibiotics may be used once you’ve contracted the flu and you experience a secondary bacterial infection such as pneumonia, but they are totally ineffective against a virus. Instead, we will prescribe an antiviral such as Tamiflu to relieve your symptoms.

If you are experiencing symptoms of the flu, especially if they seem to be growing worse, see your primary care doctor as soon as you can.

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