When Evie Clark was hit on Christmas Day with a runny nose, cough, and temperature, her parents assumed she had just had a cold.
But on New Year's Eve the seven-year-old was left in a hospital by a wheelchair because of a mysterious situation that temporarily paralyzed her.
Evie, from Maidstone in Kent, is one of the dozens of British children who last year developed a condition called acute weak myelitis, which is thought to be caused by a common virus.
Her mother, Nicola, said it was & # 39; heartbreaking & # 39; was to see how her daughter suffered from a disease that neither she nor many of the doctors they saw could understand.
Despite being largely recovered after nearly a year of physical therapy, Evie has a & # 39; sleepy & # 39; left arm and she has trouble using it.
Doctors now say that she needs a complex operation to restore nerve connections in her limbs to make it heal completely.
Evie Clark (photo this summer) got sick for Christmas for the first time last year with what her parents thought she had a cold, but her condition rapidly deteriorated to the point that she couldn't keep her own head up
Evie, pictured on her first bike ride after being released from the hospital in February, has recovered well, but surgeons want to operate to improve their left arm function
Evie's case is one of a total of 57 diagnosed throughout England since January 2018.
Public Health England has identified a peak in cases of acute limp paralysis – the paralyzing symptom of acute limp myelitis (AFM).
Almost all cases occurred during a peak in October, November and December last year and there were more than twice as many as in the last nine years combined.
That is why Public Health England launched a task force last winter to find out what causes the AFM and how to treat affected children.
The reasons behind it are unclear – although a virus named EV-D68 is a prime suspect – and the symptoms seem to vary from patient to patient.
WHAT IS ACUTE FLACCID MYELITIS (AFM)?
The term & # 39; myelitis & # 39; means inflammation of the spinal cord.
Transversal myelitis is the broad name of the disease and there are different subtypes.
It is a neurological disorder that infects the spinal cord across its width (& # 39; transversal & # 39;) and destroys the fatty substance that protects nerve cells.
This can lead to paralysis.
AFM is an unusual subtype of transversal myelitis.
Patients begin with the same spinal inflammation, but their symptoms are different and the disease develops differently.
The most important distinction is that AFM patients are weak and weak, while patients with general transversal myelitis tend to be rigid.
Most AFM patients begin to struggle with movement of the limbs, face, tongue and eyes.
They then begin to lose control of one limb or sometimes the entire body – although many remain in control of their sensory, bowel and bladder functions.
Unlike transverse myelitis, which has existed for years, doctors still do not know why and how AFM manifests itself.
Officials at PHE called the disease & # 39; serious & # 39; and said that most patients have serious long-term problems.
Evie, the youngest of a family of four, first fell ill last year on Christmas Day with a cough, runny nose, and temperature, so her mother was watching her closely.
& # 39; She slept in her sleep and breathed quickly, & # 39; Mrs. Clark, 44, told MailOnline.
& # 39; One day when I was lying in her bed, she was really shaking and her back really hurt her. I thought she had spent too much time on the couch or something.
& # 39; But she couldn't lie still and was really upset by the back pain. Then she went to the toilet, came back and said "my arm is not working". & # 39;
By that time, Mrs. Clark and her husband Geoff, a 44-year-old electrician, realized that something was seriously wrong, so they took her to the hospital.
Soon their daughter didn't have the strength to look down to touch her chin against her chest, and her arm had become so sore that she screamed when people touched him.
The A&E doctor in Maidstone referred her to another hospital, where she stayed for two days, but doctors then sent her to central London to Evelina Children's Hospital, about 64 kilometers away.
Doctors in Kent had prevented Evie from having a stroke or spinal cord injury, but did not understand why she lost the use of her arms and legs.
Evie (left, pictured with her siblings and parents on vacation in 2018) is the youngest member of her family, who lives in Maidstone, Kent
In the photo in the hospital, the now seven-year-old was in so much pain that she would scream if someone touched her, her mother said
WHAT IS ENTEROVIRUS-D68?
Enterovirus D68 (EV-D68) is a type of non-polio-causing virus.
It was first identified in the US in 1962, but the number was low. It has become increasingly common over time, but is difficult to keep up with since most cases are not recorded.
Many people infected with the virus do not develop any disease, while those who generally only get a runny nose or cough.
However, it can cause more severe respiratory problems and scientists now believe it can be a trigger for acute weak myelitis, a condition that causes swelling in the spine and causes paralyzing nerve damage.
EV-D68 is believed to spread in the same way as cold and flu germs – through the cough and sneezing of other infected people.
Children and teenagers are most likely to get sick because adults are usually exposed to them without problems, making them immune.
EV-D68 infection can only be diagnosed with specific laboratory tests and there is no cure for the disease it causes.
& # 39; She was in a lot of pain, & # 39; said Mrs. Clark.
& # 39; People were completely stunned why her arm didn't work. I had to wear her and hold her head up so she could go to the toilet.
& # 39; I felt like we were in the children's hospital, so it should go well, but I felt frustrated that nobody knew what was going on, even after an MRI and CT scan. & # 39;
Doctors in the Evelina quickly understood that Evie probably had AFM, Mrs. Clark said, and they did her steroids to try to reduce the swelling around her nerves.
AFM is a condition that causes inflammation around the spinal cord, which pressurizes the nerves and disrupts their ability to function normally.
It can also destroy the greasy protective layer around the outside of the nerve – the myelin – leading to long-term damage.
The recent wave of cases is thought to be caused by enterovirus D-68 (EV-D68), found in the spinal fluid of patients in the US and UK.
This is a virus that is spread in the same way as a cold, but it is not clear why it affects some people – mostly children under the age of five – and not others.
Public Health England & # 39; s immunization manager, Dr. Mary Ramsay, said earlier this year: & # 39; The current best theory is that (AFM) is a very rare consequence of enterovirus infection, because the increase coincides with the increase in infection, but a definitive, causal connection. has not been proven to date.
Evie (pictured on her seventh birthday in September) is happy to have to undergo the nerve transplant, her mother says, because she is getting frustrated that she cannot be as active as other children
Evie & # 39; s mother, Nicola Clark, told MailOnline: & I felt we were in the children's hospital, so we should make it, but I felt frustrated that nobody knew what was going on , even after an MRI and CT scan & # 39;
& # 39; EV-D68 was found in about one third of the cases.
& # 39; However, since the infection is common and most children are already five years old, it seems likely that other factors are involved. & # 39;
Evie's condition continued to deteriorate and she was placed in a high-dependency unit for a week while she received aggressive treatment to control the disease.
Other children affected by the condition in the US and UK have ended up in coma & # 39; s completely paralyzed and last year there was a suspicion of death in the US.
Mrs. Clark said: & I was terrified. She was in a wheelchair because she could not sit or stand upright or move her head. I now realize that the nerves were all damaged.
& # 39; She slept a lot but was awake all the time (not in a coma). I was told that she could become blind or incontinent – I had to put her back in diapers, which was surreal for a six-year-old. & # 39;
After spending more than a month in the hospital, Evie was fired and sent home in February, and managed to return to school a month later.
She is able to walk and run for short periods again, although her arm is not normal again – she calls it her & # 39; sleepy arm & # 39 ;.
In October, doctors performed extensive tests to see if inoculating a working nerve in Evie's shoulder could bring the full function back to her arm, and decided to operate.
Evie has had a lot of physiotherapy to regain the strength in her limbs. AFM causes swelling that causes nerve damage – this can be temporary and recur over time or it can take longer if the nerves or the protective coating around it are seriously damaged
Mrs. Clark said: & # 39; It has broken my heart to feel so helpless and watch my child go through it and not protect her & # 39;
& # 39; I hoped it wouldn't be necessary, & # 39; Mrs. Clark said to MailOnline. & # 39; We have made very good, though slow, progress over the past nine months.
& # 39; Evie said she is excited about the operation, because when she tries to run now, her arm turns around and it is really annoying.
& # 39; So that made me feel that the operation was the best decision, even though I'm afraid of her, it's not about me, it's about giving Evie her best chance.
& # 39; It has broken my heart to feel so helpless and watch my child go through it and not protect her.
& # 39; It's this confusing thing that I still don't really understand and we don't know where it comes from. & # 39;
Of the 57 cases of paralysis reported to Public Health England, 40 took place between January 2018 and January 2019 and are part of an ongoing investigation.
Nine of those people had confirmed AFM, seven had & # 39; probable & # 39; cases, 19 still have test results pending and five had the symptoms caused by something else.
PHE officials said in a statement: & acute weak myelitis / paralysis can be difficult to diagnose because it has many of the same symptoms as other neurological disorders.
& # 39; Doctors will usually examine a patient's nervous system and look at images of the spinal cord and brain.
& # 39; They can also test the fluid around the brain and spinal cord and check the conduction of the nervous system.
& # 39; Early physiotherapy and occupational therapy to restore the function of the affected limbs are the key to treatment.
& # 39; There are indications that children with AFP can regain strength and function in affected limbs months after years. & # 39;
POLIO-LIKE DISEASE ATTAINS A RECORD HIGH IN THE USA IN 2018
The polio-like disease that causes paralysis in children reached a record high in the US in 2018, health officials confirmed.
Acute weak myelitis, which makes young people unable to move their face, neck, back or limbs, was confirmed last year in 236 people in 41 states, according to the Centers for Disease Control and Prevention (CDC).
This was considerably higher than the 37 in 2017, and even than the 153 in 2016 – the condition, however, is to increase the year.
And the actual toll was probably even higher because not all cases are registered and not all cases that are registered are confirmed.
According to the Australian University of New South Wales, according to the Australian University of New South Wales, one person died in the US last year as a result of the condition.
An increasing number of cases may simply be due to a better diagnosis of a poorly understood condition.
Colorado, for example, was at the center of an outbreak in 2014 and therefore doctors are better at recognizing AFM symptoms.
In 2018 there were cases recorded by the CDC in all states except Alaska, Hawaii, Oregon, Idaho, West Virginia, Maine, Vermont, Connecticut and Delaware.
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