- There have been 186 confirmed cases of acute flaccid myelitis so far in 2018
- 2014 saw the first outbreak of 120 cases in the US
- The disease so far has recurred every other year starting in the late summer, with the number climbing higher with each outbreak
- Though it often coincides with respiratory infections, scientists have no idea what causes AFM
- New cases tend to taper dramatically in and following December and reemerge in August
- With no cause, and not treatment (besides time) it is difficult to say what the future will hold
- But if the current trend continues, 2020 could be the worst year yet for the polio-like disease
After a record-setting 186 cases of the polio-like disease, acute flaccid myelitis (AFM) in 2018, the peak has passed and instances of it are expected to continue to decline - until 2020.
Scientists don't know why, but the infection, which appears to attack the spinal cord and cause temporary - and occasionally permanent - paralysis primarily in young children seems to ebb and flow in every-other-other-year waves.
The first known outbreak of unknown cause or origin occurred in 2014. AFM reemerged in 2016 and struck 149 people. Then again in 2018 the disease made a comeback, hitting a record 186 confirmed cases so far this year.
So far, it appears that AFM outbreaks occur every other year - and that each resurgence is worse than the last.
One thing is becoming increasingly clear: we can now expect an approximately 14-month lull in cases of AFM.
During that time, the Centers for Disease Control and Prevention (CDC) are determined to do their utmost to crack the mystery.
The CDC has assembled a special task force to do exactly that.
Its members include parents, neurologists, epidemiologists who study disease patterns, virologists and pathologists who are investigating potential infectious triggers for the disease, doctors who study the immune system, and those who study genetic and environmental disease risk factors.
Still, for the task force and the world at large, far more is unknown than known about AFM.
The very first cases appeared in 2012, with a series of children with an average age of 10, mostly concentrated in California.
In 2014, the disease appeared in more full force, with clusters in Colorado and Utah.
Between August and December, a total of 120 cases cropped up across 34 states.
They are also investigating how a pathogen might infect different types of cells than they had previously examined, such as muscle cells themselves, or if an infection could trigger inflammation and an autoimmune response.
Furthermore, they intend to 'implement natural history stud[ies]' to try to understand what sort of biannual 'seasons' or cycles may fuel the disease's pattern.
Nonetheless, there is little that scientists can do to predict the future, especially in the case of AFM.
'It is impossible to say if we'll have any real answers ... because this is a complex public health challenge,' the CDC's Dr Thomas Clark, an epidemiologist told the Dallas Morning News.
And that leaves parents in the terrifying position of simply hoping for the best for their vulnerable children.
'Until we fully understand what causes AFM, we can't help protect people against it.'
Currently, epidemiologists like him have little to go on except the patterns that we have observed since 2014.
And if these are any indication, we can only expect more, sicker children in the winter or 2020.
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