The number of cases of rare illness acute flaccid paralysis has risen in the UK, Public Health England has warned.
Investigations into what has caused the increase are continuing, as people are being warned that if you develop weakness in any limb, medical attention should be sought immediately.
Acute flaccid paralysis (AFP) is a rare but serious neurological illness which is normally due to inflammation of the spinal cord, known as acute flaccid myelitis (AFM).
AFP and AFM causes weakness of the arms, legs or face.
In the past, AFP was commonly due to poliovirus infection.
But the success of the vaccination programme means that polio is now very rare internationally and has been eliminated in the UK.
AFP may be linked to other viral infections including non-polio enteroviruses, the government says.
Public Health England has seen an increase in reports of unexplained acute neurological symptoms, particularly AFP, in 2018 in England.
Most of the cases have been in children.
Symptoms of acute flaccid paralysis
Most people will experience weakness in an arm or leg and loss of muscle tone and reflexes which come on suddenly, Public Health England says.
People may also have:
• facial droop/weakness
• difficulty moving the eyes
• drooping eyelids
• difficulty swallowing or slurred speech
In some cases people may experience other rarer symptoms including:
• numbness or tingling (but this is rare)
• pain in their arms or legs
• inability to pass urine
In severe cases AFP can lead to respiratory failure (as the muscles involved with breathing become weak) or other serious neurological complications.
PHE’s Head of Immunisations, Dr Mary Ramsay told the Daily Express : "Our investigations into potential causes are ongoing, and we are continuing to build better awareness amongst health care professionals about how to test and manage patients with AFP.
"We are not clear whether all of the apparent increase is real, or whether this represents increased awareness and diagnosis over recent years.
"The current best theory is that this is a very rare consequence of enterovirus infection, as the increase coincides with increases in infection.
"Enterovirus D68 (EV-D68) has been found in around one quarter of cases.
"However, as the infection is very common, and most children have been infected by the age of 5 years, there must be other factors involved.
"AFP is very rare. However, if you or your child develops weakness in any limb you should seek medical care immediately so that appropriate testing and care can be given."
On 21 January 2019, 40 cases of AFP had been identified since 1 Jan 2018 with a peak in October 2018.
Investigations are ongoing.
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