Having a more restrictive definition for AFM will allow researchers to look for possible genetic vulnerabilities that allow the virus to damage the spinal cord in some children, but not others. It’s thought that about 1 percent of children who catch the viruses that have been associated with AFM go on to develop paralysis, Elrick said.

Because no one knows whether AFM will hit increasing numbers of kids as time goes on, it’s important that we learn as much as we can now, Elrick said. Looking back at polio, it’s clear the disease popped up only sporadically for decades before it ramped up to epidemic status. One scary fact is that one of the viruses thought to be involved in AFM, enterovirus D68, appears to be mutating. “Recently accumulating changes in the genome allow it to be more infectious and maybe also have a higher tropism for neurons as well,” Elrick said. “In some ways it’s taking on characteristics that make it look more like polio.”

Elrick is a coauthor on the third article, which lays out ways that primary care physicians, ED doctors and parents can spot the signs of AFM earlier, which might improve children’s prognoses. “The key point is that a lot of times when children first present to medical professionals, they initially attribute the children’s weakness to lethargy and the children just feeling awful. We want both parents and physicians to make sure the child can at least lift up all four limbs against gravity.”

Children who can’t do that need to be brought in for evaluation for AFM, Elrick said. “In many cases there is a delay of a day or two from when people first start thinking something is wrong,” he added.

There are two reasons why it’s very important to get kids diagnosed quickly, Elrick said. “First, children need to be watched closely for signs of respiratory failure,” he explained. “It can happen very quickly so they should be in an intensive care setting where support can be provided.”

The second reason is that there is a treatment that may help. “IVIG (intravenous immune globulin) we think works because of the antibodies it contains,” Elrick said. “And we suspect that the earlier it’s given the better job it does of preventing the disease from becoming more severe.”

Dr. Larry Kociolek welcomed the new articles.

“I think they are largely a call for heightened action,” said Kociolek, associate medical director of infection prevention and control at the Ann & Robert H. Lurie Children’s Hospital of Chicago and an assistant professor of pediatrics at Northwestern University’s Feinberg School of Medicine. “There’s nothing we’ve seen to suggest this is going away. And because of the profound (complications) associated with this diagnosis, we do need to escalate our public health response.”