Tag: non-polio AFP

Why Do Some People Think That Vaccines Cause AFM?

So we know that vaccines don’t cause acute flaccid myelitis.

Consider a five-year-old in Maryland who recently came down with symptoms of AFM.

Was he recently vaccinated?

Nope. It had been some time since his four-year-old vaccines. Almost a year. And he had not gotten a flu vaccine yet.

What he did have were worsening symptoms about two weeks after he had seemed to get over a cold, something he has in common with most other kids with AFM.

“To try to pin a tragic yet uncommon neurological condition caused by enteroviruses on vaccines is dangerous and puts more kids at risk.”

Scott Krugman, MD

As with this case, the CDC reports no correlation with vaccines in the cases that they have investigated.

And remember, some of these kids have been unvaccinated!

That makes you wonder why some folks actually think that vaccines are associated with AFM, doesn’t it?

Why Do Some People Think That Vaccines Cause AFM?

That’s right, as you are likely suspecting, the usual suspects are pushing anti-vaccine propaganda and promoting the idea to scare parents away from vaccinating and protecting their kids.

“…there are many other reasons to suspect vaccine-related mechanisms of causation for AFM in the U.S., a primary one being that the scientific literature has documented paralysis as an adverse reaction to vaccination for decades!”

The Non-Polio Illness That “Looks Just Like Polio” by Lyn Redwood, RN, MSN, President, Children’s Health Defense

If any of these kids had recently gotten the oral polio vaccine, then sure, an adverse reaction to the vaccination would be at the top of the list of possible causes. After all, we know that VAPP can occur after OPV, but that vaccine hasn’t been used in the United States since 2000, when we switched to IPV.

Why do these folks think that they have it all figured out?

Vaccines are not causing AFM because of needle puncture wounds or tonsillectomies.
Vaccines are not causing AFM because of needle puncture wounds or tonsillectomies.

The AFM outbreaks happen at the beginning of the school year, when kids are all getting their shots, right?

Nope. They happen during the summer and early fall, peaking in August. And despite what some folks think, most parents don’t wait until the end of summer, just before school starts, to vaccinate their kids. Plus, most kids don’t even need vaccines before the start of the school year. Kids typically only get vaccines before starting kindergarten and middle school.

But the outbreaks do coincide with the when kids get their flu shots, right?

How many kids get flu shots in June and July?

If it was flu shots, the peak would be in October and November, when most kids get their flu shots and we would continue to see cases through December and January.

Many anti-vaccine websites and Facebook groups are pushing the idea that vaccines cause AFM.
Many anti-vaccine websites and Facebook groups are pushing the idea that vaccines cause AFM.

Of course, there is absolutely no evidence that flu vaccines, or any other vaccines, cause AFM.

What about the journal article that Brandy Vaughan posts as evidence?

“By reviewing vaccine-associated inflammatory diseases of the central nervous system, this study describes the current knowledge on whether the safety signal was coincidental, as in the case of multiple sclerosis with several vaccines, or truly reflected a causal link, as in narcolepsy with cataplexy following pandemic H1N1 influenza virus vaccination.”

Vaccine-associated inflammatory diseases of the central nervous system: from signals to causation

Even if you just read the abstract, as many folks do, you get a good idea where they are going with the article. It talks about how the claims of an association between multiple sclerosis and vaccines were proven to be purely coincidental.

Remember, correlation does not imply causation.

With AFM, you don’t even have much correlation to imply causation though!

Most cases occur just before we start giving flu vaccines and they don’t occur every year or in every state.

But doesn’t the article mention myelitis?

“Most of the published associations are based on individual case reports or small series of patients.”

Vaccine-associated inflammatory diseases of the central nervous system: from signals to causation

It does mention myelitis, just like it mentions MS – where an association has been shown to be purely coincidental.

Remember, case reports are not good evidence.

“…there are many other reasons to suspect vaccine-related mechanisms of causation for AFM in the U.S., a primary one being that the scientific literature has documented paralysis as an adverse reaction to vaccination for decades!”

The Non-Polio Illness That “Looks Just Like Polio” by Lyn Redwood, RN, MSN, President, Children’s Health Defense

But isn’t acute flaccid myelitis listed as a possible side affect in the package inserts for our vaccines?

Uh, TRANSVERSE myelitis and ACUTE DISSEMINATED ENCEPHALOmyelitis are not the same as acute flaccid myeltitis.
Uh, TRANSVERSE myelitis and ACUTE DISSEMINATED ENCEPHALOmyelitis are not the same as acute flaccid myelitis.

While it should be clear that AFM isn’t the same as ADEM and TM, it is very important to understand that even when those other conditions are listed in a package insert, it is in the section that is marked “without regard to causality.”

This isn’t evidence that vaccines cause AFM!

But didn’t the BMJ publish a study about Vaccines and the U.S. Mystery of Acute Flaccid Myelitis?

BMJ seems to allow anyone to publish responses to their articles online...
BMJ seems to allow anyone to publish responses to their articles online…

Nope. What they did is let someone publish what is essentially an online letter to the editor. And anti-vaccine folks are spreading it around like it is an actual BMJ study…

Surprised?

You shouldn’t be.

This is how anti-vaccine propaganda works.

Why are vaccine injury lawyers talking about AFM?
Why are vaccine injury lawyers talking about AFM?

It’s no coincidence that anti-vaccine folks are trying so hard to associate the outbreaks of AFM with vaccines. What better way to scare folks and make them think that vaccines are dangerous?

AFM is all that anti-vaccine folks are talking about these days...
AFM is all that anti-vaccine folks are talking about these days…

How are ‘we’ working on a vaccine for AFM if we don’t even know what causes AFM???

But that’s how many anti-vaccine folks think. Everything is a vaccine injury. Everything is a conspiracy.

Don’t believe them. Vaccines are safe and necessary.

More on Anti-Vaccine Propaganda About AFM

 

Do Vaccines Cause Acute Flaccid Myelitis?

Breaking News – 158 cases of AFM in 36 states have been confirmed so far this year, with an additional 153 cases under investigation.

Since 2014, we have seen several outbreaks of acute flaccid paralysis (the sudden onset of weakness in one or more arms or legs) across the United States.

Why?

We don’t know, except we do know that these folks don’t have polio, even though folks continue to get confused because the kids are described as having a “polio-like” disease. Every case undergoes extensive testing, including testing for polio and other viral infections.

Do Vaccines Cause Acute Flaccid Myelitis?

Tragically, like some other conditions of unknown cause, some people have grasped onto the idea that AFP could be caused by vaccines.

“Of 14 patients with available information, 12 had previously received polio vaccine; one child and one adult were unvaccinated because of personal belief exemptions.”

Acute Flaccid Paralysis with Anterior Myelitis — California, June 2012–June 2014

It shouldn’t be surprising that there is absolutely no evidence that this is any type of vaccine injury.

Of nearly 350 cases of the acute flaccid myelitis (AFM), or the subtype of AFP that we have been seeing since 2014, we know that:

  • most cases occur in children
  • they have a magnetic resonance image (MRI) showing spinal cord lesion largely restricted to gray matter and spanning one or more vertebral segments
  • AFM can be caused by viruses, environmental toxins, and genetic disorders, although no common etiology has been found in recent cases
  • cases are occurring sporadically – after 120 cases in 34 states in 2014, there were only 24 cases in 17 states in 2015, but then 149 cases in 39 states in 2016 and 33 cases in 16 states in 2017. And there have been at least 62 cases in 22 states in 2018.
  • most cases occur in the late summer and early fall
  • most had symptoms of a preceding viral illness, including respiratory symptoms or diarrhea
  • some were unvaccinated
  • the ages of affected children has ranged from 5 months to 20 years
  • some patients have recovered, while others have persistent paralysis
  • there has been at least one death
  • some, but not all, were positive for enterovirus D68
  • in Colorado this year, 9 of 14 cases were linked to EV-A71 infections
  • although there was a national outbreak of EV-D68 in 2014 that coincided with the first AFM cases, we didn’t see this kind of outbreak in the following years

So what’s causing these kids, with a median age of about 7 years, to develop acute flaccid myelitis?

We don’t know, but there is certainly no reason to think that it could be a vaccine, as some anti-vaccine folks suggest.

For one thing, several of the kids were completely unvaccinated!

And then, if it was a vaccine, why the seasonal pattern?

Would a vaccine injury have such a seasonal pattern – even skipping a year?
Would a vaccine injury have such a seasonal pattern – even skipping a year?

And why don’t cases occur in all states and at the same rates each year?

Also, why the big range in ages? After all, what vaccines do a 5 month old and a 20 year old have in common?

And the CDC has been looking at all possible causes.

“Our medical team has been reviewing vaccine records when available during this year’s investigation and do not see a correlation.”

Kristen Nordlund, CDC spokeswoman

Acute flaccid myelitis is not caused by vaccines. Hopefully we will soon find out what really is causing it and can figure out how to prevent it.

Want to prevent a type of acute flaccid paralysis right now?

Get vaccinated!

While AFM is a type of non-polio AFP, we have long had a vaccine that can prevent polio, which also causes acute flaccid paralysis.

More on Vaccines and Acute Flaccid Paralysis

Updated December 10, 2018

Did Modern Ventilators Replace the Iron Lung for Folks with Polio?

Believe it or not, some folks don’t think that vaccines work and that some diseases, like smallpox and polio, never really went away.

Residual paralysis that lasts more than 60 days is the strongest predictor that a case is really polio, which is why, in addition to testing for polio virus, the 60 day standard is used.
Want the real truth? Residual paralysis that lasts more than 60 days is the strongest predictor that a case is really polio, which is why, in addition to testing for polio virus, the 60 day standard is used.

Of course, they have special little theories for how this all works.

Did Modern Ventilators Replace the Iron Lung for Folks with Polio?

In addition to thinking that we just change the names of diseases when we want them to go away, some folks think that we don’t see anyone in iron lungs anymore, not because polio has been eliminated, but because modern ventilators simply replaced the iron lung.

Is that true?

The iron lung, invented in 1927, helped people with polio breath.

In fact, in the 1940s and 1950s, there were whole hospital wards full of polio patients in iron lungs.

Unlike most of today’s ventilators, the iron lung is a negative pressure ventilator. In contrast, most modern ventilators, the ones that you see people hooked up to with a tube going down to their lungs, are positive pressure ventilators.

Iron Lung

What’s the difference?

A positive pressure ventilator pushes air into your lungs. They are useful when you have a lung disease or simply can’t breath on your own.

When people had polio, there usually wasn’t anything wrong with their lungs – it was their chest muscles and diaphragm that were the problem. So the negative pressure in the iron lung would compress and decompress their chest.

One benefit of the iron lung included that it was less invasive than ventilating someone through a tracheostomy, which became an option in the 1960s. While many new options became available for those needing long term ventilation since then, including noninvasive positive pressure ventilation, some still like to use their iron lungs.

Thanks to vaccines, most folks will only see an iron lung in a museum and read about polio in history books.
Thanks to vaccines, most folks will only see an iron lung in a museum and read about polio in history books. Photo by Oscar Tarragó, M.D., M.P.H.

And while it is true that they don’t make them anymore, iron lungs have not disappeared. There are some folks with polio that still use them.

But what if someone developed polio now, would they be put in an iron lung?

No, they wouldn’t. For one thing, they don’t make iron lungs anymore. Instead, they would likely use mouth intermittent positive pressure ventilation.

Still, we don’t see a lot of folks getting diagnosed with polio, needing to use mouth intermittent positive pressure ventilation, instead of iron lungs these days. And that’s because we don’t see a lot of folks getting diagnosed with polio.

Vaccines work. Polio is almost eradicated.

What to Know About Polio, Modern Ventilators and Iron Lungs

Although some people with polio are still using their iron lungs, the main reason we don’t see more people with polio needing to use iron lungs or modern ventilators is simply because polio is almost eradicated.

More on Ventilators and Iron Lungs

The Myth That Polio Only Went Away Because They Changed the Way It Was Diagnosed

Have you heard this one?

“Before the vaccine was developed, the diagnosis of polio required 24 or more hours of paralysis. After the vaccine release, the diagnosis changed to at least 60 days of paralysis. As you can imagine, cases of polio dropped significantly.”

So that’s why polio went away?

It wasn’t the vaccine?

The Myth That Polio Went Away Because They Changed the Diagnostic Criteria

In 1952, there were 21,000 cases of paralytic polio in the United States.

But were there really?

Didn’t they change the way they diagnosed polio a few years later, right after the first polio vaccines came out, making it less likely that folks would be diagnosed with polio?

The original diagnostic criteria for polio came from the World Health Organization and included:

“Signs and symptoms of nonparalytic poliomyelitis with the addition of partial or complete paralysis of one or more muscle groups, detected on two examinations at least 24 hours apart.”

It changed in 1955 to include residual paralysis 10 to 20 days after onset of illness and again 50 to 70 days after onset.

Why?

“In the past children’s paralysis was often not correctly diagnosed as polio. Stool samples need to be analyzed to be able to distinguish paralytic symptoms from Guillain-Barré Syndrome, transverse myelitis, or traumatic neuritis.”

Polio – Data Quality and Measurement

But you coulld’t just use stool samples, as many kids might have recently had non-paralytic polio, and could test positive for polio (false positive test), but have another reason to have paralysis.

“Isolation of poliovirus is helpful but not necessary to confirm a case of paralytic poliomyelitis, and isolation of poliovirus itself does not confirm diagnosis.”

Alexander et al. on Vaccine Policy Changes and Epidemiology of Poliomyelitis in the United States

Since polio causes residual paralysis, the new diagnostic criteria helped to make sure that kids were diagnosed correctly.

Did We Overestimate the Number of Kids with Polio?

Some folks think that since we changed the criteria, we overestimated the number of kids with polio in the years before the vaccine came out.

Most of this idea seems to come from a panel discussion in 1960 by critics of the original polio vaccine, The Present Status of Polio Vaccines, including two, Dr. Herald R. Cox and Dr. Herman Kleinman, who were working on a competing live-virus vaccine.

None in the group were arguing against vaccines, or even really, that the Salk polio vaccine didn’t work at all though. They just didn’t think that it was effective as some folks thought.

“I’ve talked long enough. The only other thing I can say is that the live poliovirus vaccine is coming. It takes time. The one thing I am sure of in this life is that the truth always wins out.”

Dr. Herald R. Cox on The Present Status of Polio Vaccines

Dr. Cox did talk a lot about the oral polio vaccine. He talked about successful trials in Minneapolis, Nicaragua, Finland, West Germany, France, Spain, Canada, Japan, and Costa Rica, etc.

When anti-vaccine folks cherry pick quotes from The Present Status of Polio Vaccines discussion panel, they seem to leave out all of the stuff about how well the oral polio vaccine works.

That’s how they work to scare parents and hope that their anti-vaccine myths and misinformation can win out over the truth that vaccines work and that they are safe and necessary.

“Since nothing is available, there seems to be no alternative but to push the use of it. I don’t think we should do so in ignorance, nor too complacently, believing that as long as we have something partially effective there is no need to have something better.”

Dr. Bernard Greenberg on The Present Status of Polio Vaccines

And of course, they did, fairly soon, switch to something better – the Sabin live-virus oral polio vaccine.

Interestingly, using the idea that we changed the diagnostic criteria to make polio go away in an argument about vaccines is known as the Greenberg Gambit.

It tells you something about anti-vaccine arguments, that these folks are misinterpreting something someone said about vaccines almost 60 years ago.

In pushing the idea that polio hasn’t been eliminated, but rather just redefined, they also miss that:

But isn’t polio still around and just renamed as transverse myelitis, Guillain-Barré syndrome (GBS), and aseptic meningitis?

Let’s do the math.

Using the adjusted numbers in the The Present Status of Polio Vaccines discussion, there were at about 6,000 cases of paralytic polio in the United States in 1959.

While 3,000 to 6,000 people in the United States develop Guillain-Barré syndrome each year, the risk increases with age, and it is rare in young kids. Remember, paralytic polio mostly affected younger children, typically those under age 5 years.

“Transverse myelitis can affect people of any age, gender, or race. It does not appear to be genetic or run in families. A peak in incidence rates (the number of new cases per year) appears to occur between 10 and 19 years and 30 and 39 years.”

Transverse Myelitis Fact Sheet

Similarly, transverse myelitis is uncommon in younger children, and there are even fewer cases, about 1,400 a year.

What about aseptic meningitis? That doesn’t usually cause paralysis.

So do the math.

You aren’t going to find that many kids (remember, the incidence was 5-7 per 1,000) under age 5 years who really have “polio,” but instead, because of a worldwide conspiracy about vaccines, are getting diagnosed with transverse myelitis, Guillain-Barré syndrome (GBS), or aseptic meningitis instead.

Anyway, kids with acute flaccid paralysis are thoroughly tested to make sure they don’t have polio. And both transverse myelitis and Guillain-Barré syndrome have different signs and symptoms from paralytic polio. Unlike polio, which as asymmetric muscle atrophy, the atrophy in transverse myelitis and Guillain-Barré syndrome is symmetrical. Also, unlike those other conditions that cause AFP, with polio, nerve conduction velocity tests and electromyography testing will be abnormal. Plus, polio typically starts with a fever. The other conditions don’t.  So while these conditions might all be included in a differential diagnosis for someone with AFP, they are not usually that hard to distinguish.

“Each case of AFP should be followed by a diagnosis to find its cause. Within 14 days of the onset of AFP two stool samples should be collected 24 to 48 hours apart and need to be sent to a GPEI accredited laboratory to be tested for the poliovirus.”

Polio – Data Quality and Measurement

But why be so strict on following up on every case of AFP?

It’s very simple.

If you miss a case of polio, then it could lead to many more cases of polio. And that would tmake it very hard to eradicate polio in an area.

If anything, until the establishment of the Global Polio Eradication Initiative (GPEI) in 1988, it is thought that cases of polio and paralytic polio were greatly underestimated in many parts of the world!

And now polio is almost eradicated.

“DR. SABIN: Let us agree, at least, that things are not being brushed aside. Let us say that we might disagree on the extent to which certain things have received study. But I hope that Dr. Bodian realizes that nobody is brushing things aside. I would not have taken the trouble of spending several months studying viremia with different strains in chimpanzees and human volunteers, and viremia produced by certain low temperature mutants to correlate it with their invasive capacity, if I were merely brushing it aside.”

Live Polio Vaccines – Papers Presented and Discussions Held at the First International Conference on Live Poliovirus Vaccines

There is no conspiracy.

Think about it.

If they redefined how paralytic polio was diagnosed in 1955 as part of a conspiracy to make it look like the polio vaccines were working, then why did the number of cases continue to drop into the 1960s?

Shouldn’t they have just dropped in 1955 and then stayed at the same lower level?

After the switch to the Sabin vaccine, polio was on its way to being eliminated in the United States.
After the switch to the Sabin vaccine, polio was on its way to being eliminated in the United States, although there was an uptick in 1959, before we made the switch.

And why don’t any of the folks with other conditions that cause paralysis, like transverse myelitis and Guillain-Barré syndrome (GBS) ever have polio virus in their system when they are tested?

Also, if the renaming theory explains why the polio vaccine didn’t work, then why do anti-vaccine folks also need to push misinformation about DDT and polio?

What to Know About Polio Myths and Conspiracies

The near eradication of polio from the world is one of the big success stories of the modern era, just as those who push the idea that has all been faked is a snapshot of society at one of our low points.

More on Polio Myths and Conspiracies

Is the Polio Vaccine Linked to Outbreaks of Hand Foot Mouth Disease?

Wait, why would anyone think that the polio vaccine could be linked to outbreaks of hand, foot, and mouth disease?

“Scientific researchers have discovered that the infectious disease Hand,Foot and Mouth Disease is vaccine-induced and then spread to others through shedding from the Polio Vaccine. Enterovirus 71 (EV71) causes Hand, Foot, and Mouth Disease. The polio vaccine (OPV and IPV) is contaminated with EV71. It, along with EV-D68 and several other enteroviruses and coxsackie viruses are used in the manufacturing of the polio vaccines, which are given to children three times in the first year of life, and again between 4-6 years of life. Bottom line: children recently vaccinated with the polio vaccine are shedding the EV71 that causes the most serious complications of HFMD. ”

Health Freedom Idaho

Shedding

Is the Polio Vaccine Linked to Outbreaks of Hand Foot Mouth Disease?

Health Freedom Idaho makes some very serious claims and even links to a research article, which in most cases, you would expect to support their claims.

Not surprisingly, the article, A Dominant EV71-Specific CD4+ T Cell Epitope Is Highly Conserved among Human Enteroviruses, says absolutely nothing about contamination of vaccines and nothing about shedding.

“Recognizing disingenuous claims made by the anti-vaccination movement is essential in order to critically evaluate the information and misinformation encountered online.”

Anna Kata Anti-vaccine activists, Web 2.0, and the postmodern paradigm – An overview of tactics and tropes used online by the anti-vaccination movement

What about a link between polio vaccines and hand, foot, and mouth disease?

It is sad that anti-vaccine propaganda gets shared so quickly among parenting groups.
It is sad that anti-vaccine propaganda gets shared so quickly among some parenting groups, who’s members obviously don’t read the articles when they do their research.

Well, hand, foot, and mouth disease is typically caused by the coxsackievirus A16 and EV71, which are enteroviruses. So is the polio virus. In fact, the Enterovirus genus is made up of 15 different species and 100s of different viruses. And they are all in the same Picornavirus family.

And that’s likely why researchers have found that “the most dominant epitope is highly conserved among enterovirus species, including HFMD-related coxsackieviruses, HFMD-unrelated echoviruses and polioviruses.”

Epitope?

“An epitope refers to the specific target against which an individual antibody binds.”

What is an Epitope?

So basically, this research isn’t saying that the polio vaccines are contaminated or that they cause hand, foot, mouth disease.

What it is saying, is that if you have been vaccinated with the polio vaccine, then you might have some protection against other enteroviruses!

“As shown here, poliovirus vaccination may have an impact on subsequent severity of HFMD disease. Cross-reactivity between EV71 A3 epitope and the A3v epitope of poliovirus 3 Sabin strain, may lead to the stimulation of protective, cross-reactive T cell responses, limiting the severity of subsequent HFMD.”

Wei et al. on A Dominant EV71-Specific CD4+ T Cell Epitope Is Highly Conserved among Human Enteroviruses

Yay for cross-reactivity!

“Cross-reactivity between antigens occurs when an antibody directed against one specific antigen is successful in binding with another, different antigen. The two antigens in question have similar three-dimensional structural regions, known as epitopes, which allow the antibody for one antigen to recognize a second antigen as being structurally the same antigen.”

Stephen J. Chadwick, MD

So you get antibodies from the polio vaccine and these antibodies cross react with the viruses that cause hand, foot, and mouth disease, which could lead to milder symptoms, because it is like you already have some antibodies to that virus too!

“HFMD outbreaks could occur where polio vaccination has failed, due to lack of refrigeration or other breaks in the cold chain that (might) go unreported.”

Exploring the Link between Polio Vaccination and Hand Foot Mouth Disease

In China, where outbreaks of hand, foot, and mouth disease are much more severe than they are in the United States, often leading to life-threatening disease, there has been a concern that the increased number of outbreaks could be linked to a failure of their polio vaccines, since getting vaccinated could be protective.

That’s the link the research is talking about…

I actually asked one of the researchers about what anti-vaccine folks were saying about their study and they told me:

“Well, that’s actually totally backwards. Our article suggests that FAILURE to get vaccinated with polio vaccine might set you up for Hand Food Mouth disease (EV71).”

Bottom line: polio vaccines are not contaminated and children recently vaccinated with the polio vaccine are not shedding the EV71 that causes the most serious complications of HFMD. Health Freedom Idaho made the whole thing up.

More on Linking the Polio Vaccine to Hand Foot Mouth Disease

Myths About Polio and Acute Flaccid Paralysis

Polio is one of the most well known causes of acute flaccid paralysis.

Although most people with polio infections have no symptoms at all, or just have a very mild illness, with a sore throat and a low grade fever, a small percentage can develop:

  • a loss of superficial reflexes
  • severe muscle aches and spasms in their limbs or back
  • an asymmetrical flaccid paralysis with diminished deep tendon reflexes

This acute flaccid paralysis only affects the child’s strength in the affected muscle groups – there is no loss of sensation. The severity of the symptoms and the disease depends on which muscles are affected the most. If it is just your legs, then you will have trouble walking. On the other hand, if it affects your chest, then you might not be able to breath, unless you are put on a ventilator (iron lung).

Acute Flaccid Paralysis

Thinking about it in the context of polio, it becomes easy to understand acute flaccid paralysis or AFP.

It is the sudden onset (acute) of a flaccid (floppy or poor muscle tone) paralysis (weakness or inability to move) of one or more muscles.

But what many people don’t understand, is that in addition to polio, there are many more non-polio causes of AFP.

Non-Polio AFP

Many of us got a crash course in non-polio acute flaccid paralysis (NP-AFP) a few years ago when we started hearing reports of kids developing polio-like paralysis in 2014. Now thought to be caused by enterovirus D68 infections (EV-D68), the paralysis followed respiratory tract infections in many of the affected children. All together, at least 120 children in 34 states developed acute flaccid paralysis that year.

Interestingly, EV-D68 is one of more than 100 non-polio enteroviruses. The virus that causes hand, foot, and mouth disease, coxsackievirus A16, is another. Others cause pinkeye, meningitis, or encephalitis.

Keep in mind that many other viruses and conditions can cause non-polio AFP too, including:

  • Guillian-Barré syndrome
  • toxins (botulism)
  • tumors
  • transverse myelitis
  • traumatic neuritis
  • other infections, including novel enterovirus C105, a non-polio enterovirus, and even tick-borne (Lyme disease) and mosquito-borne (Japanese encephalitis) infections

How do you determine the cause and how do you know it isn’t polio?

These kids with AFP typically have extensive testing to determine what is causing their AFP, including an MRI, antibody tests, and testing of their cerebrospinal fluid, etc. Although it isn’t always possible to identify a cause, you can at least rule out many potential suspects, like trauma, polio, and other infections.

Myths About Polio and Acute Flaccid Paralysis

Some folks don’t believe in non-polio AFP.

They believe that polio never really disappeared because vaccines don’t really work and that polio was simply renamed to, you guessed it, acute flaccid paralysis.

“Unbeknownst to most doctors, the polio-vaccine history involves a massive public health service makeover during an era when a live, deadly strain of poliovirus infected the Salk polio vaccines, and paralyzed hundreds of children and their contacts. These were the vaccines that were supposedly responsible for the decline in polio from 1955 to 1961! But there is a more sinister reason for the “decline” in polio during those years; in 1955, a very creative re-definition of poliovirus infections was invented, to “cover” the fact that many cases of ”polio” paralysis had no poliovirus in their systems at all. While this protected the reputation of the Salk vaccine, it muddied the waters of history in a big way.”

Suzanne Humphries, MD on Smoke, Mirrors, and the “Disappearance” Of Polio

What’s their evidence?

A rise in cases of non-polio AFP in India since 1997.

How do we know that there has been a rise in non-polio AFP cases in India since 1997?

It’s very simple and explains why there isn’t any data on before that 1997. 

As part of the strategy to eliminate polio in that country, starting in 1997, all cases of AFP started getting tested for polio. It was a way to track the effectiveness of the immunization program. If you were seeing too many cases of AFP caused by polio, then not enough people were getting vaccinated. On the other hand, if you weren’t seeing any cases of AFP in an area, then the testing and surveillance probably wasn’t getting none, since there will always be some cases of non-polio AFP.

Unfortunately, they found many cases to track. And the cases kept increasing, although more and more, they weren’t being caused by polio. At least not by live polio virus.

Were they caused by the polio vaccine?

In some cases, yes. It is well known that the live polio vaccine can rarely cause VAPP and cVDPV.

By 2015, after India was declared free of polio (the last case was in 2011), none of those cases of AFP were found to be caused by wild polio though. And India hasn’t had a case of cVDPV since 2010.

Why the increase in cases of non-polio AFP? It certainly isn’t because of Suzanne Humphries’ polio virus renaming conspiracy or any other anti-vaccine conspiracy involving the polio vaccine itself.

The 'data' that Susanne Humphries uses to try and make her case about AFP neglects to mention that in the pre-vaccine era, polio paralyzed 500 to 1,000 children in India each day! Those 180,000 to 365,000 cases of paralysis wouldn't fit on her chart though...
The ‘data’ that Susanne Humphries uses to try and make her case about AFP neglects to mention that in the pre-vaccine era, polio paralyzed 500 to 1,000 children in India each day! Those 180,000 to 365,000 cases of paralysis wouldn’t fit on her chart though…
If we simply renamed polio to non-polio AFP, why did the numbers drop for so long and then slowly start to increase? Shouldn’t it have been a rapid crossover?

More importantly,  why are the case of paralysis from non-polio AFP so much lower than the pre-vaccine era cases of AFP from polio?

And how come we rarely see large outbreaks of AFP like we did in the pre-vaccine era?

Sure, 120 kids in the EV-D68 non-polio AFP outbreak of 2014 is way more than any of us would like to see, but it is tremendously less than what we used to see in the pre-vaccine era from polio.

“Poliomyelitis is one of the important emergent viral diseases of the twentieth century… At its height, from 1950–1954, poliomyelitis resulted in the paralysis of some 22,000 U.S. citizens each year… Many thousands were left permanently disabled by the disease, while many others suffocated as a consequence of respiratory paralysis.”

Barry Trevelyan on the The Spatial Dynamics of Poliomyelitis in the US

While anti-vaccine conspiracy theories about AFP are as easy to dismiss as all of the rest they bring up,  what is behind the rise in AFP in some areas of the world?

Although one study that was published in Pediatrics, “Trends in Nonpolio Acute Flaccid Paralysis Incidence in India 2000 to 2013,” did find a correlation between the use of the OPV vaccine and the incidence of non-polio AFP, many experts think the rise is a result of better screening. Also, once polio gets under control, other more neglected diseases start getting more attention, like enteroviral infections. Not surprisingly, other parts of the world have had the same experience.

There is also the fact that in 2005, the Global Poliomyelitis Eradication Initiative began “to cast a wider net for poliovirus detection and to maximize sensitivity so that every poliomyelitis case is detected.” Why? If even a single case was missed, it could lead to continued outbreaks and would get in the way of polio elimination in the country.

“This large increase in NP-AFP cases, which represent AFP cases caused by agents other than poliovirus, probably reflects the excellent implementation of the expanded definition of AFP and highly sensitive surveillance and detection methods used by NPSP in India from 2005 onwards…”

C. Durga Rao on Nonpolio Acute Flaccid Paralysis in India

So did the polio vaccine recently cause 53,000 paralysis victims in India?

No. 

The polio vaccine has worked to get us on the brink of eradicating polio though.

What To Know About Acute Flaccid Paralysis

Acute flaccid paralysis can be caused by the polio virus, but non-polio acute flaccid paralysis becomes a more important cause once polio is eliminated in a region.

More About Acute Flaccid Paralysis