This year, more than half of all USA states have had confirmed or possible cases of acute flaccid myelitis, the polio-like illness that can cause paralysis and mostly affects children, according to an exclusive CNN analysis.
The Centers for Disease Control and Prevention says there are now 62 cases across 22 states this year.
However, officials have not been able to identify the cause of most of the AFM cases, or the reason for the spikes in 2014, 2016 and now 2018.
The increase in cases has been happening since 2014, usually in August and September, but only in 2014 and 2016, Messonnier said in a news briefing with reporters.
About 90 percent of the cases have involved paralysis, according to the CDC.
The CDC is actively investigating the cases and working with healthcare providers as well as state and local health departments to spread the word about AFM.
AFM is a condition that affects the nervous system and causes muscle weakness, according to the CDC.
Health officials said five kids in Maryland are believed to have contracted a virus this fall that has symptoms similar to polio. But officials haven't been able to find a single agent that would explain the clusters of cases that occur around the same time.
Other symptoms of AFM include facial droop, difficulty moving the eyes, drooping eyelids, difficulty swallowing and slurred speech.
"What we have been told is that he's the best case scenario of a hard situation", she said.
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Some patients recover quickly, while others experience paralysis and require ongoing care. The agency had a teleconference with health providers slated for later today, and it provided a toolkit for diagnosing AFM, along with instructions for reporting suspected cases.
Last year, one child died of the disease.
The CDC received information on 33 confirmed cases of AFM across 16 states in 2017, 149 cases in 39 states. "Parents need to know that AFM is very rare, even with the increase in cases that we are seeing now".
Ellerin said the staff at his hospital has been trained to recognize symptoms, and he encourages medical centers to train employees similarly before it's too late.
More broadly, she noted, "there is a lot we don't know about AFM".
But the agency doesn't know who may be at higher risk nor why they may be at higher risk.
Officials have not determined a cause of the rare disease. No pathogen has been consistently detected in the patients' spinal fluid.
The CDC is investigating the cases and monitoring the disease, and encourages people to prevent the disease by staying up to date on vaccines, washing hands and protecting against mosquito bites.
There is no specific treatment for AFM, but doctors may recommend physical or occupational therapy to help with arm or leg weakness.
CNN reached out to health departments in every state; 48 states responded, plus the District of Columbia.