The return of Polio to the USA? Is paralysis being mis-diagnosed as psychiatric?

[Pyrrhus]

The return of Polio to the USA? Is paralysis being mis-diagnosed as psychiatric?​

This is the first of two posts. The first post provides some essential background, and the second post examines the statistical anomaly that suggests that FND might be over-diagnosed in the US and UK.

Background:
1) Functional Neurological Disorder (FND) is a new-ish diagnosis used by doctors to imply that a patient's neurological symptoms are not real. A patient who comes into the doctor's office paralyzed in one leg is told that they are imagining their own paralysis and is given a diagnosis of Functional Neurological Disorder (FND).

2) Poliomyelitis (polio) is a disease defined by specific signs and symptoms, including paralysis. Since this disease is defined by specific signs and symptoms, patients were diagnosed with polio based on these signs and symptoms up until the mid-1990's. In the mid-1990's, diagnoses of polio started to require evidence of specific viruses, known as polioviruses.

3) Polioviruses are considered strongly associated with poliomyelitis (polio) because, in the 1950's, most of the outbreaks of polio were correlated with polioviruses found in sewage, and occasionally in the blood of the outbreak population. However, once a polio patient started showing neurological signs and symptoms, the virus had already moved out of the bloodstream into the nervous system, so diagnosis could not be made based on detection of the poliovirus in the blood. In some polio outbreaks, like the large 1955 outbreak in the USSR, no evidence of polioviruses could be found.

4) In the mid-1990's, the World Health Organization (WHO) started to receive reports of poliomyelitis that could not possibly be linked to any poliovirus. The World Health Organization (WHO) decided to call these reports "Acute Flaccid Paralysis", in order to distinguish them from polio cases that were related to polioviruses. WHO then asked all their member countries to start keeping records on cases of Acute Flaccid Paralysis (AFP), and to provide WHO with yearly reports of the number of cases. For some reason, the WHO requested that countries only report on cases of patients up to the age of 14 years old.

5) Many countries agreed to start reporting childhood Acute Flaccid Paralysis (AFP) cases to the WHO on a yearly basis. Unfortunately, some countries, such as the US, UK, and Germany, refused to provide the requested yearly reports to the WHO.

Here is a graph that shows the reports of childhood AFP that were received by WHO:

REFERENCE:
[1] Hyde MD, Byron. The Return of Polio to the USA. 2019 Kindle Edition.

 

[Pyrrhus]

Now let's take a look at the reports of childhood AFP broken down by country:

Switzerland:
* Population: 8.5 million
* Average yearly cases of childhood AFP: 10.4
* Average yearly cases of childhood AFP per million residents: 1.22

Canada:
* Population: 36.7 million
* Average yearly cases of childhood AFP: 30.7
* Average yearly cases of childhood AFP per million residents: 0.836

Australia:
* Population: 24.5 million
* Average yearly cases of childhood AFP: 50.5
* Average yearly cases of childhood AFP per million residents: 2.06

New Zealand:
* Population: 4.9 million
* Average yearly cases of childhood AFP: 9.16
* Average yearly cases of childhood AFP per million residents: 1.87

So, industrialized countries are seeing about 0.836-2.06 average yearly cases of childhood AFP per million residents.

Therefore, the USA, which has a population of 328 million, should have been seeing 274-676 yearly cases of childhood AFP each year for the last 20 years. But the CDC, which only started tracking AFP in 2014, says that there have been only 110 cases per year!

And the UK, which has a population of 67.5 million, should have been seeing 56-139 yearly cases of childhood AFP each year for the last 20 years. But the UK AFP Task Force says that there were only 40 cases in a one-year period!

Thus, we have the question:
What has been happening to the other paralyzed children in the US and UK, if the health authorities in these countries say that these AFP cases never happened? Are they being misdiagnosed with Functional Neurological Disorder (FND) or some other psychiatric diagnosis?


REFERENCE:
[1] Hyde MD, Byron. The Return of Polio to the USA. 2019 Kindle Edition.

 

[valentinelynx]

Isn't FND just "rebranding" of "Conversion Disorder"?

 

[lauluce]

it's the same old hysteria, with a new name. A dumping basket for people that the governments and medical community doesn't want to expend any time, effort and money in

 

[wholepartthings]

The fact that only affected children up to the age of 14 years are covered suggests that the figures should remain low.

I am unfortunately aware of a case that woke up with paralysed legs shortly before his 18th birthday (in 2018).

Everyone things that the Polio vaccine protects from paralyzed children.
But that, as you can see with AFM or AFP, is not true.
Also other Enteroviruses can cause paralysis.

They simply do not want the population to realize that "polio" was not the only problem, there are others.

However, conventional medicine has nothing against them (except to administer expensive IVIG directly at the first symptoms).

 

[Pyrrhus]

The fact that only affected children up to the age of 14 years are covered suggests that the figures should remain low.

I am unfortunately aware of a case that woke up with paralysed legs shortly before his 18th birthday (in 2018).

Yes, the literature suggests that these viruses are striking people of all ages. Although paralysis is less common in older adults, it does happen, well into the 30's.

They simply do not want the population to realize that "polio" was not the only problem, there are others.

It's not clear that the reason for using the term "Acute Flaccid Paralysis" instead of "Poliomyelitis" was to hide the problem from the public. It may have been, I don't know. Or they wanted to avoid confusion since the word "poliomyelitis" has become so strongly associated with polioviruses.

But yes, it is likely that one or more of the historical polio outbreaks were actually due to related enteroviruses, not due to a poliovirus at all. History is a funny thing. Even the most famous polio patient, Franklin Delano Roosevelt, is now thought to have suffered from Guillain-Barré Syndrome, not from polio at all.

 

[Pyrrhus]

For some insight into the CDC’s thinking, consider this 2014 article from the Lancet:

Polio-like disease in the news: much ado about nothing?
Reports of polio-like acute flaccid paralysis have received much attention in both the USA and India. Uncertainty about causes and the fear of polio lie behind the media coverage. But why does uncertainty persist? Dara Mohammadi investigates.
...
But, Mark Pallansch, Director of the Division of Viral Diseases at the US Centers for Disease Control and Prevention (CDC; Atlanta, GA, USA), explains that a causative relation between the presence of this common virus and paralysis cannot be assumed.

“Detection of common agents in non-sterile sites is never diagnostic”, he tells The Lancet Neurology. Children often carry such viruses asymptomatically or with respiratory symptoms, but to be diagnostic for causation it would have to be found in the CSF of one or both of the two infected children—which it was not. The other three children had no diagnosis. “Our interpretation is that there is no specific aetiology linked to those five cases.”
...
More pressing for Pallansch and colleagues at the state level is figuring out whether the CDC has the resources to pursue a dogged, full-scale investigation to elucidate the reasons behind these and other unexplained cases of AFP.

“There's no argument that it's absolutely a serious clinical condition, and yes, maybe we should know more about it”, he says. “But these are extremely rare cases which might not be linked, and there are other competing priorities and limited resources.”

Note that this was published almost 20 years after the first reports of Acute Flaccid Paralysis were received by WHO. Although Switzerland had already reported roughly 150 cases, Australia had reported roughly 700 cases, and New Zealand had reported roughly 130 cases, the CDC was still talking as if there had been only 5 cases in the US.

REFERENCE:
[1] https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(14)70132-2/fulltext

 

[Judee]

it's the same old hysteria, with a new name. A dumping basket for people that the governments and medical community doesn't want to expend any time, effort and money in

...and so they can get the smug satisfaction of feeling superior to someone else.

 

[lauluce]

...and so they can get the smug satisfaction of feeling superior to someone else.

exactly, they even dare to say they're doing something from them, by giving them that pseudo-diagnosys!

 

[percyval577]

Isn't FND just "rebranding" of "Conversion Disorder"?

Taken by word, no. (Indeed I have come across one article that states the advantage of this new term would be that it doesn´t say anything about the causation, like "conversion disorder" referring to a psychogenic evolution).

Sadly the understanding of the new term then is mostly immediatly "(probabaly) psychogenic" which shows that people (psychiatrists) are not able to think in a logical clear manner, and being dishonest. They also could skip the new term and hold to the old one, it would be one lie less about their minding.

 

[Snow Leopard]

Thus, we have the question:
What has been happening to the other paralyzed children in the US and UK, if the health authorities in these countries say that these AFP cases never happened? Are they being misdiagnosed with Functional Neurological Disorder (FND) or some other psychiatric diagnosis?

They aren't being reported as cases, either to the authorities, or by the authorities whom are finding excuses to exclude them from the statistics.

5) Many countries agreed to start reporting childhood Acute Flaccid Paralysis (AFP) cases to the WHO on a yearly basis. Unfortunately, some countries, such as the US, UK, and Germany, refused to provide the requested yearly reports to the WHO.

Notably, this applies to cases who are under the age of 15. I know from personal experience that my own experience of acute onset AFP (bilateral, likely case of Acute Motor Axonal Neuropathy) was not reported to the authorities due to this technicality.

Bilateral cases of AFP are mostly due to Guillain Barre Syndrome or related syndromes such as Transverse Myelitis. Putatively, unilateral cases are thought to be associated with enteroviruses by researchers in other countries, such as Japan.

I have no doubt that cases are underreported, particularly cases of acute onset GBS within 6 weeks of a vaccine, without any signs of an infection. (note the mechanism of GBS triggered by a vaccine is almost the same as cases triggered by specific infections such as influenza and campylobacter jejuni).

Also keep in mind that there are vaccine-associated-paralytic-polio cases in countries that still use the oral (live) polio vaccine, whereas this vaccine is rarely if ever used in the USA since 2000 and hence would lead to no cases.

 

[Pyrrhus]

Related discussions:

Infectious virus causing polio-like paralysis in Australia (2013)
https://forums.phoenixrising.me/threads/infectious-virus-causing-polio-like-paralysis.23530/

Reports of a small outbreak of a polio-like disease in California (2014)
https://forums.phoenixrising.me/thr...-of-a-polio-like-disease-in-california.28470/

Cluster of acute flaccid paralysis in Colorado children (2015)
https://forums.phoenixrising.me/thr...flaccid-paralysis-in-colorado-children.35244/

Enterovirus Infection Linked to Acute Flaccid Myelitis (2019)
https://forums.phoenixrising.me/thr...ction-linked-to-acute-flaccid-myelitis.77515/

Enterovirus D68 is found to be the cause of Acute Flaccid Myelitis after postive tests in CSF. (2020)
https://forums.phoenixrising.me/thr...id-myelitis-after-postive-tests-in-csf.75964/

CDC finally admits: Enterovirus D68 causes paralysis (2020)
https://forums.phoenixrising.me/threads/cdc-finally-admits-enterovirus-d68-causes-paralysis.75973/

 

[hapl808]

I'm unable to walk without support. Whether that's due to CFS or some other illness, no idea. Especially things like GBS seem like relatively vague diagnoses without much help, at some point I kind of gave up on getting a definitive diagnosis. My legs work, but they are quite weak and the muscles will tire into pain and damage after more than a few steps unassisted.

 

[Pyrrhus]

My legs work, but they are quite weak and the muscles will tire into pain and damage after more than a few steps unassisted.

What you describe sounds like paresis, which at one time was called "incomplete paralysis".

But yes, it is likely that one or more of the historical polio outbreaks were actually due to related enteroviruses, not due to a poliovirus at all.

Interestingly, the paralytic enterovirus called Enterovirus A71 first emerged around the late 1930s or early 1940s. So it is possible that some of the polio epidemics in the 1940s or 1950s were actually due to Enterovirus A71, not due to a poliovirus. More information here:

How the first outbreaks of ME/cfs in the 1940s correspond with the emergence of the new Enterovirus A71 (2021)
https://forums.phoenixrising.me/thr...ed-by-another-coronavirus.86397/#post-2380702

 

[hapl808]

What you describe sounds like paresis, which at one time was called "incomplete paralysis".

I would say that sounds like an accurate description. My legs have never been completely paralyzed, but sometimes they get more stiff and weak. Before I was more severe, this tended to happen in a more minor way, but a few days or weeks in bed and I would recover. Now it just doesn't seem to heal at all, so it's been this way for several years.

 

[Pyrrhus]

Enterovirus D68 in the Anterior Horn Cells of a Child with Acute Flaccid Myelitis (Vogt et al., 2022)
https://www.nejm.org/doi/full/10.1056/NEJMc2118155

Autopsy material from a child who died from an acute flaccid myelitis–like illness showed EV-D68 RNA and protein in anterior horn cells and their axons, strongly implicating the virus as the cause of the disorder.

https://twitter.com/i/web/status/1529578609777774592

 

[Pyrrhus]

Polio case reported in New York, the first US case since 2013.
https://www.usatoday.com/story/news...-county-ny-first-in-u-s-in-years/10119514002/

1. An unvaccinated person caught poliovirus from another person inside the U.S., which means that poliovirus may be circulating in this part of the U.S.
2. The other person, who has not been identified, had been vaccinated with the oral polio vaccine, which occasionally mutates into the regular poliovirus.
3. This phenomenon is called "vaccine-derived polio".

A case of polio has been reported in New York, Rockland County officials said Thursday. The viral disease, which can cause neurological symptoms, paralysis or death, was declared eliminated in the U.S. in 1979.

Although routine spread has been halted for decades, occasionally travelers with polio have brought infections into the U.S. In 2013, a case occurred in a 7-month-old who had recently moved to the U.S. from India.

The patient in the new case, a young adult who did not recently travel outside the country, was hospitalized but is no longer, officials confirmed. Officials said the person had presented with paralysis but wouldn’t say if the patient was still dealing with that side effect.

 

[Pyrrhus]

Polio case reported in New York, the first US case since 2013.
https://www.usatoday.com/story/news...-county-ny-first-in-u-s-in-years/10119514002/

Polioviruses found in wastewater samples in 2 N.Y. counties, suggesting continued spread (Helen Branswell writing for STAT, 2022)
https://www.statnews.com/2022/08/04...n-2-n-y-counties-suggesting-continued-spread/

New York State health authorities revealed Thursday that they had detected additional polioviruses in wastewater sampled in two counties north of New York City, findings that signal continued spread of the viruses in the region.

The positive wastewater samples were found in Rockland County, where health authorities revealed two weeks ago that a man in his 20s had been paralyzed by so-called vaccine-derived polioviruses, and in neighboring Orange County as well. Positive samples were collected in June and July in Orange County and in July in Rockland County, suggesting that viruses have been spreading for some time.

 

[Jadzhia]

Yes travellers/visitors/immigrants can all bring poliovirus into a country that uses IPV rather than OPV. People can shed live polio virus for a long time (years!) after vaccination with OPV. Something I didn't know.

If you want to ask more questions about polio/entero viruses (or any viruses!), then I recommend tuning into TWiV's weekly Q&A session with Prof Vincent Racaniello and Dr Amy Rosenfeld on YouTube, the former a world expert in polio, the later in enteroviruses. It's a live stream so you can ask directly - it's a wonderful resource to have access to experts like they are! Or watch TWiV's weekly podcast - this weeks' includes the current poliovirus situation.

Q&A with A&V Livestream 8/3/22 (weekly podcast)

TWiV #925