A mysterious polio-like illness that spiked in 2014, leading to paralysis in children across the U.S., may have divulged one of its secrets. Researchers have now found the most direct evidence to date of a viral culprit — the remnants of the immune cells that responded to the virus in the spinal fluid of patients.

Acute flaccid myelitis, or AFM, is a rare disease of the nervous system that mostly develops in children. Symptoms include loss of muscle tone and weakness in the arms and legs, decreased reflexes and, in the most extreme cases, paralysis. This year, there have been 22 confirmed cases of AFM in the U.S.; 236 AFM cases in 41 states were confirmed in 2018, according to the Centers for Disease Control and Prevention. Since 2014, the CDC has confirmed 590 cases.

Image source: Cynthia S. Goldsmith and Yiting Zhang, CDC

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