Letter to the Editors, Volume 53 Issue 4: Acute Flaccid Myelitis

Photo by Patrick Fore on Unsplash.

Dear Editors,

Dirty air conditioning systems in automobiles and/or homes may be responsible for a seemingly new, paralyzing epidemic affecting children across the United States, and has also been reported in Canada and around the world. The paralysis is correctly called polio-like, although the disease is so new that lifelong paralysis cannot be established. The disease also has confirmed fatalities.

In the Northern Hemisphere, the month of August, when air conditioners are used heavily, sees a sharp rise in cases of Acute Flaccid Myelitis. July is also a month of heavy air conditioner use, especially the last two weeks, but the disease seems to have a two week incubation period, so the cases appear mainly in August. Acute Flaccid Myelitis, labelled as AFM, spikes dramatically again even higher in September, when school begins and when contagious children are packed tightly together in a school bus. It is easy to see the cause of the September spike in a month where air conditioning not being used heavily.

A main suspect in causing AFM is Enterovirus (EV) EVD68, classed as “Epidemiologic Association,” meaning its involvement is greater than by chance; however that virus has not been found in all cases, meaning either tests need to improve, or there are other causes.

Legionnaires Disease is one example of many air systems illnesses. The bacteria causing Legionnaires Disease, in its first major attack in a Philadelphia hotel in 1976, proliferated in the air system’s cooling towers. This incident infected 211 and killed 29 people. Legionnaires has been caused by infected hospital air systems as well. “Sick Building Syndrome” is widely recognized; airlines have had to increase fresh air on airliners because so many people were catching respiratory illnesses during flights.
Acute Flaccid Myelitis begins as an upper respiratory tract infection and a high fever, then attacks the spinal cord. In the U.S., there were 120 cases in 2014, then 149 in 2016, with 62 until October of this year. Another 65 cases being investigated.

The disease also appears in globally, but I cannot find statistics for Canada. One report contradicts another report by saying that the disease has not reached Canada yet. However, one of my family members, a child in elementary school, was afflicted with either AFM or a similar disease about 10 years ago, and required a long hospital stay. The child’s AFM resulted in partial paralysis of one of her legs.

Black Mold and other environmental factors have also been mentioned as possible causes of AFM; it is possible there is more than one direct cause, as no singular mechanism has been determined after five years. Most of the cases of AFM are said to be in young children, median age about 10, who were be seated in the back seat of automobiles in a small space where minimal air circulation would enable causative agents to congregate. Therefore I think it likely that the automobile air conditioner is the most likely breeding ground of the causative agent, rather than the home air conditioner. Although the home air conditioner can easily be a breeding place the viruses, bacteria, or mould would be expelled into a much larger environment with more free air circulation.

Whatever the final decision on cause, it seems absolutely necessary to NOT wait for that final word, as lifetime of paralysis may result. Most motor vehicle air systems include a replaceable cabin filter which is either easily changed by yourself or by a mechanic. Vacuuming the vents may be possible. Spraying a mixture of water and chlorine into the air intake while the cabin air filter is out with the fan turned on high will kill moulds, viruses, and bacteria. All the vents into the vehicle cabin can be disinfected by changing the direction of airflow.

My opinion of the motor vehicle airflow systems being the main source of the causative agent is not a professional one; I am not a doctor or an engineer. However, I have a lifelong problem with asthma and have read much on the necessity for clean air. While taking community college courses on property management, I took a course in Heating, Ventilation, and Air Conditioning. My opinion also includes that home air system ducts should be cleaned and disinfected every two years at least, and the best possible filters used. The expense will be worth every penny. I promise you I’m not an agent for a duct cleaning company, nor do I or anyone I know work in the industry; but suddenly, that bothersome person on the telephone asking if he can clean your home heating/air conditioning ducts seems a LOT less offensive, and whatever a mechanic would charge to change your vehicle’s cabin air filter and disinfect those vents would also be worth every penny.

We must not wait until Canada begins reporting dozens of cases of AFM each year. We may stop it now through preventive measures.

Bob Mosurinjohn, Lakefield

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