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The symptoms tend to occur about a week after they had a fever and respiratory illness.

Of these, 62 have been confirmed by the CDC, and the remainder continue to be investigated, said Nancy Messonnier, director of the agency's National Center for Immunization and Respiratory Diseases.

In an email Tuesday, Maryland Department of Health spokeswoman Brittany Fowler said the CDC will "make a determination about the status of the cases" in Maryland "based on clinical and laboratory information".

The condition is not new, but the CDC said it saw an increase in cases beginning in 2014.

According to the CDC 127 people are believed to be sick with the illness. "However this year, two years ago, four years ago - so 2014 and 2016 - we definitely saw, along with the rest of the country, clusters of cases where we had multiple patients in the span of a couple of months". Officials said it's too early to know whether the total for 2018 will surpass those previous years.

Unfortunately, there is now no specific treatment plan for the disease, though medics may advise physical or occupational therapy on a case-by-case basis.

Some patients have quickly recovered, but one child who contracted AFM - which affects the nervous system via the spinal cord - died past year.

She said the CDC and research partners are casting a wide net trying to figure out what is causing the rise in cases, suggesting scientists have been looking at a variety of viruses and even environmental toxins in their search. Maryland's first case was reported September 21.

To give parents, healthcare workers, and public health officials a look at what to expect, she said the CDC will report suspected cases this year, as well as confirmed ones.

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"There is a lot we don't know about AFM", Messonnier said during a teleconference for reporters. "We recommend seeking medical care right away if you or your child develops sudden weakness of the arms and legs", she said.

There's no vaccine that can protect against AFM-causing enteroviruses.

There is no known cause or treatment, a state Department of Public Health advisory said.

Lacking an established cause, health officials confirm cases through a review of brain scans and symptoms.

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 long-term effects of the disease are also unknown. Nor can they explain why only a handful of infected children developed AFM.

The CDC is not saying how many states have patients under investigation, only that it's more than 22. CDC has tested every stool specimen from every AFM patient.

Parents are urged to have their children take basic precautions, such as washing hands and using insect spray to ward off mosquito bites.

There is no specific treatment for AFM, but neurologists who specialize in treating brain and spinal cord illnesses may recommend certain interventions, such as physical or occupational therapy, on a case-by-case basis. There was one death of a child who had AFM, in 2017, said Messonnier. "You don't need an very bad lot of paralyzed children to make this an important problem".

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