A mysterious polio-like illness that paralyzes people may be surging this year

McKenzie Anderson, before and after she came down with a mysterious disease called acute flaccid myelitis, which is a lot like polio. (Family photos) Before dinner on July 29, 3-year-old Carter Roberts of Chesterfield, Va., seemed perfectly healthy. That evening, he vomited. When he woke up the next morning with a slight fever of 99 degrees, his mother, Robin Roberts, figured that he was coming down with a cold. The next morning, she found him collapsed on his bedroom floor. “Mommy,” she recalls him saying. “Help me, help me.” Carter could barely stand when she picked him up, and his neck was arched backward. “What was most alarming,” she said, “is he had no control over his right arm whatsoever.” In the hospital, Carter lost control of his right arm, then over his legs and other muscles within a few days. He now can only wiggle a toe and move the left side of his face. He has been diagnosed with a mysterious, polio-like illness called acute flaccid myelitis, a condition that seems to be surging this year. Source: Centers for Disease Control and Prevention Among the many unanswered questions about the condition are what causes it, how best to treat it and how long the paralysis lasts. Although most cases occur in children, AFM occasionally affects adults. The CDC official who leads the surveillance efforts said that confirmed numbers for August will not be available until the end of this month, but the number of reports she is receiving from doctors around the country continues to rise. “CDC is looking at these trends very carefully,” Manisha Patel said. “We have sent out several health alerts to states to let them know we are seeing an increase in reporting and to encourage them to communicate with doctors to report these cases in a timely fashion.” Five-year-old Braden Scott sits up unassisted at a rehab facility two months after he was struck with acute flaccid myelitis. It's a major improvement for someone with this polio-like illness. Health officials and physicians around the country said they are concerned that the rising number of cases through July could foretell a repeat of 2014. “You hate to be an alarmist, but there’s reason to have some concern,” said Avindra Nath, chief of the section of infections of the nervous system at the National Institute of Neurological Disorders and Stroke. “What we don't know is

McKenzie Anderson, before and after she came down with a mysterious disease called acute flaccid myelitis, which is a lot like polio. (Family photos)
Before dinner on July 29, 3-year-old Carter Roberts of Chesterfield, Va., seemed perfectly healthy. That evening, he vomited. When he woke up the next morning with a slight fever of 99 degrees, his mother, Robin Roberts, figured that he was coming down with a cold. The next morning, she found him collapsed on his bedroom floor.
“Mommy,” she recalls him saying. “Help me, help me.”
Carter could barely stand when she picked him up, and his neck was arched backward. “What was most alarming,” she said, “is he had no control over his right arm whatsoever.”
In the hospital, Carter lost control of his right arm, then over his legs and other muscles within a few days. He now can only wiggle a toe and move the left side of his face. He has been diagnosed with a mysterious, polio-like illness called acute flaccid myelitis, a condition that seems to be surging this year.
Through July, 32 new cases of AFM have been confirmed across the United States this year by the Centers for Disease Control and Prevention, a sharp rise compared with last year, when just seven cases had been confirmed by that month. The numbers have risen steadily since April. In past years, most cases have occurred between August and December, with a peak in October.
Source: Centers for Disease Control and Prevention
Among the many unanswered questions about the condition are what causes it, how best to treat it and how long the paralysis lasts. Although most cases occur in children, AFM occasionally affects adults.
The CDC official who leads the surveillance efforts said that confirmed numbers for August will not be available until the end of this month, but the number of reports she is receiving from doctors around the country continues to rise.
“CDC is looking at these trends very carefully,” Manisha Patel said. “We have sent out several health alerts to states to let them know we are seeing an increase in reporting and to encourage them to communicate with doctors to report these cases in a timely fashion.”
The CDC began tracking AFM in 2014, when 121 cases were confirmed. That year, the CDC counted only children affected by the disease. Their average age was 7. Most had a fever or a respiratory illness a few days before developing paralysis. Many had to be placed on respirators. Although 85 percent of the children recovered partially, only three of them recovered fully.
Five-year-old Braden Scott sits up unassisted at a rehab facility two months after he was struck with acute flaccid myelitis. It's a major improvement for someone with this polio-like illness.
Health officials and physicians around the country said they are concerned that the rising number of cases through July could foretell a repeat of 2014.
“You hate to be an alarmist, but there’s reason to have some concern,” said Avindra Nath, chief of the section of infections of the nervous system at the National Institute of Neurological Disorders and Stroke. “What we don't know is where are these cases. Are they clustered? Do they all look alike?  Getting more information on these cases would be helpful.”
Beyond saying that confirmed cases have been reported in 17 states through July, Patel declined to reveal which states have been involved. But conversations and emails with physicians around the country indicate that at least four cases have occurred in California and at least three in Massachusetts, and that others have been seen in Florida, Texas, Pennsylvania and New York, as well as Virginia.
“We are definitely hearing of cases from our colleagues across the country,” said Teri Schreiner, a neurologist at the University of Colorado and Children's Hospital Colorado. “It’s a trend that’s worrisome … what I'm hearing from others seems to be coming at a tempo similar to what happened in 2014.”
Jean-Baptiste Le Pichon of Children’s Mercy Hospital in Kansas City, Mo., said that doctors on a U.S. email list for pediatric neurologists reported five new cases of AFM in just the past few days. “There is definitely an explosion of cases,” Le Pichon said.
No treatment other than physical therapy has yet been shown to markedly improve outcomes, although some doctors have reported that treatment with intravenous immunoglobulin (IVIG), used to treat some other viral infectious diseases afflicting the nervous system, might help. It’s also been suggested that Prozac could prove beneficial. The degree of paralysis in the first month has generally improved only slightly over the course of a year.
“After about a year or so, what you’ve got is what you’ve got,” said Max Wiznitzer, a pediatric neurologist at Case Western Reverse University in Cleveland.
Most perplexing is what causes the disease. The 2014 outbreak of AFM occurred at the same time as a far larger outbreak of enterovirus D68 across the United States. The vast majority of patients infected with the virus developed only a respiratory illness. Some physicians were convinced that EV-D68 was the cause, not only because both outbreaks occurred at the same time but also because of a study that identified a particular strain of EV-D68 in the airways of children with AFM. But officials at the CDC and some doctors, including Wiznitzer, insist that the cause remains unproved.
So far this year, no similarly widespread outbreak of EV-D68 respiratory infections has been reported, although cases of it and other enteroviruses have been seen in some areas.
On Friday, Le Pichon, in Kansas City, said, “I just got confirmation that we have an epidemic of enterovirus breaking out here and at least a few cases [of enterovirus] have typed positive for EV-D68.”
Carol Glaser, a pediatric infectious-disease specialist at Kaiser Permanente in Oakland, Calif., said: “If the theory is right that it’s caused by EV-D68, which some of us believe more than others, this would be the time of year we start seeing it. It’s an enterovirus, and they tend to peak in late summer and early fall.”
Because the CDC’s surveillance of AFM is less than two years old, it remains unclear if some of this year’s apparent rise in confirmed cases is due simply to more doctors sending in case reports, Patel said. And Wiznitzer emphasized that with just 32 confirmed cases across the United States so far, AFM remains extremely rare
Glaser, however, said she is convinced that the condition is new. She worked at the California Department of Public Health when, in 2012, some of the first reports of AFM anywhere in the country came in from physicians there.
“I was there for 15 years and talked to neurologists every single day,” she said. “It wasn’t until the fall of 2012 when the first physician called in and wanted a test for polio on one of his patients. One of my colleagues in the office chuckled and said to me, ‘We don't have polio in the United States.’ But in the next two weeks, I got two very similar phone calls. We had never had a report like that. I do think there was something new going on. Fortunately, it’s still rare.”
If EV-D68 does somehow cause AFM, studying the virus may lead to prevention or treatment. One glimmer of good news came from Kenneth Tyler, chair of neurology at the University of Colorado School of Medicine. He and his colleagues have been conducting experiments to infect mice with EV-D68 and have them develop loss of muscle control like that seen in AFM. He says he has submitted a paper to a peer-reviewed medical journal describing his success in doing so.
The goal, he said, is to use mice to study how EV-D68 causes harm to the spinal cord and muscles, and to test potential therapies, such as IVIG.
“It looks like we’re seeing protection with IVIG in the mouse model,” he said.
Robin Roberts said she wishes more was known about the condition that has harmed her son. “In this day and age to not have information about something like this is very frustrating. There needs to be more done about it, and for more parents and doctors to know about it,” she said.
Angie Andersen said that her daughter McKenzie was sent home from the hospital twice in the first two weeks of her illness because doctors did not understand the severity of what was happening. Finally her pediatrician told Andersen to bring McKenzie to another hospital.
McKenzie was 6 years old when she developed sniffles in December 2014. “Within 12 days,” Andersen said, “she was paralyzed from the neck down, on a ventilator to breathe for her. She was left with her left hand and her feet and toes that move.”
“You know you could understand the bad that comes from a car wreck, or if she got cancer,” Andersen said. “How do you ever wrap your brain around the fact that she got a cold, and now she’s a quadriplegic on a ventilator? It’s a nightmare you never wake up from.”
Still, she said, McKenzie can now speak and even sing softly despite having a tracheotomy. “She has a lot of spunk, and that is helping her through,” Andersen said.
Correction: This article originally misnamed Robin Roberts as Robin Carter.
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Find information about a new disease that seems to be emerging with polio-like symptoms.

I'm interested in the states that have children who have been diagnosed with the polio like disease (PLD).  I'm not interested with any other country who has identified children with the PLD.  Interested in experimental trials and research on PLD.  What do we know about this disease?

I'm interested in the states that have children who have been diagnosed with the polio like disease (PLD).  I'm not interested with any other country who has identified children with the PLD, nor information solely from any one individual state - it must reference multiple states or the broader USA.  Interested in experimental trials and research on PLD.  What do we know about this disease?

Find research or data on a specific disease's impact within a region to answer this question.

What does it look like when children might have Enterovirus 68?

Will Cornejo, recovering at Denver's Rocky Mountain Hospital for Children on Sept. 5. (Cyrus McCrimmon/The Denver Post) What has mothers and fathers so worried? Here's what a few of them reported: 'Like a goldfish gasping for breath' Rachel and Rodney Nash's young son started to develop cold-like symptoms in late August, according to CNN. His condition worsened a few days later, they said. The parents told CNN "You could see him trying to pull the air in," Rachel Nash recalls. "His nostrils flared as he inhaled, and you could see the muscles in his neck and collarbone working extra hard." Rodney Nash adds, "I remember as a kid my goldfish jumped out of the bowl. That's how he looked to me -- like a goldfish gasping for breath." 'I was really scared' "I heard these kids ending up in the ICU with it, and I was really scared," Ratajczak said. Her son, who also has asthma, made two trips to the ER, and was eventually tested for entrovirus, she said. It was unclear if the boy was battling the D68 strain, although the symptoms seemed to match, according to Ratajczak. "He was wheezing and coughing so bad he was turning blue around the mouth," she told the station. "We had some great paramedics who helped him out." 'He just passed out' "He was in really bad shape," she told the station. "He came really close to death. He was unconscious at our house and white as a ghost with blue lips — he just passed out." Here is how William Cornejo described it: "My head started hurting. And after that my lungs started closing up. It felt different." 'It came on very, very fast' Glen told the Toronto Star that her 7-year-old daughter, who suffers from seasonal asthma, was weak, and coughing up a "nasty green phlegm." Glen took her daughter to a hospital, where she began to vomit. "When you have a child, you can tell how pale their skin is and how tired they look," Glen told the newspaper. "In any case you are just hoping and praying she’s breathing and that she’s got a pulse." A Windsor Regional Hospital spokesman told the paper that Glen's daughter had a suspected case of EV-D68. Tests would confirm whether she has the infection. RELATED: Centers for Disease Control officials say a potentially deadly respiratory virus that has sent hundreds of

Will Cornejo, recovering at Denver's Rocky Mountain Hospital for Children on Sept. 5. (Cyrus McCrimmon/The Denver Post)
A total of 220 people in 32 states have been diagnosed with Enterovirus 68, a viral infection that can cause symptoms such as wheezing and low blood oxygen levels, according to the Centers for Disease Control and Prevention.
The respiratory illness — which is also known as Enterovirus D68 or EVD-68 — has been particularly challenging for children, many of whom are being swept into emergency rooms by frantic parents.
What has mothers and fathers so worried?
Here's what a few of them reported:
'Like a goldfish gasping for breath'
Rachel and Rodney Nash's young son started to develop cold-like symptoms in late August, according to CNN. His condition worsened a few days later, they said.
The parents told CNN
"You could see him trying to pull the air in," Rachel Nash recalls. "His nostrils flared as he inhaled, and you could see the muscles in his neck and collarbone working extra hard."
Rodney Nash adds, "I remember as a kid my goldfish jumped out of the bowl. That's how he looked to me -- like a goldfish gasping for breath."
'I was really scared'
Maryland mother Brandi Ratajczak told WBAL-TV that she grew concerned after her son started to have difficulty breathing.
"I heard these kids ending up in the ICU with it, and I was really scared," Ratajczak said.
Her son, who also has asthma, made two trips to the ER, and was eventually tested for entrovirus, she said. It was unclear if the boy was battling the D68 strain, although the symptoms seemed to match, according to Ratajczak.
"He was wheezing and coughing so bad he was turning blue around the mouth," she told the station. "We had some great paramedics who helped him out."
'He just passed out'
Jennifer Cornejo of Colorado told Denver's ABC affiliate that her 13-year-old son, William, had cold symptoms that developed overnight into a life-threatening illness.
"He was in really bad shape," she told the station. "He came really close to death. He was unconscious at our house and white as a ghost with blue lips — he just passed out."
Here is how William Cornejo described it: "My head started hurting. And after that my lungs started closing up. It felt different."
'It came on very, very fast'
"This was a lot more severe than a normal asthma attack," Ontario mother Joanna Glen said. "It came on very, very fast."
Glen told the Toronto Star that her 7-year-old daughter, who suffers from seasonal asthma, was weak, and coughing up a "nasty green phlegm." Glen took her daughter to a hospital, where she began to vomit.
"When you have a child, you can tell how pale their skin is and how tired they look," Glen told the newspaper. "In any case you are just hoping and praying she’s breathing and that she’s got a pulse."
A Windsor Regional Hospital spokesman told the paper that Glen's daughter had a suspected case of EV-D68. Tests would confirm whether she has the infection.
RELATED:
Centers for Disease Control officials say a potentially deadly respiratory virus that has sent hundreds of kids to the hospital in the Midwest is likely to spread across the country.


The rare respiratory virus sickening children has been confirmed in 16 states across the country

A 13-year-old being treated in Denver for the virus. (Denver Post/Cyrus McCrimmon) The rare respiratory illness that cropped up in multiple states recently has been confirmed in four new states, public health officials said Wednesday. Cases have been confirmed in Connecticut, Montana, Nebraska and Virginia, according to the Centers for Disease Control and Prevention, which means that 16 states now have confirmed cases of the virus. The others are: Alabama, Colorado, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Missouri, Oklahoma, Pennsylvania and New York. The rare virus strain, enterovirus 68, can cause severe breathing problems. There have been 140 cases confirmed by laboratory tests, the CDC said, but it is believed that many more people have the virus and that it will continue to appear in additional states in the near future. Enteroviruses are very common, causing between 10 million and 15 million infections each year. But this particular strain has not appeared very often since it was first isolated in California in 1962. Public health officials have said that other states are presumably going to join this list, with cases expected to be confirmed in other places where there have been clusters of children suffering from respiratory illnesses. There are suspected cases in Georgia and Michigan, while health officials in Ohio and Utah have told The Post they suspect that they have cases of the virus. The CDC expects that the number of infections is going to drop later in the year. Most enterovirus infections in the United States occur in the summer and fall, so these are coming at a typical time, Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases, told reporters last week. Only children have been confirmed to have the virus so far, as they lack the immunity that comes from being exposed to a disease, according to the CDC. The virus spreads when an infected person coughs or sneezes, so health officials are encouraging people to wash their hands and avoid excessive contact with those already sick. (Here’s the advice in infographic form.) Here’s more information on the virus itself. And here is some background on why we are only gradually learning how many states have this virus.

A 13-year-old being treated in Denver for the virus. (Denver Post/Cyrus McCrimmon) Cases have been confirmed in Connecticut, Montana, Nebraska and Virginia, according to the Centers for Disease Control and Prevention, which means that 16 states now have confirmed cases of the virus. The others are: Alabama, Colorado, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Missouri, Oklahoma, Pennsylvania and New York. The rare virus strain, enterovirus 68, can cause severe breathing problems. There have been 140 cases confirmed by laboratory tests, the CDC said, but it is believed that many more people have the virus and that it will continue to appear in additional states in the near future. Enteroviruses are very common, causing between 10 million and 15 million infections each year. But this particular strain has not appeared very often since it was first isolated in California in 1962.


The mysterious polio-like illness that has afflicted more than 100 children

Last September, Melissa Lewis, of Denver, helps her son, Jayden Broadway, 9, his bed at the Children’s Hospital Colorado in Aurora, Colo. He was treated for the enterovirus 68 and released. (Cyrus McCrimmon/Denver Post via AP) Since last summer, public-health officials have been trying to figure out why more than 100 children in dozens of states have suffered from a polio-like weakness in their limbs. Still, another concern in this latest illness is how many children have not seen any improvement since developing symptoms. Two out of three have said they had some improvement, compared to one in three who showed none. So far, only one child with the illness had fully recovered, the CDC says.

Last September, Melissa Lewis, of Denver, helps her son, Jayden Broadway, 9, his bed at the Children’s Hospital Colorado in Aurora, Colo. He was treated for the enterovirus 68 and released. (Cyrus McCrimmon/Denver Post via AP)
Since last summer, public-health officials have been trying to figure out why more than 100 children in dozens of states have suffered from a polio-like weakness in their limbs.
And while authorities have not found a direct link to the severe respiratory illness that affected children across the country last year, they are exploring whether that nationwide outbreak may be tied to this mysterious situation.
There have been 103 confirmed reports of children who have developed the illness, which is called “acute flaccid myelitis,” according to the Centers for Disease Control and Prevention. These cases, which span 34 states, have almost all led to the hospitalization of the affected children, with some of them put on breathing machines.
Last fall, the CDC began testing cases that occurred after Aug. 1. They had tested 88 cases by mid-November and found some possible trends, but the ultimate cause of the illnesses were still unclear. A handful of cases involved children who had been affected by the enterovirus D68 outbreak, but the CDC cautioned that no causal relationship between the illness could be confirmed by that time. There are also other viruses that can cause illnesses with symptoms like the ones currently being seen, the CDC noted.
The possible tie to the enterovirus D68 (or EV-D68) outbreak is particularly worrisome, given how widespread this virus became. More than 1,100 people — again, most of them children — have been affected since last August. This number is likely severely underestimating how many were infected, as the CDC says there were presumably “millions” of mild infections in people who did not get tested. The virus was ultimately confirmed in 49 states and the District of Columbia.
In September, as the enterovirus outbreak continued, health officials in Colorado explored a cluster of nine children suffering from weakness and paralysis. Some of these children tested positive for the enterovirus.
Still, another concern in this latest illness is how many children have not seen any improvement since developing symptoms. Two out of three have said they had some improvement, compared to one in three who showed none. So far, only one child with the illness had fully recovered, the CDC says.
Nearly a year ago, another polio-like illness may have affected up to 25 children in California, leading to some limb paralysis. Enterovirus D68, which at that time was still considered a rare virus and had not become as widespread as it was later in the year, was cited as one possible factor.


Rare respiratory illness has spread to a dozen states

The Centers for Disease Control and Prevention in Atlanta. (David Goldman/AP) So far, the other states with confirmed cases are Alabama, Colorado, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Missouri and New York. There have been 130 confirmed cases, the CDC says, but the number of actual cases is likely much higher. As for why it is taking so long to confirm all of the places seeing this virus, that stems from issues with the testing that is required. Health officials say testing for this particular strain can only be done by the CDC and at a certain number of other laboratories. States are sending their specimens to the CDC for testing, which has created a backlog. Still, even as the number of states with confirmed cases rises, it’s important to remember that these confirmations don’t necessarily mean the virus has suddenly cropped up in these places without warning. Some states told us after submitting specimens to the CDC for testing that they expected it could take weeks to hear results. And cases may be confirmed after the number of afflicted children seeking treatment has decreased. Consider Children’s Mercy Hospital in Kansas City, Mo., which reported treating nearly 500 children for respiratory illnesses since last month. Mary Anne Jackson, director of the hospital’s infectious diseases division, said she believes between 70 and 90 percent of these children had the rare strain. Jackson said that the number of children coming in with respiratory illnesses peaked during the latter third of August. “We really were inundated with cases at that point,” she said. The daily number of cases began declining in September. She said there is no need for public panic, because most illnesses relating to this strain will be akin to a common cold. But as Jackson pointed out, it is still likely the number of states with cases will increase. “The way this virus spreads, kid to kid, it’s likely if it’s in 12 states it will be in more than 12 states over the next several weeks,” she said last week.

The Centers for Disease Control and Prevention in Atlanta. (David Goldman/AP)
The rare respiratory illness affecting children has now been confirmed in a dozen states, the Centers for Disease Control and Prevention reported Tuesday.
The two newest states with confirmed cases: Oklahoma and Pennsylvania, which join a growing roster of states that officially have cases of enterovirus 68, a rare virus strain that can cause severe breathing problems.
Hospitals around the country are seeing an increase in the number of children dealing with respiratory illnesses. Testing has shown that many of these children are suffering from this enterovirus strain. Enteroviruses are quite common, causing between 10 million and 15 million infections each year, but this particular strain has not appeared very often since it was first isolated in California in 1962.
So far, the other states with confirmed cases are Alabama, Colorado, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Missouri and New York. There have been 130 confirmed cases, the CDC says, but the number of actual cases is likely much higher.
Public health officials continue to warn that other states are presumably going to join this list, with cases expected to be confirmed in other places where there have been clusters of children suffering from respiratory illnesses. There are suspected cases in Georgia and Michigan. At least two other states — Ohio and Utah — have no confirmed cases yet, but health officials have told The Post they suspect that they have cases of the virus.
The CDC expects that the number of infections is going to drop later in the year. Most enterovirus infections in the United States occur in the summer and fall, so these infections are coming at a typical time for enteroviruses, Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases, told reporters.
Only children have been confirmed to have the virus so far, as they lack the immunity that comes from being exposed to a disease, according to the CDC. The virus spreads when an infected person coughs or sneezes. (There is no vaccine, so health officials encourage people to follow the usual common-sense guidelines: Wash your hands, avoid excessive contact with sick people, that sort of thing. Here’s the advice in infographic form.)
As for why it is taking so long to confirm all of the places seeing this virus, that stems from issues with the testing that is required. Health officials say testing for this particular strain can only be done by the CDC and at a certain number of other laboratories. States are sending their specimens to the CDC for testing, which has created a backlog.
Still, even as the number of states with confirmed cases rises, it’s important to remember that these confirmations don’t necessarily mean the virus has suddenly cropped up in these places without warning. Some states told us after submitting specimens to the CDC for testing that they expected it could take weeks to hear results.
And cases may be confirmed after the number of afflicted children seeking treatment has decreased. Consider Children’s Mercy Hospital in Kansas City, Mo., which reported treating nearly 500 children for respiratory illnesses since last month. Mary Anne Jackson, director of the hospital’s infectious diseases division, said she believes between 70 and 90 percent of these children had the rare strain.
Jackson said that the number of children coming in with respiratory illnesses peaked during the latter third of August. “We really were inundated with cases at that point,” she said. The daily number of cases began declining in September.
She said there is no need for public panic, because most illnesses relating to this strain will be akin to a common cold. But as Jackson pointed out, it is still likely the number of states with cases will increase.
“The way this virus spreads, kid to kid, it’s likely if it’s in 12 states it will be in more than 12 states over the next several weeks,” she said last week.


Rare respiratory virus spreads to 22 states

That rare respiratory illness sickening children around the country continues to crop up in new places. It has been confirmed in 22 states, the Centers for Disease Control and Prevention said Friday, appearing in three states where it had not been previously: Georgia, Michigan and Washington state. These children are facing an uncommon enterovirus strain. While enteroviruses in general are quite common, this particular strain — enterovirus 68 — has not cropped up terribly often since it was first identified in 1962. It can cause severe breathing problems, a particular danger for children who may suffer from asthma or other respiratory issues. Testing has found 160 cases spread across these states that span from coast to coast, though public health officials have warned that the actual number of cases is likely much higher. In addition, there are other states where clusters of children are facing similar respiratory illnesses that could turn out to be this virus. (Health officials in Ohio and Utah have told The Post that they suspect they have cases of the strain.) Head here for a list of the other states with this virus. Here is more information on the enterovirus and how it was first identified as part of this recent surge. And here is why we are only gradually learning about how many states have this virus.


More cases reported of a mysterious polio-like illness that killed a 6-year-old

(Courtesy of Marijo De Guzman via Facebook) On Wednesday, Oct. 12, 6-year-old Jonathan Daniel Ramirez Porter woke up with a fever. His mother, Marijo De Guzman, decided to keep him home from kindergarten in Ferndale, Wash., a small town less than an hour south of the Canadian border. Instead of getting better, Daniel complained of a severe headache the next day. By Saturday, Oct. 15, he was stumbling and drooling, unable to keep food in his mouth or to speak clearly. De Guzman and Daniel’s father, Jose Ramirez, brought him to Seattle Children’s Hospital, where his condition at first baffled physicians there, his mother said. “They had no clue what it was,” said De Guzman, 33. “At first they thought it was a bacteria, so they were giving him antibiotics. That didn’t work, and they figured out it was a virus. They were giving him pain medicine, blood pressure medicine and steroids to help with swelling in his brain.” With local news reports describing other children in Washington state as having a polio-like condition called acute flaccid myelitis, or AFM, De Guzman said, “I asked the doctor if it’s possible he could have this, because a lot of the symptoms sounded the same.” As his condition worsened,Daniel was given a tentative diagnosis of AFM. “They said they could try to put him in an induced coma to let his body fight the virus,” De Guzman said. “All Daniel wanted to do when he got this was to rest, so we chose the coma.” Despite the efforts of some 30 doctors treating him, Daniel died Oct. 30. Daniel is one of nine children tentatively diagnosed in recent weeks with AFM across Washington state, and the first person known to have died of the mysterious disease. The Centers for Disease Control and Prevention began tracking the disease in 2014, when 120 cases were confirmed between August and December. The condition mimics polio but is not caused by the polio virus. It affects primarily children, causing sudden loss of control of the muscles in limbs and other parts of the body. It’s not clear what causes the disease, and no medical treatment has proved effective. In Philadelphia, nine children were treated for AFM in August and September, said Sarah Hopkins, a pediatric neurologist at Children’s Hospital of Philadelphia. Although the average age of children treated during the 2014 outbreak was 7, the average

(Courtesy of Marijo De Guzman via Facebook)
On Wednesday, Oct. 12, 6-year-old Jonathan Daniel Ramirez Porter woke up with a fever. His mother, Marijo De Guzman, decided to keep him home from kindergarten in Ferndale, Wash., a small town less than an hour south of the Canadian border.
Instead of getting better, Daniel complained of a severe headache the next day. By Saturday, Oct. 15, he was stumbling and drooling, unable to keep food in his mouth or to speak clearly.
De Guzman and Daniel’s father, Jose Ramirez, brought him to Seattle Children’s Hospital, where his condition at first baffled physicians there, his mother said.
“They had no clue what it was,” said De Guzman, 33. “At first they thought it was a bacteria, so they were giving him antibiotics. That didn’t work, and they figured out it was a virus. They were giving him pain medicine, blood pressure medicine and steroids to help with swelling in his brain.”
With local news reports describing other children in Washington state as having a polio-like condition called acute flaccid myelitis, or AFM, De Guzman said, “I asked the doctor if it’s possible he could have this, because a lot of the symptoms sounded the same.”
As his condition worsened,Daniel was given a tentative diagnosis of AFM.
“They said they could try to put him in an induced coma to let his body fight the virus,” De Guzman said. “All Daniel wanted to do when he got this was to rest, so we chose the coma.”
Despite the efforts of some 30 doctors treating him, Daniel died Oct. 30.
Daniel is one of nine children tentatively diagnosed in recent weeks with AFM across Washington state, and the first person known to have died of the mysterious disease.
The Centers for Disease Control and Prevention began tracking the disease in 2014, when 120 cases were confirmed between August and December. The condition mimics polio but is not caused by the polio virus. It affects primarily children, causing sudden loss of control of the muscles in limbs and other parts of the body. It’s not clear what causes the disease, and no medical treatment has proved effective.
This year, reports of new cases in the United States doubled in September compared with August, the CDC reported Monday, with the year-to-date total of 89 cases in 33 states on track to match or exceed the 120 cases confirmed in all of 2014.
Locally clustered cases of AFM have been reported in Philadelphia and, for the first time, in Europe. The first cluster of European cases of the polio-like condition was described in British news reports last month, involving four cases being treated at the Royal Hospital for Sick Children in Edinburgh, Scotland. Two cases of AFM have also been reported in Canada.
In Philadelphia, nine children were treated for AFM in August and September, said Sarah Hopkins, a pediatric neurologist at Children’s Hospital of Philadelphia. Although the average age of children treated during the 2014 outbreak was 7, the average age of the nine children seen this year by Hopkins has been closer to 5.
Most of the children treated in 2014 have made a modest recovery, she added, although none is back to their original strength.
The CDC defines AFM as the sudden onset of flaccid paralysis, in which muscles controlling the limbs, face or other body parts become droopy (not stiff), and in which an MRI exam shows damage to the gray matter of the spinal cord. The condition is often preceded by a fever or severe headache. Although some cases involve only a mild paralysis of a single limb, others affect the muscles that control breathing, and patients require mechanical ventilation to survive.
As the number of cases rises this year, researchers at the CDC say they are more mystified than ever by what is causing the condition.
“It’s a complete puzzle,” said Steve Oberste, chief of the CDC’s Polio and Picornavirus Laboratory Branch. “What’s going on now is really odd. I hope we can assure the public that people are working on it, not just the CDC but many others. There are so many things about this outbreak that are puzzling, and the pieces aren’t fitting together yet. Eventually we’ll know more, but right now it’s pretty difficult.”
During the 2014 outbreak, a growing line of evidence suggested that the condition may be a rare but serious complication of infection with enterovirus D68. That year, more than 1,000 children across the country were treated for serious respiratory illnesses linked to D68, which is in the same viral family as the polio virus.
The problem with that hypothesis was that D68 was never found in the spinal fluid of infected children. Even so, many doctors remain convinced by studies showing a strong geographic and chronological association between D68 and AFM, and by the fact that D68 is related to polio.
This year, however, the case for D68 has weakened, because no similar outbreak of respiratory illnesses associated with D68 or any other enterovirus has been seen in the United States, leaving researchers desperately searching for answers. (Both children affected by AFM in Canada, however, tested positive for exposure to D68.)
“What we saw in 2014 was a temporal relationship between D68 and AFM,” said Manisha Patel, who leads 10 researchers working full time at the CDC investigating the AFM outbreak. “This year, we don’t have that. So we are not ruling anything out. We’re looking at not just viral causes but environmental causes. Yes, enteroviruses are biologically plausible, but there are also other things that could cause this.”
Some of the apparent rise in cases, Patel said, may be due to increased surveillance by the CDC and rising awareness among physicians and the public. And despite the higher numbers, she emphasized, the condition remains extremely rare.
In the two years and three months since the CDC began tracking the condition, she said, “less than one in a million people have developed AFM. It’s a very serious illness that CDC is taking very, very seriously. But what remains consistent is that AFM is still rare.”
For all the CDC’s efforts, some doctors think the agency still is not doing enough and should make it mandatory for doctors to report all new cases of AFM and other cases of sudden paralysis to health authorities.
“A mandatory reporting for non-traumatic paralytic disease should be urgently considered nationwide,” said Benjamin M. Greenberg, a neurologist at the University of Texas Southwestern Medical Center in Dallas, who has treated some of the children afflicted by the disease. Mandatory reporting, he said, would pick up paralysis due not only to AFM but also to Zika, West Nile, Guillain-Barré and a variety of other paralyzing conditions.
“We need to be proactive, not reactive,” he said.
After losing her child, De Guzman said, “we’re still fighting to figure out what happened to Daniel and to warn people about this. He wouldn’t want this to happen to any other kid.”
As of Thursday morning, a GoFundMe page set up to help pay for Daniel’s medical care had raised $14,317 from 295 people.
Read more:
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Opioid pills “are like guns”: More than 13,000 children were poisoned during six years
Correction: This article originally misspelled the name of Jonathan Daniel Ramirez Porter's mother. She is Marijo De Guzman, not Marijo Ceguzman.


Rare respiratory illness now in 19 states as cases are confirmed in California, Minnesota and New Jersey

The rare respiratory illness affecting children across the country has now spread to at least 19 states, with confirmed cases in California, Minnesota and New Jersey, public health officials confirmed Thursday. This rare virus strain, known as enterovirus 68, can cause severe breathing problems. There have now been 153 confirmed cases across the country, according to the Centers for Disease Control and Prevention. But it is believed that many more people have the virus and that it will appear in additional states in the near future. Minnesota and New Jersey are just the latest places with this virus, joining a list of states that has lengthened as testing confirms cases. The other states are Alabama, Colorado, Connecticut, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Missouri, Montana, Nebraska, Oklahoma, Pennsylvania, New York and Virginia. Public health officials say other states are expected to join this list, as cases could likely be confirmed in other places where there have been clusters of children suffering from respiratory illnesses. There are suspected cases in Georgia and Michigan, while health officials in Ohio and Utah have told The Post they suspect that they have cases of the virus. Enteroviruses are very common, causing between 10 million and 15 million infections each year. Most enterovirus infections in the United States occur in the summer and fall, so these are coming at a typical time, Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases, told reporters last week. But this particular strain has not appeared very often since it was first isolated in California in 1962. The CDC expects that the number of infections will drop later in the year. Here’s more information on the virus itself and how it is treated. And here is some background on why we are only gradually learning how many states have this virus. This post has been updated to note the confirmed cases in California. First published: 1:04 p.m. Last updated: 4:28 p.m.

This rare virus strain, known as enterovirus 68, can cause severe breathing problems. There have now been 153 confirmed cases across the country, according to the Centers for Disease Control and Prevention. But it is believed that many more people have the virus and that it will appear in additional states in the near future. Minnesota and New Jersey are just the latest places with this virus, joining a list of states that has lengthened as testing confirms cases. The other states are Alabama, Colorado, Connecticut, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Missouri, Montana, Nebraska, Oklahoma, Pennsylvania, New York and Virginia. But this particular strain has not appeared very often since it was first isolated in California in 1962. The CDC expects that the number of infections will drop later in the year. This post has been updated to note the confirmed cases in California. First published: 1:04 p.m. Last updated: 4:28 p.m.


I'm interested in details about panda cub Bao Bao's upcoming departure to China.

The National Zoo's panda cub, Bao Bao, will be sent to China. I'm looking for information regarding the reasons and timing of her departure. Events planned by the Zoo to celebrate the cub's departure are relevant. Community and media reactions to her leaving are relevant as well. Documents related to the Smithsonian Institute are not related.

Find details online to answer this question about an event.

All that traffic near the National Zoo is for Bao Bao

Born at the National Zoo in 2013, Bao Bao leaves her parents and little brother to move to China as part of a breeding program. Don’t be alarmed if you hit a standstill in portions of Northwest Washington this weekend. It’s likely the back up from everyone wanting to say bye bye to Bao Bao. Traffic cameras Sunday morning show heavy traffic along Connecticut Avenue NW near the National Zoo as scores of people were paying a final visit to the zoo’s 3-year-old female giant panda before she leaves Tuesday for a new home in China. (screenshot of Zoo traffic Sunday morning). No, there are no crashes reported, D.C. police said. No calls about stranded cars either. And, with temperatures in the mid-60s and sunny, certainly no weather-related troubles on the road. “People are just trying to get into the zoo,” a National Zoo police spokeswoman said. “Everything is good. It’s a lot of traffic due to Bao Bao leaving.” The traffic was slow in both directions Sunday morning between Van Ness Street NW and Calvert St. NW. The traffic app Waze was telling drivers in the area to add up to 30 minutes to their drive. Remember that if you are driving in that area, portions of Beach Drive near the Zoo remain closed for a reconstruction project. UPDATE: Connecticut Ave NW still jammed. Will add 34m to your drive #DCTraffic https://t.co/BYtVe2Kor3 https://t.co/pIYl50jNFR The 3-year-old panda is leaving Tuesday morning for the China Conservation and Research Center for the Giant Panda. She leaves her family behind, including younger brother Bei Bei, but she has older brother Tai Shan waiting for her. Drivers in the area should expect delays Sunday and Monday near the zoo. With spring-like temperatures in the area, the crowds are expected to be even bigger.

Born at the National Zoo in 2013, Bao Bao leaves her parents and little brother to move to China as part of a breeding program. Don’t be alarmed if you hit a standstill in portions of Northwest Washington this weekend. It’s likely the back up from everyone wanting to say bye bye to Bao Bao. Traffic cameras Sunday morning show heavy traffic along Connecticut Avenue NW near the National Zoo as scores of people were paying a final visit to the zoo’s 3-year-old female giant panda before she leaves Tuesday for a new home in China. (screenshot of Zoo traffic Sunday morning). No, there are no crashes reported, D.C. police said. No calls about stranded cars either. And, with temperatures in the mid-60s and sunny, certainly no weather-related troubles on the road. “People are just trying to get into the zoo,” a National Zoo police spokeswoman said. “Everything is good. It’s a lot of traffic due to Bao Bao leaving.” UPDATE: Connecticut Ave NW still jammed. Will add 34m to your drive #DCTraffic https://t.co/BYtVe2Kor3 https://t.co/pIYl50jNFR The 3-year-old panda is leaving Tuesday morning for the China Conservation and Research Center for the Giant Panda. She leaves her family behind, including younger brother Bei Bei, but she has older brother Tai Shan waiting for her. Drivers in the area should expect delays Sunday and Monday near the zoo. With spring-like temperatures in the area, the crowds are expected to be even bigger.


Bao Bao, the National Zoo’s 3-year-old giant panda, is moving to China next year

The playful panda cub Bao Bao is leaving the National Zoo for China early next year, zoo officials announced Thursday. As part of a breeding agreement with the China Wildlife Conservation Association, all giant pandas born at the Washington zoo move to China by the time they turn 4. Bao Bao will celebrate her fourth birthday August 23. “Bao Bao is very special to us at the Smithsonian’s National Zoo,” Brandie Smith, associate director of animal care sciences, said in a statement. “She was the first surviving cub born at the Zoo since 2005.” “We are sad to see her go,” she added, “but excited for the contributions she is going to continue to make to the global giant panda population.” Bao Bao will fly FedEx to Chengdu, in southwestern China, in the first several months of 2017. The zoo said that she was leaving so early in the year because it is better for pandas to travel in the winter months, when it isn’t hot. From Chengdu, Bao Bao will be driven to a base run by the China Conservation and Research Center for the Giant Panda, where she will be part of a breeding program that aims to increase the wild panda population. The International Union for Conservation of Nature recently took the giant panda off the endangered species list and classified it as “vulnerable,” estimating that there are about 1,860 pandas in the wild. Bao Bao’s older brother, Tai Shan, moved to China in 2010. With Bao Bao’s departure, the zoo will be down to three pandas: Bao Bao’s mom and dad, Mei Xiang (may-SHONG) and Tian Tian (t-YEN t-YEN), and her younger brother, Bei Bei, who was born in August 2015. The zoo said that special opportunities for visitors to say goodbye to Bao Bao will be announced soon. For now, we’re left to replay a video of her having fun in the snow. kidspost@washpost.com

kidspost@washpost.com


How did the postponement of the 2020 Olympics affect athletes?

For Olympic athletes, a one-year postponement of the Tokyo 2020 Olympics presented numerous challenges in terms of training and eligibility.  During the global pandemic, athletes' training was severely limited as their training sites were closed. Given that the Olympics are every four years meant that in one year, an athlete could blossom, suffer a career-ending injury, an aging veteran could age out, and specifically for female gymnasts whose competitive life span is brief, the impact was significant.  Other effects of postponing the Olympics, such as on construction or businesses, are not relevant. To be sure the article is referencing the correct Olympics, it must mention Tokyo directly.

Find an article discussing the impact of the Olympic delay on athletes' preparation.

USA Gymnastics calls for postponement of Tokyo Olympics

With many elite U.S. gymnasts favoring a delay, USA Gymnastics on Monday added its voice to that of USA Swimming and USA Track and Field in calling for the postponement of the Tokyo Olympics, scheduled to start July 24, because of the risk posed by the novel coronavirus.
USA Gymnastics President and CEO Li Li Leung said the governing body would ask the U.S. Olympic and Paralympic Committee to advocate that the International Olympic Committee delay the Games until they can be safely held. The request won’t specify a preferred timetable.
“This pandemic affects the entire world, and everyone’s health and safety should always be first,” Leung told reporters in a conference call.
USA Gymnastics is the United States’ third major sports governing body to call for a delay of the 2020 Games because of the virus’s health risks and the upheaval it has created in athletes’ training. On Friday, USA Swimming asked for a one-year delay; soon after, executives of USA Track and Field requested a delay of unspecified duration. Later Monday, the USOPC called for a postponement as well.
Swimming, track and field, and gymnastics are the most watched summer Olympic sports and the most lucrative and influential in IOC decision-making. In raising their voices, the sports’ American governing bodies made a powerful statement that the Games should not be held as scheduled.
Before taking a public position on the question, USA Gymnastics polled its men’s and women’s national teams to gauge their sentiments.
The athletes were asked whether they favored postponing the Olympics and, if so, how far out they felt they should be postponed. The options presented on the survey were three to four months, one year or “other.”
About 80 percent of the roughly 70 national team members responded. Of those, 62 percent were in favor of postponing the Games, while 38 percent wanted them to be held as scheduled, Leung said. Of the 62 percent in favor of a postponement, most favored a one-year delay rather than a three- to four-month delay, while other athletes suggested different timetables.
Because the survey was anonymous, there was no way to tell whether the top prospects for making the high-profile U.S. women’s artistic gymnastics team for Tokyo, led by 23-year-old Simone Biles, take a different view than male trampolinists, for example.
Leung said that in terms of reasons cited by those favoring a delay, many mentioned health and safety concerns as well as the impact that coronavirus restrictions are having on their ability to train as normal.
Among the 38 percent who favor starting the Games on July 24 as scheduled, Leung said, age-related issues tended to be cited. Some viewed waiting another year as posing further risk of injury and wear on the body. Others cited financial constraints and the added burden to their families of paying for an additional year of training. Others said a 12-month delay would complicate their plans to start college or enter the job market.
“It’s not an easy answer for any of us,” Leung said. “There are a lot of differing opinions.”
Leung said if the Olympics are delayed until 2021, the U.S. Olympic team trials, scheduled for June 24-28 in St. Louis, will be canceled. But it’s possible that the 2020 U.S. Olympic championships, scheduled for June 4-7 in Fort Worth, could be held or rescheduled later in the year.
While International Olympic Committee chairman Thomas Bach said Sunday the IOC would issue a decision on the Games’ timing within the next four weeks, several prominent national governing bodies have pushed back, ramping up pressure for a delay. They also want a quicker decision on that delay, which, they argue, would spare athletes needless risk and the mental anguish of continuing to train under difficult and potentially dangerous circumstances for an event that may or may not be held.
Canada acted first, announcing Sunday night that it would refuse to send its athletes to the Tokyo Olympics if held as scheduled. Australia adopted a similar position.
On Monday, Germany’s Olympics chief advocated a quicker resolution and a guarantee that the Olympics would be delayed at least one year.
And in Japan, Prime Minister Shinzo Abe acknowledged for the first time that postponing the Summer Olympics was a possibility.


Japan says postponing Olympics is ‘inconceivable,’ but one Tokyo 2020 board member disagrees

TOKYO — Japan tried to quash talk of a possible postponement of the Olympics on Wednesday, but at least one member of the Tokyo 2020 organizing committee issued another round of warnings saying they need to consider exactly that.
The messages were distinctly mixed as senior Japanese officials said one thing and then quite the opposite about the impact of the new coronavirus. Tokyo 2020 executive board member Haruyuki Takashashi told Reuters and the Wall Street Journal Tuesday the financial damage from canceling the Games would be too great and that a postponement of one or two years would be the “most feasible” option if the virus prevents organizers from going ahead this summer.
On Wednesday, Japan’s Olympics Minister Seiko Hashimoto told a parliamentary committee that canceling or postponing the Games was “inconceivable,” although she said the International Olympic Committee would make the final decision.
Even as coronavirus fears mount around the globe, IOC officials have been adamant that the Tokyo Games will take place as scheduled this summer. The IOC said it intends to follow advice from the World Health Organization, and IOC President Thomas Bach said the words cancellation and postponement were not even mentioned at an executive board meeting last week in Lausanne.
The Tokyo Olympics are scheduled to begin July 24.
“The decision is: The Games go ahead,” IOC spokesman Mark Adams said last week. “That was made some time ago. We see no reason to change that decision. All the advice we have at the moment is, the Games are going ahead, from all the competent authorities.”
A pair of U.S. lawmakers sent a letter to the IOC Wednesday inquiring about its plan to safeguard athletes, fans, sponsors and journalists in Tokyo this summer, requesting “a transparent, detailed description of protocols in place to deter further spread of the disease.” Sens. Jerry Moran (R-Kan.) and Richard Blumenthal (D-Conn.) posed a series of questions to Bach, asking for contingency plans, details about the organization’s coordination with agencies such as the U.S. Centers for Disease Control and Prevention and the World Health Organization and whether the IOC has a response plan prepared in the event that someone contracts the disease during the Tokyo Games.
“This public event, particularly with an exposed population that has a wide distribution geographically, is concerning,” the senators wrote. “If not handled properly, this year’s Olympic Games present a dangerous opportunity for COVID-19 to spread at unprecedented levels throughout the globe.”
Earlier in the day Tokyo 2020 Olympics chief Yoshiro Mori said his team was not considering changing plans for the Games and claimed Takahashi had apologized for the comments.
But no sooner had those comments been reported, Takahashi doubled-down on his fears for the Olympics taking place as scheduled, telling Kyodo News that he would consider proposing a postponement when the Tokyo 2020 organizing committee meets at the end of this month. “In light of the reality, we need to respond accordingly,” he said.
Takahashi is one voice on the influential executive board. There are 24 others, and he’s the only one who has publicly urged a postponement.
Experts say a delay of one or two years would pose logistical problems in terms of the global sporting calendar but would fit in with U.S. broadcasters who provide much of the IOC’s funding and have freer summer schedules.
It would also wreak havoc on the schedules for athletes, who have been targeting the summer of 2020 and built their lives and training schedules around peaking competitively this year.
U.S. swimmer Katie Ledecky, who figures to be one of the biggest American stars in Tokyo, said she has been following coronavirus headlines closely and remaining diligent about washing her hands and limiting her visits to crowded places. She trains at Stanford University, which has canceled in-person classes for the remainder of the quarter and moved all instruction online.
“In terms of how it affects the next couple of months, we’re all preparing like everything will go on as scheduled,” Ledecky said in an interview last week. “I trust USOPC, USA Swimming and everybody above them — IOC, CDC, World Health Organization — to make the right decisions. We’ll just follow their guidance and be flexible if we need to be."
Maese reported from Washington.


How the Tokyo Olympics delay complicates USA Basketball’s Dream Team plans

This story has been updated.

This story has been updated.
Rarely has a gold medal felt as trivial as it did this week, when the International Olympic Committee announced that the 2020 Tokyo Games would be postponed because of the novel coronavirus.
For USA Basketball, there was plenty at stake this summer. The program’s chase for a fourth straight Olympic gold. A revenge tour following a dismal seventh-place finish at the 2019 FIBA World Cup in China. A triumphant send-off for Gregg Popovich, the legendary coach seeking a career-capping gold medal. The possibility of a fourth Olympic appearance for LeBron James, basketball’s biggest superstar, and an Olympic debut for Stephen Curry.
Like everything else these days, those story lines will have to wait.
“USA Basketball is in full agreement and support of the decision … to postpone,” American basketball’s governing body said in a statement Tuesday. “ … The health, wellness and safety of the world, as well as our athletes, coaches, staff and fans is USA Basketball’s No. 1 priority and this postponement was necessary to ensure that. As further details become known, USA Basketball will work toward fielding and best preparing its Olympic basketball teams for 2021.”
The process of constructing a roster isn’t top of mind right now, with the NBA’s season suspended and the coronavirus’s death toll climbing. But the one-year delay will have major roster implications, at minimum, and it could create a direct schedule conflict if the NBA resumes play this summer.
Two pieces that won’t change: Managing Director Jerry Colangelo and Popovich, who both recommitted this week.
The good news: Colangelo, who has headed USAB since 2005, need not worry about the impact of aging or retirements, and the one-year delay could buy him some time with notable names who dealt with injury issues this season.
James, who will be 36 next summer, is easily the oldest serious candidate in the player pool. He remains one of the NBA’s top talents and is under contract with the Los Angeles Lakers through the 2021-22 season. The rule that would have applied this summer still will apply next summer: If James wants to play, a spot will be waiting.
Kevin Durant was weighing the possibility of playing in Tokyo, his business partner, Rich Kleiman, told The Washington Post last month, but he would have been just 13 months out from tearing his Achilles’ tendon. Rather than working his way back onto the court for the first time in July 2020, Durant could be close to full health and have a full season under his belt by July 2021.
Kyrie Irving, Durant’s teammate on the Brooklyn Nets, had shoulder surgery in early March. Curry missed most of this season because of a broken hand, and Klay Thompson, his backcourt partner on the Golden State Warriors, has been sidelined all year following an ACL tear. Even Zion Williamson, who returned to the court for the New Orleans Pelicans in January after undergoing minor knee surgery in October, could be in a better position physically to represent his country in 2021.
James, Durant, Irving, Curry, Thompson and Williamson would put USAB halfway to a full-fledged Dream Team. Throw in Paul George, James Harden, Damian Lillard, Jimmy Butler, Jayson Tatum and Bam Adebayo, all of whom were included in USAB’s 44-man player pool in February, and world domination starts to feel like a foregone conclusion.
The central dilemma for Colangelo, though, is this: While the Tokyo Olympics were officially rescheduled for July 23 to Aug. 8 2021 on Monday, the NBA hasn’t decided when or whether it will resume the 2019-20 season. How and when, exactly, the NBA picks up its action will determine whether USAB can count on its top talent for Tokyo.
Imagine if the NBA resumes play in June or July, which would push the 2020 Finals to August or September. That could delay the start of the 2020-21 season and, in turn, push back the end of the 2021 playoffs. That could create a direct conflict with the Olympics. Potential headliners such as James, Durant and Curry might still be chasing the Larry O’Brien Trophy when USAB would need to begin its Olympic preparations. In this scenario, USAB might be able to scrounge up a roster of players from lottery teams.
From USAB’s perspective, the cleanest scenario would be this: The NBA doesn’t resume play this summer, the 2020-21 season starts as planned in October and ends as planned in late June. Even then, there would only be a one-month gap between the end of the Finals and the start of the Olympics. In a normal year, that tight turnaround might turn off some veterans, especially those who are coming off deep playoff runs. Obviously, this is no normal year. Who would blame on-the-fence players for staying home given the accumulated psychological toll of the coronavirus?
Even before this recent turn of events, USAB was consumed by recruiting problems. A-list stars skipped the World Cup process entirely, and a long list of B-listers withdrew as the competition grew closer. International competition requires top-level, highly paid players to give up a month of their summers, assume extra injury risk, work around their NBA commitments and contract negotiations, and compete in an unforgiving, gold-or-bust environment.
Now USAB must add schedule conflicts and concerns about international travel, among other virus-related topics, to its long list of hurdles.


As Olympics concerns mount amid spreading coronavirus, IOC says ‘the Games will go ahead’

What do you want in an Olympics newsletter? Take our 30-second survey. Simon Denyer contributed from Tokyo. Read more Dustin Johnson will skip Tokyo Olympics, boosting Tiger Woods’s chances Pita Taufatofua, the shirtless Tongan flag-bearer, qualifies for third straight Olympics Shaun White won’t compete in skateboarding at the Tokyo Olympics this summer Simone Biles blasts USA Gymnastics’ settlement proposal; Aly Raisman assails ‘massive cover up’

What do you want in an Olympics newsletter? Take our 30-second survey.
The International Olympic Committee stridently doubled down on its stance that the coronavirus will not affect the 2020 Tokyo Olympics, even after a Japanese official raised the possibility of a postponement during a government hearing.
The IOC Executive Board, holding a scheduled meeting at its headquarters in Lausanne, Switzerland, released a statement Tuesday expressing “full commitment to the success” of the Tokyo Olympics taking place from July 24 to Aug. 9 as originally planned. An IOC spokesman later said the organization has not even discussed contingency plans and vowed the Games would begin July 24 despite the global spread of, and unease regarding, the coronavirus.
“The IOC remains fully committed to the success of the Olympic Games #Tokyo2020,” IOC President Thomas Bach said, through the IOC’s Twitter feed. “I encourage all athletes to prepare for the Games with 'full steam.’ ”
The IOC said it intends to follow advice from the World Health Organization and encouraged athletes to continue training for the Olympics as planned. A suspension or cancellation would be massively disruptive for athletes, many of whom design training schedules years in advance to peak for the Olympics.
On Tuesday in Japan, the country’s Olympics minister said its contract with the IOC would allow it to suspend the Games.
“The contract calls for the Games to be held within 2020. That could be interpreted as allowing a postponement,” Seiko Hashimoto said in response to a lawmaker’s question in parliament, Reuters reported.
Still, at a news conference Tuesday evening in Lausanne, IOC spokesman Mark Adams dismissed the possibility of the coronavirus affecting the scheduled start of the Olympics, a remarkable show of confidence given the uncertainty surrounding the disease, for which there currently is no vaccine.
“For us, the Games are going ahead on the 24th of July, and we confidently expect to deliver them on that date,” Adams said. “All the advice we’ve been given is that that can go ahead, from the WHO and other organizations that are competent.”
“You can ask your question many, many ways,” Adams added later. “But the conclusion from us is the Games are going ahead. The Games will go ahead. We’re confident they will go ahead and we’re confident they will start on the 24th of July. All the rest is speculation.”
Adams cited the lack of an international travel ban and the WHO having yet to declare a pandemic as reasons for Bach’s certitude. Adams said he wanted to avoid “mass speculation” and “fevered imaginations” by relying on experts, primarily the WHO.
Asked whether the IOC had a deadline about whether to postpone or cancel the Olympics, Adams insisted there was no need.
“We’ve made a decision,” Adams said. “The decision is: The Games go ahead. That was made some time ago. We see no reason to change that decision. All the advice we have at the moment is, the Games are going ahead, from all the competent authorities.”
Speculation about the fate of the Games, even five months away from their start, has grown as the coronavirus has spread. Canadian IOC member Dick Pound said in an interview with the Associated Press last week that the IOC would have until late May, about two months before the start of the Games, to decide whether to cancel them. He said moving them would present too many logistical challenges. The IOC quickly asserted Pound’s comments did not reflect its stance.
Postponing would raise many issues, the thorniest of them coming from financial considerations. The IOC receives the majority of its revenue from its television rights contract with NBC, which would not want to pit Olympic broadcasts against NFL programming in the fall.
In interviews last week, multiple health experts said it is too early to know how the coronavirus could affect the Olympics, in part because so little is known about the disease and when possible vaccines or medication will become available. But they cautioned against the IOC’s insistence that everything will be fine.
“They should let people know that we are currently in the midst of a pandemic, and social distancing is a significant public response element of pandemics,” said University of Nebraska professor Ali Khan, formerly the director of the Office of Public Health Preparedness and Response at the Centers for Disease Control and Prevention. “We should expect that we will have to factor that into the Olympics.
“I do not like the message that the risk is low and there’s nothing to worry about and things will be fine. I think they should engage their community to say that there’s a possibility if this epidemic is not in check, we will need to make adjustments and cancel the event. That’s what I would want to hear: If they have to cancel the Olympics, what are they going to do?”
Olympic organizers have said the coronavirus could alter the torch relay, a tradition in which an Olympic flame is carried around the world in advance of the Opening Ceremonies, beginning in Athens. Greek Olympic officials said the lighting will go forward next week as scheduled, according to the Associated Press. Greece has seen seven cases of the coronavirus, all among people who recently traveled to Italy.
The coronavirus has already wreaked havoc on international qualifying events. Last week, the International Triathlon Union announced that its qualifying would be moved from China to Spain. On Friday, FINA announced the women’s water polo qualification tournament, hosted in Trieste, Italy, would be delayed from March 8 to May 17. On April 20, it will decide if Trieste can still host the event or if needs to be moved. Baseball’s qualifying tournament, scheduled to be held in Taipei, was pushed from April to July, the sport’s governing body announced Monday.
Adams acknowledged those challenges and said the IOC would need to be “flexible” to accommodate qualification, but he expressed confidence the events will take place in time.
The Olympic men’s soccer qualifying tournament for Concacaf, a federation made up of North American and Central American countries, is scheduled to begin March 20 in Guadalajara, Mexico. It remains on schedule.
“At Concacaf we are closely following the Center for Disease Control and Prevention guidelines in the United States, and monitoring public health developments across the entire region,” Concacaf spokesman Nicholas Noble said in a statement. “Based on the information available to us at this time, we are working on our upcoming tournaments going ahead as planned. We are in ongoing discussions with our member football associations, clubs and other stakeholders in all the countries we operate and will of course follow any new guidance provided by local authorities or relevant government departments.”
An Alpine skiing test event for the 2022 Beijing Winter Olympics has also been canceled.
Simon Denyer contributed from Tokyo.
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Tokyo Games postponement appears inevitable as countries grow impatient with IOC

Postponement of the Tokyo Olympics appeared increasingly inevitable Monday as a growing number of countries signaled their athletes would not participate if the Games were held as scheduled this summer, the United States advocated for a delay and Japanese officials conceded for the first time that one was possible.
A whirlwind 24-hour period started Sunday with International Olympic Committee President Thomas Bach issuing a letter to Olympic athletes, saying the IOC was considering delaying the Summer Games because of the novel coronavirus pandemic. Since 1896, the Summer Olympics have taken place every four years except for 1916, 1940 and 1944, when they were canceled because of world wars. Bach said a cancellation had been ruled out and that the IOC would consider different scenarios and make a final decision within the next four weeks.
That long timetable led Canada to call for a postponement Sunday night and say it would not send any athletes to Tokyo if the Games began as scheduled July 24. Australia and Germany followed with similar announcements Monday, and other countries, such as the United States, Britain, Brazil, Norway and Slovenia, either urged a postponement or said conditions must improve if they're to participate.
On Monday night, the United States' Olympic governing body issued its strongest statement to date, a gentle vote for postponement. In a joint statement, U.S. Olympic and Paralympic Committee chair Susanne Lyons and USOPC CEO Sarah Hirshland said that after polling 1,780 athletes, the USOPC had reached the conclusion that postponement was the best option.
The USOPC said 68 percent of the athletes it surveyed did not think the Games could be fairly competed this summer, and 65 percent said their training has been severely impacted by the coronavirus pandemic.
"Even if the current significant health concerns could be alleviated by late summer, the enormous disruptions to the training environment, doping controls and qualification process can't be overcome in a satisfactory manner," Lyons and Hirshland said in the statement. "To that end, it's more clear than ever that the path toward postponement is the most promising, and we encourage the IOC to take all needed steps to ensure the Games can be conducted under safe and fair conditions for all competitors."
Earlier Monday, Dick Pound, the longest-serving IOC board member, told USA Today that "postponement has been decided," but the IOC has given no indication that a delay was certain. In a request to comment on Pound's assertion, an IOC spokesman said, "It is the right of every IOC Member to interpret the decision of the IOC [executive board] which was announced yesterday."
Pound is one of 100 IOC members, having joined the committee in 1978. He is not one of the 15 members of the IOC's powerful executive board, which plays a pivotal role in all important Olympic matters.
Aruban IOC executive board member Nicole Hoevertsz said in an email Monday afternoon that the board "discussed and took a decision about" postponement Sunday, signaling the IOC had not changed its stance. She then pointed to the portion of the IOC's official statement that said it would start discussions about postponement scenarios and was confident those discussions would be completed within four weeks. A postponement of any length would involve many complexities, with global and local ramifications on athletes and residents, sponsors and television networks.
Pound did not return messages Monday. He did speak to the Canadian Press, striking a less-definitive tone.
"You're looking at a postponement," Pound said. "I think that's out there now. . . . We're all reading the tea leaves and so on, but the Japanese themselves are talking about postponing. A lot of national Olympic committees and countries are calling for a postponement."
Until Monday, Japan had insisted that the Games must go ahead as scheduled, although Prime Minister Shinzo Abe said last week that the priority must be to hold the Olympics in a “complete manner.” On Monday, he told parliament this might mean the dates would have to change.
“If that is difficult, we would have no choice but to decide to postpone, with athletes as the first priority,” Abe said, underlining that an outright cancellation is not an option.
Later Monday, Tokyo 2020 Organizing Committee President Yoshiro Mori acknowledged it was time to consider alternatives.
“What we are going to do before anything else is to start by simulating about whether we postpone one month, three months, five months, one year,” Mori said. “We need to make a simulation about the various scenarios.”
Japan Olympics Minister Seiko Hashimoto said she was “glad to hear” that the IOC was not considering canceling the Games, and Mori said the IOC and Japan would like to “closely examine” the various scenarios.
For athletes, ambiguity regarding postponement has led to frustration. They have continued to train as facilities have shuttered and governments have imposed restrictions. Over the weekend, USA Swimming and USA Track and Field called for the Games to be postponed, with USA Swimming specifically asking for a delay until 2021. Both federations cited protecting athletes’ physical and mental health. USA Gymnastics joined them Monday after polling athletes over the weekend. Sebastian Coe, head of World Athletics, the international governing body for track and field, responded to Bach’s letter Sunday by writing to him and saying the current schedule is “neither feasible nor desirable.”
Germany on Monday became the latest country to announce that it would not send athletes to Tokyo this summer. Michael Schirp, a spokesman for the German team, said about 200 German athletes participated in a teleconference Saturday evening with the country’s top Olympic officials to voice their concerns. They were given a survey to complete, gauging their willingness to compete this summer. Their feelings were supposed to guide the German response, Schirp said, but after the IOC said a decision could take another four weeks, Alfons Hörmann, head of Germany’s Olympic committee, decided he had to act sooner.
Britain subsequently joined the chorus.
“If the virus continues as predicted by the Government, I don’t think there is any way we can send a team,” British Olympic Association chair Hugh Robertson told Sky Sports.
Beyond determining what is feasible from a public health standpoint, postponement would be an enormously complicated undertaking.
For each scenario, organizers would have to work out whether they could still secure the Olympic venues for all 33 sports, as well as for the Paralympics, and what the costs would be. There are also doubts about the availability of some sites, including the Olympic Village, where hundreds of apartments have been sold by a consortium of real estate developers for occupancy after the Games had been scheduled to conclude Aug. 9, and the planned media headquarters at Tokyo Big Sight, a tightly booked conference center.
“We have to go through each of them one by one,” Mori said. “Considering just these things alone would take an enormous time.”
Mori hinted that organizers would prefer to keep the Olympics within this calendar year when he said, “We are 2020, so that is the direction for now.”
For athletes, the length of a delay would alter drastically who is able to qualify or excel, with wide varieties depending on the sport. A long delay could mean some aging veterans miss the chance at a final Olympics. Some athletes, particularly female gymnasts, have small windows during which they are the best in the world and might prefer to compete closer to the time at which they had been preparing to peak.
NBC executives also have been in conversation with Olympic officials, and their wishes carry weight. More than 70 percent of the IOC’s nearly $6 billion from the current four-year Olympic cycle comes from TV revenue. Of that, NBC and parent company Comcast pay around half of it.
One former NBC executive believed the company would be satisfied with postponing the Games exactly a year. A shorter postponement — into the fall of this year, for instance, would force the Olympics to compete with football and a number of other events that already have been pushed from this spring, such as the Masters golf tournament.
For now, organizers say they will push ahead with the torch relay, which is set to start Thursday in Fukushima in northeastern Japan and is meant to symbolize Japan’s recovery from a 2011 tsunami and nuclear accident in the area. Mori said the prime minister was unsure whether he would attend the start of the relay — the government wanted to discourage crowds forming — although Mori said he himself would attend.
Mori acknowledged the relay route may need to be modified and said organizers were studying how it should be held given the fast-changing situation with the virus.
Tens of thousands flocked to a stadium in Sendai north of Tokyo to see the Olympic flame burning in a cauldron over the weekend after it arrived from Greece.
“We had a turnout nearly 10 times that we had estimated,” Tokyo 2020 CEO Toshiro Muto said.
Muto said organizers should be happy with the turnout “in and of itself” but had placed risk as their top priority and had changed arrangements so people simply passed by the flame without a crowd forming.
rick.maese@washpost.com


For Tokyo 2020, the IOC is weighing many factors. Are athletes one of them?

The International Olympic Committee claimed Tuesday that it is “fully committed to the Olympic Games Tokyo 2020, and with more than four months to go before the Games there is no need for any drastic decisions at this stage; and any speculation at this moment would be counterproductive.” On Wednesday, the U.S. Olympic and Paralympic Committee closed its training facilities and sent athletes home, their preparation — like their lives — in complete upheaval.
You know what’s counterproductive? Forcefully claiming that the Olympics will be contested on schedule and unhindered in a world that is in complete and utter crisis. Perhaps, in the near term, that serves Japan, which desperately wants to stage the Games to boost both its economy and its morale. Perhaps it serves NBC, which invested $12 billion to broadcast 10 Winter and Summer Games between 2012 and 2032.
You know who it doesn’t serve? The athletes, on whose backs the Olympics are built but whose thoughts too frequently don’t matter enough. Nor does it serve public health, given the coronavirus pandemic that has parts of the world paralyzed.
The athletes are caught in the middle and have no clear idea how to proceed. Continue a strict and regimented training program designed to peak for qualifiers that might not take place? Or curtail training in hopes of protecting themselves and others — but risk falling behind if, against all odds, the show goes on as scheduled?
“Athletes are in a no-win situation where they are trying to continue to prepare for the Olympic/Paralympic Games, but they are finding it more difficult to do so and will need to take more and more risks in order to get the appropriate training,” Han Xiao, a table tennis player who serves as the chair of the USOPC’s Athletes’ Advisory Council, wrote in an email to The Washington Post. “They will eventually be endangering both themselves and the public in order to prepare to compete, and it will not be their fault.”
Xiao said his council does not have an official position on whether the Olympics should be postponed or canceled, but it has heard from athletes across sports. Right now, he said, athletes are against cancellation, which makes sense. These people aren’t just deciding whether to go for a run after work. These runs are their whole lives. Players in the NBA or Major League Baseball will have another season if this one is canceled. An athlete preparing for the Tokyo Games has been building to this point for four years — and more. The idea of cancellation makes the brain hurt and the heart fall.
But Xiao said more athletes are open to the idea of postponement. Internationally, some are calling for it. Their training already has been disrupted. Like the rest of us, they’re concerned for their safety.
They deserve clear and transparent messaging about contingency plans should the Games not be able to start as scheduled July 24.
“I would like to encourage all the athletes to continue their preparation for the Olympic Games Tokyo 2020 with great confidence and full steam,” IOC President Thomas Bach said March 3.
Think about how long ago that feels and how much has changed since. Yet the IOC hasn’t backed down from that stance, as absurd as it seems. How is an athlete to train “with great confidence and full steam” in the current environment? Spain and Italy, for instance, are completely shut down. Try finding great confidence and full steam there.
“We want the Olympics to take place, but with security,” Spanish Olympic Committee President Alejandro Blanco said in a statement reported by Reuters. “We’re an important country in the world, and four months before the Games, our athletes can’t arrive in equal conditions.”
That is plain fact, and Spain is not alone. There are so many health concerns when considering whether to stage an Olympics given there will be more than 11,000 athletes and countless officials, fans, media and workers arriving from all over the globe. But if experts deem it safe enough to pull off, it ought to be done as a fair competition, right? That already seems impossible.
“I think the IOC insisting this will move ahead, with such conviction, is insensitive and irresponsible given the state of humanity,” Hayley Wickenheiser, a Canadian hockey player who is a member of the IOC’s Athletes Commission, wrote Tuesday on Twitter. “We don’t know what’s happening in the next 24 hours, let alone the next three months.”
The head of the French swimming federation, a pharmacist named Gilles Sezionale who is working on the coronavirus impact in his country, was blown away by the IOC’s tone-deafness this week.
“I can’t explain it,” he said in an interview with the newspaper Le Parisien. “What they write is indecent. It’s shocking.”
Even in their steadfastness, the IOC must be working through alternatives and scenarios. To not do so would be irresponsible. The athletes deserve to be included in that discussion. Short of that, they should at minimum be informed of it. How will officials make a decision? When will officials make a decision?
“Although it’s not correct to speculate, the message that we are going full-steam ahead is speculation,” Xiao wrote in his email. “We still have no information about when the decision will be made whether to postpone, and how the IOC will make that decision.
“What conditions need to be met, for example, for the Games to proceed? This is the type of information that we would like in order to have certainty that athletes and the general public will be appropriately protected.”
That’s exactly right. If, in fact, the IOC is being guided by health experts the world over, then they should share the specifics that are driving their decision-making processes. According to the World Health Organization, Japan had 873 confirmed coronavirus cases as of Wednesday. Does the IOC have information that would lead it to believe that number will be, say, zero by July 24? What about the travelers — athletes, sponsors, fans, all of them — coming from countries, including the United States, where the worst is yet to come?
About the United States: The USOPC is holding a board meeting via video conference Wednesday and Thursday. It is approaching the first Olympics under the leadership of new CEO Sarah Hirshland. Will Hirshland do what her predecessor, Scott Blackmun, failed to do in spectacular fashion: protect athletes’ safety and well-being above all else?
On Wednesday, the IOC said Bach held a conference call with more than 200 athletes from around the world.
“We will keep acting in a responsible way in the interest of the athletes,” Bach told an in-house IOC interviewer afterward.
Will they? The athletes are certainly wondering.
“The decisions the IOC is making and the way they communicate those decisions is not just affecting people four months in the future,” Xiao wrote in his email. “It is impacting them right now.”
Becoming an Olympian is, at some level, built on hopes and dreams. But staging a safe Olympics must be based on facts and figures that are clearly communicated. There is no room for bravado. The Games may be months off. The decision to deal with a delay that feels inevitable should be made right now.