State and federal health officials confirmed Florida’s first case of Acute Flaccid Myelitis in 2018 on Saturday, adding to what has become a record year of cases for the rare but serious polio-like illness that affects the nervous system, reports the Miami Herald.

AFM is not a new condition. But it is a disease without a known cause that has spiked in cases reported since 2014, when the Centers for Disease Control and Prevention first started surveillance of the illness. The CDC has seen increases in AFM cases every two years since 2014 and mostly in young children.

As of Dec. 14, the CDC had reported 165 confirmed cases of AFM in 36 states in 2018. All but five cases have been in children younger than 18. Florida’s first case of the year reported on Saturday adds to the nationwide count.

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