Maryland health officials said their first case was reported to them September 21.

State and national health authorities are raising the alarm about a polio-like "mystery illness" that has left dozens of children with paralysis and other symptoms in MA and 21 other states.

More than 120 confirmed or possible cases are under investigation nationwide, according to the CDC. Another spike came in 2016. There has been one AFM-related death, which happened in 2017. The U.S. has had 386 confirmed cases since August 2014. Officials said it's too early to know whether the total for 2018 will surpass those previous years.

"This is actually a pretty dramatic disease", Messonnier told reporters on Tuesday.

More broadly, she noted, "there is a lot we don't know about AFM". Specifically, the disease affects the area of the spinal cord called gray matter. The CDC still has not pin-pointed exactly what's causing this disorder, but they suspect a virus that circulates this time of the year.

The CDC is actively investigating the cases and working with healthcare providers as well as state and local health departments to spread the word about AFM.

States are reporting their cases to the CDC, Messonnier said. There was one confirmed death past year, the CDC said on Tuesday.

In 2014, a large AFM epidemic coincided with a national outbreak of severe respiratory illness caused by enterovirus D68 (EV-D68), but in-depth testing of patient samples hasn't consistently found a common cause.

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The symptoms are very similar to polio, or poliomyelitis, an infectious disease caused by a virus. Messonnier said West Nile virus, which had been listed as a possible cause on the CDC's website, is not causing the illnesses. Those officials are probing another 65 illnesses in those states.

Of the 127 cases, about 90 percent are people under the age of 18, Reuters reported.

Officials said they will be conducting additional analysis on this year's cases.

"Any weakness, including trouble swallowing, weakness of an extremity, especially in a child who has recently gone through signs of an infection, those would be the main red flags", said Sarah Hopkins.

The CDC has tested many different specimens from patients with this condition for a wide variety of pathogens, or germs, that can cause AFM.

That's up from 22 people who were said to have it in 2015. But, if their child is diagnosed, parents should prepare for extensive physical therapy - therapy that isn't always covered by insurance, he said. It could be potentially deadly if the diaphragm is paralyzed because the child would be unable to breathe.

On Monday, CNN reached out to health departments in every state and received responses from 48 states plus the District of Columbia.

Dana Hedgpeth and Justin Wm.