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PITTSBURGH (KDKA) — Nearly 200 cases of Acute Flaccid Myelitis were confirmed in the United States in 2018.

As of Dec. 28, the Centers for Disease Control said there were 186 confirmed cases in 38 states.

Of those 186 cases, nine were in Pennsylvania.

As of Nov. 19, there were six confirmed cases of AFM in the Pittsburgh area. Five of those patients are Allegheny County residents. The sixth patient is a Washington County resident.

There were also three suspected cases of AFM in the area. Those patients were from Allegheny, Beaver and Westmoreland counties.

Officials have not been able to find a connection between the cases.

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Acute Flaccid Myelitis is a rare disease that affects a person’s spinal cord and nervous system. Experts have no idea what causes it, but they know it comes from one of the more than 100 enteroviruses. There is no known cure or vaccine.

Doctors say the first sign of AFM in a child is usually weakness of one or both arms or legs.