Rare Childhood Illness on the Rise: What You Need to Know About Acute Flaccid Myelitis

. January 15, 2019.
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AFM (Acute flaccid myelitis), a polio-like illness, has been in the news a lot lately, especially since confirmed cases were recently reported in Lucas and Wayne Counties. The condition is not new, but the large numbers of AFM cases which have been documented since 2014 when the Centers for Disease Control began surveillance are surprising.

Even so, it’s estimated that less than one to two in a million children in the United States will contract AFM every year. So exactly what is the condition and how can you protect your family from contracting it?

Defining AFM

“AFM can develop as a result of viral infections, including enterovirus and West Nile, as well as environmental toxins,” explains Shannon Lands, Director of Health Promotion and Policy Integration with the Toledo-Lucas County Health Department. “Fortunately, AFM is not contagious and cannot be transmitted from person to person.”

In the past four years, more than 90% of AFM patients had a mild respiratory illness or fever consistent with a viral infection prior to developing the condition. All of the patients tested negative for poliovirus, so the Center for Disease Control is working alongside experts in the field to better understand the possible causes of AFM.

The CDC has seen increases in the disease every two years since 2014, mostly in young children. Most of the AFM cases occurred in late summer and early fall, and the majority of the patients had symptoms of a preceding viral illness, including respiratory symptoms or diarrhea.

Signs and symptoms

On the onset, most people will initially experience weakness in the arms or legs. Loss of muscle tone and reflexes is also common. In addition, some people have a facial droop or weakness, difficulty moving the eyes, drooping eyelids, difficulty swallowing, or slurred speech. Numbness or tingling is not as common, but some people have leg and arm pain. The most severe symptom of AFM is respiratory failure which requires immediate ventilator support.

Ms. Lands urges, “If parents see potential symptoms of AFM in their child, they should contact their clinician as soon as possible.”

While AFM can be difficult to diagnose because it mimics many of the symptoms of other neurological diseases like transverse myelitis and Guillain-Barre syndrome, with the help of testing and examinations, doctors can make a distinction between AFM and other diseases.

Prognosis and treatment

“There is no specific treatment for AFM,” Ms. Lands says. “A doctor who specializes in treating brain and spinal cord illnesses may recommend interventions on a case-by-case basis. For example, neurologists may recommend physical therapy or occupational therapy to help with arm or leg weakness.” While some patients make a full recovery, most have continued muscle weakness, even a year after the initial diagnosis.

The CDC understands that parents who have a child with AFM are in the best position to be their advocate. They encourage parents to talk with their doctor about any discomfort their child is having and ask questions about treatment options. Parents can also contact their school system about resources it may have to accommodate the special needs of their child.

Spending time with friends and family is a vital part of health and recovery. Parents should encourage others to spend time with their recuperating child if he/she feels well enough for visitors.

Safeguarding against infection

While poliovirus is an enterovirus, not all enteroviruses cause polio. “Being inoculated with the polio vaccine protects you from poliovirus,” Ms. Lands says. “But it does not protect against other viruses that may cause AFM.”

The Center for Disease Control recommends protecting yourself against bites from mosquitoes (which can carry West Nile virus) by using repellent, staying indoors at dusk and dawn (when bites are more common), and removing standing or stagnant water near your home (where mosquitoes can breed). You can also protect yourself and others from viruses by washing your hands often with soap and water, avoiding close contact with people who are sick, and disinfecting frequently touched surfaces.

Some good news

Respiratory illnesses and fever from viral infections are common, especially in children, and most people recover. Fortunately, in the 80 documented cases the CDC compiled from January 1 through November 2 of this year, none of the patients died, nor did they test positive for the poliovirus. There are still about 250 additional cases under investigation. Once the CDC discovers the cause, which could be a new enterovirus, they can actively work toward creating a vaccination.

It’s important to remember that, as with any illness, an ounce of prevention can go a long way. Above all, the CDC recommends practicing good hygiene as one of the best ways to protect your family from contracting the diseases that may lead to AFM.

Tips to staying healthy

  • Wash hands frequently which limits exposure to germs.
  • Cover your cough or sneeze.
  • Stay home if you are sick or keep your child home if he/she is not feeling well.
  • Stay up-to-date on vaccinations.
  • Stay informed. Go to lucascountyhealth.com for more information about AFM and the Toledo-Lucas County Health Department.
  • Read more about AFM on the Center for Disease Control’s website: cdc.gov/acute-flaccid-myelitis.