What we know (and don’t) about acute flaccid myelitis, polio-like illness affecting U.S. children

A rare but serious condition affecting children is causing concern nationwide this fall. Acute flaccid myelitis, abbreviated as AFM, and described as a polio-like illness, has afflicted a confirmed 72 individuals in 24 states so far, according to the Centers for Disease Control and Prevention (CDC).

AFM affects the “Gray Matter” area of the spinal cord that controls motor movement, says Benjamin Ross, M.D., a pediatric neurologist with HCA Healthcare affiliate Rocky Mountain Hospital for Children in Denver, Colorado.

Dr. Ross adds that in general, approximately 90 percent of confirmed cases are pediatric patients.

Here’s what else parents should know:

What symptoms should parents look for?

Its symptoms are likened to those caused by polio, an eradicated disease in the U.S. that could cause life-long paralysis. Parents should look for a new, sudden or unexplained muscle weakness, usually in one or more limbs, such as an arm or a leg. AFM can also affect an individual’s face and speech with symptoms like:

• Facial droop
• Drooping (lazy) eyelids
• Slurred speech, or
• Difficulty swallowing

How many people are affected by AFM each year?

It’s quite rare. Overall, the rate of AFM is less than one in a million in the United States each year. The CDC has confirmed 386 cases of acute flaccid myelitis since the first wave of the condition occurred in 2014. And there appears to be a spike in cases every two years, with 120 confirmed cases in 2014 and 149 in 2016. (There were 22 cases in 2015 and 33 in 2017.)

What don’t we know about AFM?

It remains largely unknown what causes the condition. It has been linked to some common cold viruses, particularly enterovirus (D68), which is essentially a respiratory illness, but the CDC and others are actively conducting research and laboratory testing to find the cause and better understand the condition.

How is it treated?

Although many different therapies have been tried for AFM, there is currently no specific treatment that has proven beneficial. Standard therapy is supportive with aggressive physical therapy to help patients regain movement.

What can parents do to help prevent AFM?

• Since the illness may be linked to certain viruses, general good health and hygiene practices, like handwashing, are recommended.
• Stay current on all vaccinations, specifically polio.
• Use insect repellent to protect against mosquito bites. Viruses like West Nile may play a role in some AFM cases.

Visit here for more information on acute flaccid myelitis.

Benjamin Ross, M.D., is a physician with Rocky Mountain Pediatric Neurology & Sleep Medicine. 

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