It’s important to monitor symptoms in children
Acute flaccid myelitis is a rare polio-like neurologic condition that typically affects children.
Since it was first recognized in 2014, there has been an increase in the number of cases in even-numbered years, which could mean higher case numbers expected in 2020.
The peak typically occurs in late July to early August but can continue through the late fall.
As of July 31, there had been 16 confirmed cases of AFM in the United States. None of these children have been in Delaware, but neighboring states have had cases reported. Since the Centers for Disease Control and Prevention started tracking AFM in 2014, there have been 633 confirmed cases nationwide.
The CDC recently sent out an alert on AFM due to the expectation of higher numbers of cases this year. With COVID-19 still causing illness and hospitalization, there is a concern that parents may delay taking their children to the doctor’s office or hospital. It is extremely important to recognize possible symptoms of AFM so children can be evaluated and treated as rapidly as possible.
AFM is believed to be caused by specific strains of a virus, most commonly Enterovirus D68 and Enterovirus A71. Another virus, Coxsackievirus A16, has been reported in one case of AFM. Strains of enterovirus and coxsackievirus are very common, and tend to cause respiratory and gastrointestinal symptoms, but only a very small number of those infected will develop AFM.
Children are more likely to develop symptoms than adults.
AFM is a serious illness that can lead to lifelong paralysis and even death, especially if there is a delay in diagnosis and treatment. Usually, patients develop respiratory symptoms and/or a fever about one week before developing weakness, sometimes associated with pain.
The weakness may be seen in a child as difficulty raising the arms or rising from the floor or a seated position. It is important to seek medical care if you or your child develop muscle weakness, drooping of the face or eyelids, difficulty moving the eyes, or trouble speaking or swallowing. Your doctor may note decreased reflexes in the legs and arms. The ability to breathe can be affected by AFM, and 25 percent of patients need to be placed on a ventilator to support breathing as they recover.
At this time, there is no cure for AFM, but symptoms can be relieved with use of a medication called IVIg which is administered in the hospital. Many children do recover fully or have minor residual symptoms. Rarely, some can continue to have severe lifelong disability.
The same precautions to avoid COVID-19 also help prevent AFM, including washing hands often with soap and water, avoiding close contact with those who are ill, and avoiding touching your face. Cleaning and disinfecting frequently touched surfaces, including toys, tables and doorknobs, can help decrease the spread of viral infections.
Talk to your family and children about AFM, and make sure any limb weakness is reported immediately so you can take action and seek treatment. For more information, go to cdc.gov.
