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Health Experts Warn of Rise in Acute Flaccid Myelitis Cases This Fall

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  • Acute Flaccid Myelitis is characterized by weakness or limpness of arms and legs, facial drooping and difficulty breathing, swallowing and speaking.
  • Though it's exceedingly rare, AFM is a serious, sometimes life-threatening condition in children.
  • Current research indicates that AFM is not caused by or related to COVID-19.

In August, a Centers for Disease Control and Prevention (CDC) press briefing put parents and healthcare workers on high alert, warning of a resurgence in cases of Acute Flaccid Myelitis (AFM), a rare neurological disease that mostly affects children. Though uncommon, this serious disease tends to peak every two years, with 2018 being the last year doctors saw an increased number of cases.

According to a CDC press release: “When health care providers recognize symptoms as soon as possible, there is a better chance of detecting the cause of AFM, which might help predict the outcome.”

Symptoms of Acute Flaccid Myelitis

Acute Flaccid Myelitis is a disease that affects the gray matter in the spinal cord, causing muscle weakness and a loss of tendon reflexes, says Leann Poston, MD, M.Ed., a physician and contributor for Invigor Medical. “Other symptoms parents should be on the lookout for include recent history of respiratory or gastrointestinal illness, sudden onset of muscle weakness in one or more limbs, pain, facial muscle weakness, difficulty breathing, swallowing or speaking, and difficulty controlling the bowel or bladder.”

Leann Poston, MD

Other symptoms parents should be on the lookout for include recent history of respiratory or gastrointestinal illness, sudden onset of muscle weakness in one or more limbs, pain, facial muscle weakness, difficulty breathing, swallowing or speaking, and difficulty controlling the bowel or bladder.

— Leann Poston, MD

While AFM is a rare disease (CDC reports indicate there were just 238 cases countrywide during the 2018 peak), it can be life-threatening and should be treated as a medical emergency. Parents who notice the above symptoms in their child should seek emergency care. According to Poston, “AFM is a medical emergency because it can cause respiratory symptoms that require support for breathing.”

Is AFM Caused by COVID-19?

If there’s a bit of good news in all this, it’s that Acute Flaccid Myelitis isn’t caused by COVID-19. Unlike MIS-C, a rare inflammatory disease that’s been linked to cases of COVID-19 in children, AFM is most likely caused by an enterovirus rather than a coronavirus, which includes COVID-19. "If social distancing measures decrease circulation of enteroviruses this year, AFM cases may be fewer than expected or the outbreak may be delayed," the press release stated.

What’s more, says Poston, the best practices recommended for the prevention of COVID-19—washing your hands, wearing a mask, maintaining social distancing, and avoiding people who are ill—will help prevent the spread of enteroviruses, which should make this year’s number of cases of AFM even smaller than usual.”

Act Fast for Better Outcome

While it’s likely that COVID-19 doesn’t lead to AFM, the pandemic could potentially create another worrisome outcome—parents who avoid seeking treatment for their kids out of fear of contracting COVID-19 at a medical facility. It’s important to remember that although AFM is very rare, complications can be severe and even life-threatening.

Treatment for AFM

Treatment for Acute Flaccid Myelitis can vary based on individual symptoms, according to the CDC. In some cases, improvement can happen with the use of antiviral and/or steroid medication, while other children may require physical rehabilitation in order to recover from limb weakness. In any case, early access to intensive medical treatment typically results in good outcomes for cases of AFM.

What This Means for You

Though rare, Acute Flaccid Myelitis is a disease parents should be vigilant about, since it can quickly become serious. Any muscle or limb weakness, especially following a minor childhood illness like a cold or stomach bug, should be promptly evaluated by a medical professional. That’s especially the case this year, since the virus seems to peak every two years. 

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