ATLANTA, Ga. – The Centers for Disease Control and Prevention (CDC) is warning parents to be on the lookout for symptoms of acute flaccid myelitis (AFM) in children.
The public health agency said Tuesday that it anticipates that 2020 will be another peak year AFM, an uncommon but serious neurologic condition that affects mostly children.
AFM can progress rapidly over the course of hours or days, leading to permanent paralysis and/or the life-threatening complication of respiratory failure in previously healthy patients, so it’s important to seek medical care as soon as possible.
The disease has peaked every two years between August and November in the U.S. since 2014, when the nation experienced the first peak of 120 cases, according to the CDC. There were also peaks in 2016 and 2018.
The third and largest peak of AFM occurred in 2018, with 238 cases in 42 states. Most cases were in children (94%) and most patients (86%) had AFM onset during August through November. Most patients had a fever and/or respiratory illness approximately six days before limb weakness onset. Other common early symptoms were difficulty walking, neck or back pain, fever, and limb pain.
The CDC says parents and doctors should suspect AFM in patients with sudden limb weakness, especially during August through November. Recent respiratory illness or fever and the presence of neck or back pain or any neurologic symptom should heighten their concern.
Experts say enteroviruses, particularly enterovirus-D68 (EV-D68), are likely responsible for these peaks in cases. EV-D68 is the most common virus identified among specimens collected from patients with AFM. However, other viruses can cause AFM and may also be contributing to the biennial peaks.
Although AFM symptoms resemble those of polio, all specimens have tested negative for poliovirus.
There is currently no specific test, proven treatment or prevention method for AFM.
“As we head into these critical next months, CDC is taking necessary steps to help clinicians better recognize signs and symptoms of AFM in children,” said CDC Director Robert Redfield, M.D. “Recognition and early diagnosis are critical. CDC and public health partners have strengthened early disease detection systems, a vital step toward rapid treatment and rehabilitation for children with AFM.”
AFM and COVID-19
The CDC says AFM is a medical emergency and patients should seek immediate medical care, even in areas with high COVID-19 activity.
It’s not known how the COVID-19 pandemic and the social distancing measures may affect the circulation of viruses that can cause AFM, or if COVID-19 will impact the health care system’s ability to promptly recognize and respond to AFM.
There is one bright side. If social distancing measures decrease circulation of enteroviruses this year, AFM cases may be fewer than expected or the outbreak may be delayed.