Acute Flaccid Myelitis--Should you be concerned?
Reports of children who’ve contracted acute flaccid myelitis (AFM) have been in the news lately. According to the Centers for Disease Control (CDC), the illness, which is a rare but serious condition, affects the nervous system – in particular, the area of spinal cord called gray matter. Symptoms include sudden onset of muscle weakness, with loss of muscle tone and reflexes, resulting in:
- Extremity weakness/paralysis (ranging from affecting 1 extremity to affecting all 4 extremities),
- Respiratory weakness,
- Difficulty controlling the bowel and bladder,
- Drooping eyelids, or
- Difficulty with swallowing or slurred speech due to facial weakness.
AFM is likely started by a viral infection. It is not new, but the rise in the number of cases since 2014 is new. Still, the CDC estimates that only one in a million people in the U.S. will contract the disease.
Prevention
The best way to prevent any viral infection is to practice standard precautions: Good hand-washing, avoiding those who are ill, and staying home if you are ill. Parents should make sure their children get a flu vaccine, said Josh Schaffzin, MD, PhD, director, Infection Prevention.
Nearly all children with cold symptoms will get better on their own and can be cared for at home without seeing a medical provider or going to an emergency room. Children who do not improve after seven to 10 days, get better and then worse, or who develop new symptoms, including muscle weakness, should prompt a call to a medical provider to decide whether they need to be seen. If there is concern for muscle paralysis, the patient should be evaluated urgently.
AFM in our area
Cincinnati Children’s role with acute flaccid myelitis (AFM) and any reportable condition is to identify possible cases and notify public health officials in the counties where the patients live. Public health’s role is to investigate our reports and determine which cases are “confirmed.”
“For this reason, it would be inappropriate for Cincinnati Children’s to label any case as confirmed or not, and we would defer to public health authorities for that information,” said Schaffzin. “We’ve reported a small number of patients with symptoms to public health authorities. Because of patient confidentiality, we cannot say what county or state these patients reside in.”
For more information about AFM, visit https://www.cdc.gov/acute-flaccid-myelitis/about-afm.html.
If you suspect one of your patients has AFM, please arrange for a consultation with Neurology.
