Rarest of the rare

Acute flaccid myelitis (AFM) remains an extremely rare condition despite a recent uptick in national confirmed cases. And some of the best preventive techniques for it are the same we should all be doing every day to prevent colds and flu such as practicing good hand hygiene.

According to the Centers for Disease Control and Prevention, acute flaccid myelitis (AFM) is a condition that affects the nervous system, specifically the spinal cord. The CDC states there have been 62 confirmed cases in 22 different states in 2018 as of October 16.

The CDC reports that the condition increase in prevalence beginning in 2014, when there were 121 confirmed cases. In 2014, 2016 and 2018, seasonal spikes in the illness were more significant than in 2015 and 2017. Health officials said it can occur as a result of a variety of viruses including enteroviruses, West Nile virus and adenoviruses. The CDC has found no clear cause for many of the cases and the investigation about the cause is still  ongoing. The cause is being investigated to try to understand if the disease is caused by an immune response to a viral infection (how the body responds to try to fight the viral infection) or an actual viral invasion of the spinal cord and neural tissue.

These viruses are common illnesses and usually affect children with no long lasting effects. It is unknown why a common illness can lead to the inflammation seen in AFM.

So what are the symptoms? AFM mostly starts with a sudden onset of limb weakness and loss of muscle tone and reflexes. Almost 90 percent of cases are reported in children. Some patients also may see the following:

  • Facial droop/weakness
  • Difficulty moving the eyes
  • Drooping eyelids
  • Slurred speech or difficulty swallowing

A doctor can tell the difference between AFM and other diseases with a careful examination of the nervous system by looking at the location of the weakness, muscle tone and reflexes. There is no specific treatment for acute flaccid myelitis, but a doctor who specializes in treating brain and spinal cord illnesses (neurologist) may recommend certain interventions on a case-by-case basis, according to the CDC.

The main forms of prevention are the same as many other conditions, both rare and common.

  • Washing hands often with soap and water (especially before and after eating)
  • Avoiding close contact with sick people
  • Cleaning surfaces with a disinfectant—especially those that a sick person has touched

In addition, make sure all vaccinations are current so the child is not susceptible to a preventable infections like influenza. This helps the body stay healthy and be better able to respond to non-vaccine preventable illnesses.

Robin LaCroix, MD, is medical director of Prisma Health Children’s Hospital and a pediatric infectious disease physician.

Last updated 10/2018
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