Following an uneventful respiratory infection, a child develops sudden loss of use of one or more limbs. Some children will have neck pain. In rare instances, difficulty swallowing, urinating, or breathing could be presenting signs and symptoms. An MRI scan demonstrates abnormalities along the spinal cord. Sometimes, nerve conduction studies (nerve response tests) or testing of the fluid around the spinal column is needed for diagnosis.
Since fall 2014, the Centers for Disease Control and Prevention (CDC) have reported almost 400 confirmed cases of AFM (acute flaccid myelitis) in the Unites States. Most of the cases involve children. We do not understand why some children develop the disease and others do not. This year, over 90% of cases have been in children less than 18 years of age. To date, no deaths from AFM have been reported.
What is most concerning is the accelerated numbers of cases in the past few years. Although less thanone in a million people in the United States are diagnosed with AFM each year.
AFM affects the spinal cord which results in weakness of the extremities. Affected patients may have difficulty with control of their arms and legs and require assistance with activities of daily living (eating, walking, weight-bearing, etc.). These children will usually experience respiratory infections prior to developing severe neurological symptoms. It is likely that a virus seen in common respiratory infections may be a cause (in other words, antibiotics can not prevent the infection). The virus shares many similarities the polio virus that was rampant in the 1950’s. Polio
There is evidence that enterovirus may be a contributing factor. A specific sub-type of the virus (EV-D68) seems to have commonality among many sufferers. In the past, other viruses such as adenoviruses (responsible for the common cold among others) and West Nile virus have been responsible.
How do you prevent it? Good hand washing to minimize germ exposure. Stay up to date on vaccines and maintain protection from mosquitos; especially with recent flooding in our state and increased chances of exposure to stagnant water filled with mosquito larvae.
If your child develops sudden weakness of the limbs, it is important they seek medical attention immediately. While approximately half of all cases will see full recovery within four months, many children are left with residual weakness.