Staying Fit
The Centers for Disease Control and Prevention (CDC) is bracing for a potential outbreak of a rare but life-threatening disease in children that typically strikes between August and November, and is warning parents, grandparents, caregivers and clinicians to be on the lookout for its symptoms.
Acute flaccid myelitis, or AFM, attacks the nervous system and can quickly lead to paralysis; some patients even require a ventilator to help them breathe. Cases are expected to spike this year because the virus that most commonly causes AFM — enterovirus D68, or EV-D68 — “tends to come in two-year cycles,” CDC Director Robert Redfield, M.D., explained in a recent call with reporters — and the last outbreak occurred in 2018.
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"This means it will be circulating at the same time as flu and other infectious diseases, including COVID-19, and could be another outbreak for clinicians, parents and children to deal with,” Redfield said.
The warning signs of AFM
The biggest warning sign to pay attention to is weakness in the arms or legs. Often this will follow a fever or other symptoms of respiratory illness. Muscle weakness or “droopiness” in the face may also signal AFM, explains Roberta DeBiasi, M.D., chief of the Infectious Diseases Division at Children's National Hospital in Washington, D.C. The same goes for altered ability to breathe, gait difficulty, and severe back or neck pain.
"That would be an emergency; don't wait three days, just go in and get checked out,” DeBiasi says of AFM symptoms. The CDC stresses that delays in care can put patients at serious risk, “as this condition can progress rapidly to respiratory failure,” Redfield said.
The last outbreak, in 2018, resulted in 238 cases of AFM in 42 states. Most cases were in young children; the average age was 5. More than half of patients were admitted into intensive care, and 23 percent required ventilation or the use of machines to help them breathe, according to the CDC. Some children recover from the disease; however, many are left with a permanent disability. While AFM is often referred to as a “polio-like” condition, the CDC says all patients it has tested since 2014 have come back negative for the poliovirus.
