AFM: A scary polio-like illness

It is a scary illness, not just for parents but for doctors, too: acute flaccid myelitis (AFM) causes sudden weakness and loss of muscle tone in the arms and legs and can go on to cause even more serious problems.

It’s not just the symptoms that are scary. It’s also scary because we don’t fully know what causes it. Although the symptoms are similar to polio, patients with AFM have tested negative for polio. One culprit may be an enterovirus known as EV-D68. Usually, this causes mild symptoms such as fever, runny nose, cough, and body aches, but in a small number of children, it may lead to AFM. Other viruses such as West Nile virus, or a combination of factors, also may trigger AFM.

What we do (and don’t) know about AFM

We know that AFM is more common in children, and we know that cases spike in summer and fall. We know that the symptoms are like those caused by viruses such as enterovirus, adenovirus, or West Nile virus, but after that, there’s not much we know. Because we have been following this illness only since 2014, we don’t know its long-term effects of it either. Some patients recover quickly and completely, but for others, the weakness doesn’t go away.

AFM symptoms

The symptoms of AFM include:

  • weakness in the arms or legs, or both
  • loss of muscle tone in the arms or legs, or both. This means that not only are the arms or legs weak, they seem looser or floppier than usual.
  • Loss of reflexes
  • In some cases, symptoms can also include
    • weakness of the muscles of the face, which may cause the face to droop
    • trouble moving the eyes
    • weakness of the eyelids, so that they droop
    • pain in arms, legs, neck, or back
    • trouble talking
    • trouble swallowing
    • trouble breathing.

If your child shows any of these symptoms, call your doctor right away.

Treating AFM

Because we don’t know exactly what is causing AFM, we don’t have a definitive treatment. We support patients when they are sick, giving medicines to help their symptoms, and physical therapy and other such treatments that may help with weakness, but there is no medicine we can give to cure or even treat the illness itself.

AFM and public health

Since 2014, there have been about 700 confirmed cases. Getting exact numbers on this illness is hard because there is no clear test for it. The Centers for Disease Control and Prevention (CDC) is concerned that cases will rise this fall, given relaxed guidelines on masks and distancing. The CDC relies on clinical symptoms, lab tests, and MRI (magnetic resonance imaging) of the brain to decide whether someone has AFM. Because not all patients get this testing, and because not all patients get reported to the CDC, it’s likely that the numbers are higher.

What parents need to know

Since we don’t know exactly what causes AFM, it’s hard to tell people how to prevent it. You can prevent polio by being vaccinated, and everyone should be vaccinated. West Nile virus can cause similar symptoms, and avoiding mosquito bites is the best way to prevent that. The best advice we can give now to prevent the viruses that might cause AFM is the simplest: wash your hands, well and often.

Despite all this scary stuff, it’s important to remember that overall this is a rare disease — less than one in a million people get it.

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

2 Corinthians 13:9 For we rejoice when we ourselves are weak but you are strong; this we also pray for, that you be made complete.

Colossians 1:28 We proclaim Him, admonishing every man and teaching every man with all wisdom, so that we may present every man complete in Christ.

Colossians 4:12 Epaphras, who is one of your number, a bondslave of Jesus Christ, sends you his greetings, always laboring earnestly for you in his prayers, that you may stand perfect and fully assured in all the will of God.

2 Corinthians 10:15-16 not boasting beyond our measure, that is, in other men’s labors, but with the hope that as your faith grows, we will be, within our sphere, enlarged even more by you, so as to preach the gospel even to the regions beyond you, and not to boast in what has been accomplished in the sphere of another.

2 Thessalonians 1:3 We ought always to give thanks to God for you, brethren, as is only fitting, because your faith is greatly enlarged, and the love of each one of you toward one another grows ever greater;

2 Peter 3:18 but grow in the grace and knowledge of our Lord and Savior Jesus Christ To Him be the glory, both now and to the day of eternity. Amen.

Ephesians 1:17-18 that the God of our Lord Jesus Christ, the Father of glory, may give to you a spirit of wisdom and of revelation in the knowledge of Him. I pray that the eyes of your heart may be enlightened so that you will know what is the hope of His calling, what are the riches of the glory of His inheritance in the saints,

Ephesians 3:16-19 that He would grant you, according to the riches of His glory, to be strengthened with power through His Spirit in the inner man, so that Christ may dwell in your hearts through faith; and that you, being rooted and grounded in love, may be able to comprehend with all the saints what is the breadth and length and height and depth, read more

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