News of a mysterious illness called acute flaccid myelitis, or AFM, has been prominent in recent months. The U.S. Centers for Disease Control and Prevention has been tracking cases since 2014, and this year had received reports of at least 252 cases and confirmed 90 by mid-November, mainly in children ages 2-8. The illness generally begins with cold- or flu-like symptoms, but some children suffer sudden paralysis within three to 10 days. About half of children recover fully, while others suffer permanent disabilities.
AFM is still rare. CDC estimates that one or two children in a million in the U.S. will get AFM each year. Pediatric neurologist Emmanuelle Tiongson, M.D., from Children’s Hospital Los Angeles, offers information and perspective. She also recommends the CDC website cdc.gov/acute-flaccid-myelitis as a good source for updates.
Have we had confirmed cases of AFM in California?
Yes. One case we were investigating here at CHLA has been confirmed.
What are the prevailing theories about what causes AFM?
The current theory is that it is a type of enterovirus. We think the virus is going into the spinal cord and causing damage to the neurons that control movement, and that’s what’s causing the paralysis.
Do we have an idea of how contagious this is?
We’ve seen here at our hospital and at other hospitals that you’ll have an entire family sick with something, and then just one kid is affected by AFM. So, we think there is a virus that could be contagious, but that certain people are more susceptible than others to getting the complications.
What early symptoms of AFM might a parent be able to notice at home?
If there’s a stiff neck, or if there’s pain in the muscles or in the body and the child is not acting like he or she usually is, that’s something that should be seen in the hospital.
What are you doing to treat patients suspected of having AFM?
At CHLA we give what we call intravenous immune globulin, or IVIG, when we suspect something immune or something infectious is going on with the spinal cord, to try to boost the patient’s immune system to fight it off.
Can early treatment prevent some of the worst outcomes or complications?
That’s what we’re hoping. The earlier we get to the patient, the better, to prevent complications and possibly further permanent damage. But we haven’t confirmed that this is the case in all patients.
What is your advice for parents who have heard about AFM and are afraid?
To put it in perspective, it’s still a relatively rare condition. While it is very scary and there’s not a lot we can do right now, it’s not as contagious as the common cold or the flu, even though it’s caused by a virus that can look like either of these. I think that being vigilant in practicing good hygiene, staying healthy and getting all the vaccinations is the best that parents can do to prevent infection in general. It’s not a widespread epidemic, and a lot of doctors, researchers and the CDC are working on figuring this all out and hopefully coming up with more information soon.