Understanding Acute Flaccid Myelitis (AFM)

Rare spinal cord condition produces polio-like symptoms

Acute flaccid myelitis (AFM) is a serious, polio-like illness that affects the spinal cord. In 2016, reports of this nervous system condition spiked—and it’s unknown what has caused this increase. This article describes the basics of AFM, so you’ll understand how to respond if you or a loved one experiences symptoms.

What is Acute Flaccid Myelitis?
Acute flaccid myelitis is a syndrome that impacts your nervous system—specifically, it causes inflammation of the spinal cord. This inflammation can cause a spectrum of neurologic symptoms, and the tell-tale sign of AFM is a sudden feeling of weakness in your arms and legs. Some people also struggle speaking and experience facial drooping. You can read more about AFM’s symptoms below.

AFM is a rare disease; in fact, fewer than one in a million people will develop it. Anyone, from children to adults, can get AFM.Child in hospital bed in icuWhile the syndrome is uncommon, the Centers for Disease Control and Prevention (CDC) has tracked an increase in AFM cases in the United States in 2016. From January 1 through September 30, 2016, 89 people developed a confirmed case of AFM. For comparison, only 21 total cases of AFM were confirmed nationwide in 2015. The CDC is actively investigating why this spike has occurred, though it doesn’t fully understand what is causing the increase.

What Causes Acute Flaccid Myelitis?
In many cases of acute flaccid myelitis, doctors are unable to identify an exact cause of the illness. However, AFM has been connected to a variety of diseases and external factors, including:

  • Germs and viral infections: Enteroviruses (such as polio), mosquito-borne viruses (such as West Nile virus), and viruses responsible for the common cold have all been linked to AFM.
  • Environmental toxins
  • Genetic disorders and autoimmune conditions: Conditions that mistakenly attack bodily tissues as foreign invaders, such as Guillain-Barre syndrome, may cause AFM.

Acute Flaccid Myelitis Symptoms                   
Acute flaccid myelitis’ symptoms have been compared to those of polio. The most common symptoms are sudden feeling of weakness in your arms and legs, along with reduced muscle tone and impaired reflexes. You may also feel pain in your arms and legs.

Sometimes, patients experience symptoms impacting their face, such as facial and eyelid drooping, and difficulty moving their eyes. Some people also have a change in voice and may struggle to swallow.

The most life-threatening symptom of AFM is respiratory failure, which occurs when your breathing muscles are weakened by the illness. Breathing machines can help mitigate the serious effects of this symptom.

Diagnosis and Treatment of Acute Flaccid Myelitis
If you or a loved one is struggling to walk, stand, or suddenly develops limb weakness, you should see a doctor immediately to determine what’s causing the problem.

To confirm a case of acute flaccid myelitis, your doctor conducts a variety of tests. Magnetic resonance imaging (MRI) is the most common diagnostic imaging exam to identify AFM, but your doctor may also perform an exam that identifies any areas of neurologic weakness. Additionally, testing the fluid around the spinal cord and brain—known as cerebrospinal fluid—may also help doctors understand whether your symptoms are indicative of AFM.

If your doctor suspects you have AFM, you will work with a neurologist—a specialist in spinal cord conditions. There is currently no standard course of treatment for AFM, but your neurologist will work with you to develop a treatment plan catered to your specific symptoms and disease progression.

Preventing Acute Flaccid Myelitis
While clinicians don’t fully understand what causes AFM, they recognize a connection to an array of other illnesses that can be prevented.

The simple steps below can help you prevent AFM, in addition to a host of other diseases:

  1. Wash your hands. The whole family should know the right way to wash their hands—simple soap and water will make a huge difference in preventing disease. Wash your hands before eating, after going to the bathroom or changing a diaper, and after playing with or feeding pets.
  2. Stay current on vaccinations. Check with your doctor to make sure you and everyone else in your family is up-to-date on all recommended vaccines.
  3. Protect yourself against mosquitos. Dusk and dawn are prime mosquito-biting times, so stay indoors during those periods. Also, use mosquito repellent when you are outdoors to reduce your chance of contracting a mosquito-borne illness.
  4. Avoid people who are ill. If you are around sick people, make sure you wash your hands regularly and disinfect any surfaces they may have touched.

The uptick in acute flaccid myelitis cases in 2016 has alarmed both the families impacted along with the infection-control  community. While the CDC and other health agencies are working to better understand this spinal cord illness, you can help protect yourself and your family today by practicing simple yet effective disease-prevention practices.

Updated on: 02/23/17
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