The Centers for Disease Control and Prevention (CDC) is warning parents and doctors to expect a possible outbreak of acute flaccid myelitis (AFM) in children this fall. According to the CDC, cases of the rare but serious neurological condition have peaked among U.S. children between August and November of every other year since 2014. The U.S. last saw a surge of AFM case in 2018, when 238 children were diagnosed with the paralyzing condition.
"As we head into these critical next months, CDC is taking necessary steps to help clinicians better recognize signs and symptoms of AFM in children," CDC Director Robert Redfield said in a statement released by the agency on Tuesday. "Recognition and early diagnosis are critical. CDC and public health partners have strengthened early disease detection systems, a vital step toward rapid treatment and rehabilitation for children with AFM."
While AFM is often described as a "polio-like" condition, children diagnosed with the condition have all tested negative for the poliovirus since 2014. Instead, the CDC has said enteroviruses like enterovirus-D68 — a virus that can cause mild to severe respiratory illness with a runny nose, sneezing, coughing, body aches, wheezing, and trouble breathing — are more than likely responsible for AFM outbreaks.
As a neurological condition, AFM affects the grey matter of the spinal cord, an area of the body's central nervous system that contributes to muscle control. Early symptoms of AFM include fever and respiratory illness followed by a sudden weakness of the limbs and reflexes. But the condition can quickly escalate, causing paralysis or permanent disability, the CDC warned. Other symptoms of AFM include headache, pain or numbness in the limbs, weakness in the neck or facial muscles, back or neck pain, difficulty talking or swallowing, and difficulty walking.
According to the CDC, prompt recognition of AFM is vital as the condition requires hospitalization and careful monitoring for respiratory failure. What health experts don't know is how or if the ongoing coronavirus pandemic might affect this year's expected AFM outbreak. According to the CDC, social distancing and face masks could help limit the spread of enteroviruses and thus delay or minimize this year's expected AFM outbreak. Or, surging COVID-19 cases could overwhelm hospitals and discourage parents from bringing their children in for care when early symptoms first develop, hindering doctors' ability to diagnose and treat AFM early.
"All clinicians should remain vigilant for AFM and promptly evaluate patients," said Thomas Clark, deputy director of the CDC's Division of Viral Diseases. "During the COVID-19 pandemic, this may require adjusting practices to perform clinical evaluations of patients by phone or telemedicine. However, clinicians should not delay hospitalizing patients when they suspect AFM."
As of July 31, the CDC has reported 16 confirmed cases of AFM and 38 reports of patients under investigation for the condition this year alone. More than 90% of AFM cases occur in young children with the average age being 5 years old.
If you think you’re showing symptoms of coronavirus, which include fever, shortness of breath, and cough, call your doctor before going to get tested. If you’re anxious about the virus’s spread in your community, visit the CDC for up-to-date information and resources, or seek out mental health support. You can find all of Romper’s parents + coronavirus coverage here.