In recent years, reports have emerged about a rare illness that appeared to be primarily targeting children, and leaving doctors baffled. The concern? Acute Flaccid Myelitis, or AFM, was inexplicably causing serious complications, like paralysis, in young children who seemed to be otherwise healthy, and no one could figure out why. But even more unsettling, this year, the number of children affected seems to be climbing. On Monday, the Centers for Disease Control and Prevention reported that 155 patients are now being investigated for AFM, according to CNN. With so much still unknown about it though, here are the updates on the polio-like illness affecting children that parents will want to be aware of amid experts' growing concern.
Perhaps the most important thing to keep in mind about AFM is that, as alarming as it certainly sounds, it is still considered a very rare illness, and the CDC is continuing to emphasize that fewer than one in a million people contract AFM in the United States each year. The problem? That's not exactly reassuring or helpful for the families of the children who have developed the condition, particularly since it's still not understood why it's happening, how it can be effectively treated, or how parents can help prevent their children from falling ill.
Even though there is still a lot that is unknown about AFM, and many question marks still lingering, medical experts have been trying to piece together as much as possible, and here is what they know:
The Number Of AFM Cases Is On The Rise
Though the confirmed number of cases of AFM in the United States currently sits at 62, the number of suspected cases is increasing. According to CNN, 155 patients are now under investigation as possibly having AFM, which is up from 127 patients a week ago.
In comparison, the highest number of confirmed cases since 2014 occurred in 2016, when 149 people were confirmed to have AFM in 39 states, according to the CDC, while in 2014, 120 cases of AFM occurred in 34 states.
Even if the number of confirmed cases doesn't increase this year, 2018 has already outpaced both 2017 (33 confirmed cases in 16 states), and 2015 (22 confirmed cases in 17 states), according to the CDC.
AFM Affects The Spinal Cord Similar To Polio — But It's Not The Same Thing
It's not at all surprising that the rise in AFM cases is leaving the American public feeling extremely concerned, and given that the rare illness has largely been described as being "polio-like," it's understandable that it would seem particularly scary. At a time when vaccine-preventable illnesses, like measles and whooping cough, have been making a reappearance — in August, a measles outbreak spread to 21 states and the District of Columbia, according to USA Today — it was worrisome that AFM seemed to be affecting people in a similar way to polio, which has technically been long-considered eradicated in the United States.
It's important to understand that, despite the similarities, AFM is *not* actually polio. Both AFM and polio affect the spinal cord, and can cause limb weakness and paralysis, according to the CDC. In severe cases, both illnesses can lead to respiratory failure, as noted by the CDC. But though there is certainly an overlap in symptoms, the CDC has confirmed that those with confirmed cases of AFM have actually tested negative for poliovirus.
In other words? AFM doesn't mean that polio is making a resurgence — though that also appears to mean that being vaccinated against polio won't necessarily protect you from contracting AFM.
Children Are Being Disproportionately Affected
Another very concerning aspect of AFM is that the majority of those who have contracted it are children. According to CNN, Dr. Nancy Messonnier, director of the CDC's National Center for Immunization and Respiratory Diseases said that more than 90 percent of confirmed AFM cases have occurred in children 18 and younger, and that the average age those affected is only 4 years old. It also appears to come on suddenly, can cause serious symptoms in otherwise healthy, active children.
The seriousness of the disease is why experts are urging parents to familiarize themselves with the symptoms, even though the likelihood of their children coming down with AFM is very rare. Earlier this month, Virginia dad Christopher Carr told The Washington Post that his 4-year-old son, Camdyn, initially came down with a sinus infection, but he then began having difficulty moving the right side of his face or lifting his arm. Soon, Carr told the publication that Camdyn's "whole body seized up" and that he was "suddenly paralyzed."
Other signs of AFM to be aware of? Like Camdyn, the CDC has said most people will show signs of "sudden ... arm or leg weakness and loss of muscle tone and reflexes," though facial drooping, difficulty moving the eyes, or difficulty swallowing or slurred speech may also be signs of AFM, and indicate the need for prompt medical attention.
The Cause Is Not Yet Understood
AFM may not be caused by polio, but it's still not quite clear what it is caused by. Based on the data that exists from AFM cases dating back to 2014, the CDC has found that AFM symptoms also seem to resemble complications from "non-polio enteroviruses, adenoviruses, and West Nile virus," though no pathogen has been found in the spinal cord fluid of those affected consistently enough to suggest that it's actually the cause.
Until researchers are able to better understand what's behind AFM, the advice for prevention is pretty standard and common-sense: the CDC recommends staying up-to-date on vaccines, washing hands regularly and thoroughly, and, because of the possible connection to West Nile Virus, trying to avoid mosquito bites as much as possible.
There's No Known Cure, But Recovery Does Seem Possible
In addition to a lack of understanding of what's causing AFM, it's also not clear what the prognosis is. For one, no official treatment currently exists for the illness, according to The Washington Post, and according to CNN, Messonnier has said it's not clear why some patients recover quickly while others continue to experience complications. The hopeful news though, is that some of the children affected at least do appear to be doing quite well.
At 6 years old, Lydia Pilarowski was diagnosed with AFM in 2014, after her parents noticed she was suddenly unable to use her left arm. Thanks to physical therapy and occupational therapy, Lydia's parents recently told CNN that their now 10-year-old daughter still continues to have some weakness on her left side, but said that "she is really leading a wonderful life at this point in time." And that could actually be specifically because she contracted AFM at such a young age: as Rebecca Martin, rehabilitation therapist at the Kennedy Krieger center for spinal cord injuries explained to The Washington Post,
It is unfortunate that [AFM] affects really little kids, but in many ways they have an advantage over adults. An adult nervous system is rigid and a child’s system may have a greater capacity for change, repatterning and growth.
Given the sudden and extreme nature of AFM, it's entirely understandable that parents would feel very concerned about the increase in cases reported by the CDC this year. But for now, it seems that the best thing we can do is stay aware of the risk while also remembering that it's still highly unlikely that AFM will strike. If it does, however, getting prompt medical help does seem like it can make a difference. And with doctors and researchers working to better understand the illness, hopefully it won't be too long before we have more answers than questions.