Michigan health officials said Tuesday two more cases of AFM, a polio-like disease, have been confirmed in the state, bringing the total to four.
The confirmed cases involve children in Ottawa and Macomb counties.
The state’s first AFM case was confirmed Dec. 5 and involves a child in Wayne County. A second case was confirmed in an Oakland County child on Dec. 12.
Five suspect cases of AFM in Michigan remain under investigation, while one case was ruled not to be AFM by the CDC. The four confirmed AFM cases had onsets of illness between August and October.
Acute flaccid myelitis (AFM) is a rare condition. It affects a person’s nervous system, specifically the spinal cord, causing weakness in one or more limbs. AFM or neurologic conditions like it have a variety of causes such as viruses and environmental toxins.
What causes AFM?
Certain viruses are known to cause AFM including enteroviruses, such as poliovirus and enterovirus A71 (EV-A71), and West Nile virus. Since 2014, most patients with AFM (more than 90%) had a mild respiratory illness or fever consistent with a viral infection before they developed AFM.
Who's most at risk?
Most patients are children. CDC has seen increases in AFM cases every two years since 2014 and mostly in young children. Still, CDC estimates that less than one to two in a million children in the United States will get AFM every year.
Of the cases being investigated in Michigan, the ages range from 5 months to 55 years old.
How does it spread?
AFM affects mainly children and is not believed to be contagious. It may be a rare complication following a viral infection, and environmental and genetic factors may also contribute to its development.
CDC has tested many different specimens from AFM patients for a wide range of pathogens (germs) that can cause AFM. To date, no pathogen (germ) has been consistently detected in the patients’ spinal fluid; a pathogen detected in the spinal fluid would be good evidence to indicate the cause of AFM since this condition affects the spinal cord.
What are the symptoms of AFM?
The patients’ symptoms have been most similar to complications of infection with certain viruses, including poliovirus, non-polio enteroviruses, adenoviruses, and West Nile virus.
- Sudden muscle weakness in the arms or legs
- Difficulty moving the eyes
- Drooping eyelids or a facial droop/weakness
- Difficulty swallowing or slurred speech
Numbness or tingling is rare in people with AFM, although some people have pain in their arms or legs. Some people with AFM may be unable to pass urine (pee). The most severe symptom of AFM is respiratory failure that can happen when the muscles involved with breathing become weak. This can require urgent ventilator support (breathing machine).
In very rare cases, it is possible that the process in the body that triggers AFM may also trigger other serious neurologic complications that could lead to death.
How is AFM treated?
There is no specific treatment for AFM, but a doctor who specializes in treating brain and spinal cord illnesses (neurologist) may recommend certain interventions on a case-by-case basis. For example, neurologists may recommend physical or occupational therapy to help with arm or leg weakness caused by AFM. CDC is working closely with national experts to better understand how to treat AFM and update our clinical management considerations.
How can we prevent the spread of AFM?
Since AFM may develop due to a viral infection, health officials recommend parents and children take basic steps to avoid infections and stay healthy:
- Wash your hands frequently with soap and water
- Stay up to date on vaccinations
- Protect yourself and children against mosquito bites by wearing protective clothing and using EPA-registered insect
You can protect yourself and your children from poliovirus by getting vaccinated. Polio vaccine contains inactivated (not live) virus, and protects against poliovirus. This vaccine does not protect against other viruses that may cause AFM.
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