CDC says AFM cases tend to spike in late summer, early fall

CDC stresses importance of reporting cases to health officials

By Frank McGeorge, MD - Medical Expert

The illness is called acute flaccid myelitis, or AFM or short.

It causes sudden limb weakness, and we've now seen three outbreaks of it since 2014. It has tended to peak in even years, but the CDC warns cases are occurring every year and spotting it sooner could hold the key to solving this mystery.

On a conference call this week the CDC stressed cases of AFM have tended to spike in late summer and early fall.

"There may have been great awareness among pediatricians last October when the media was covering this extensively, but October was a long time ago, and so we do hope today's report will be a reminder to clinicians and parents," the CDC said.

While most parents of children affected have sought quick medical care, there has been a major delay in doctors contacting local health departments and the CDC.

Suspected cases were reported to CDC anywhere from 18 to 36 days after onset of limb weakness. This delay hampers our ability to understand the causes of AFM," the CDC sad.

The CDC said faster notification will help efforts to find the cause and develop better treatments.

"We really do suspect viruses play a role and enterovirus is among the leading suspects," they said.

The CDC also says nearly all patients with confirmed cases of AFM had a fever or respiratory illness in the month before they developed paralysis. While there's no cure or specific treatment, early and aggressive physical therapy has helped. The bottom line for parents:

"The season for enteroviruses is coming and if your child develops arm weakness or leg weakness, please seek medical care right away," the CDC said.

So far there have been 11 confirmed cases of AFM this year in eight states. None of those cases are in Michigan.

The CDC has created a hotline for doctors to give us quick access to experts at the CDC. Again, this is something most doctors have never treated before. There is no vaccine against this. The only real defense right now is good hygiene and handwashing.

Symptoms of AFM (per the CDC)

Most people will have sudden onset of:

  • Arm or leg weakness
  • Loss of muscle tone and reflexes
  • Sudden arm or leg weakness

Some people will also have:

  • Facial droop or weakness
  • Difficulty moving eyes
  • Drooping eyelids
  • Difficulty swallowing
  • Slurred speech
  • Pain in arms or legs
  • Difficulty moving the eyes or drooping eyelids
  • Facial droop or weakness
  • Difficulty with swallowing or slurred speech

In rare cases, people may also:

  • Have numbness or tingling
  • Be unable to pass urine (pee)

The most severe symptoms of AFM are:

  • Respiratory failure: This happens when the muscles involved with breathing become weak and can require a ventilator (a machine to help them breathe).
  • Serious neurologic complications: 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.

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