PULSE Magazine | October 2018 Issue

ACUTE FLACCID MYELITIS

Acute flaccid myelitis (AFM) is a rare but serious condition, that looks like/mimics polio. AFM affects the nervous system, specifically the area of spinal cord called gray matter, which causes the muscles and reflexes in the body to become weak. This condition is not new, but the increase in cases the past three years is new. The US Centers for Disease Control and Prevention recently reported 28 new cases in just one week. There are 155 patients under investigation this year for acute flaccid myelitis, a condition that can cause paralysis and mostly affects children. Of these, 62 have been confirmed by the CDC in 22 states, and the remainder continue to be investigated. Of those confirmed cases 8 are in Texas with one here in Travis County thus far.

The average age of patients confirmed to have AFM is 4 years old, and more than 90% of cases over- all occur in children 18 and younger, according to Dr. Nancy Messonnier, director of the agency's National Center for Immunization and Respiratory Diseases.

CDC has been actively investigating AFM, testing specimens and monitoring this disease since 2014. Most AFM cases peak in the late summer and fall, in addition there has been no geographic clustering of the disease.

Symptoms

Most people will have sudden onset of arm or leg weakness and loss of muscle tone and reflexes. Some people, in addition to arm or leg weakness, will have:

facial droop/weakness,

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difficulty moving the eyes,

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drooping eyelids, or

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 difficulty with 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 pro- cess in the body that triggers AFM may also trigger other serious neurologic complications that could lead to death.

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