CDC Warns Of Return Of Acute Flaccid Myelitis Outbreak

Federal disease experts warn parents and doctors they should prepare for an outbreak of acute flaccid myelitis, a virus that leads to polio-like paralysis symptoms in children.

The U.S. Centers for Disease Control and Prevention (CDC) issued a press release on August 4, urging doctors to become familiar with the symptoms of acute flaccid myelitis (AFM) and act quickly to hospitalize patients if they suspect the disease.

Health experts predict this fall there may be another peak for cases of AFM, as the illness has largely followed an every other year pattern for peak infections.

Prior acute flaccid myelitis outbreaks have been seen since 2014, typically during the months of August to November, and have affected hundreds of children over the past decade.

The disease is an uncommon, but serious, neurologic condition that affects primarily children, although some adults do contract the disease.

In 2018, nearly 240 cases of AFM were reported, with many patients suffering paralysis and weakened limbs, in addition to respiratory symptoms.

A CDC Vital Signs report, published the same day as the press release, alerts healthcare providers to the potential risk of outbreak.

According to the report, many patients experienced a delay in treatment in 2018. More than 35% of patients were not hospitalized until two or more days after experiencing the first signs of limb weakness.

AFM can progress rapidly over the course of hours or days, and often leads to permanent paralysis and/or life-threatening complications of respiratory failure in patients who were previously healthy. Many patients experienced fever or respiratory illness six days before experiencing limb weakness.

The outbreak in 2018 was the third outbreak and the largest peak of AFM cases, spanning 42 states.

During the 2018 outbreak, nearly 98% of patients with AFM were hospitalized. One in four hospitalized patients needed mechanical ventilation and most cases, nearly 94%, occurred among children.

CDC research has indicated enteroviruses, more specifically enterovirus-D68 (EV D68), are likely responsible for the outbreak of illnesses. Testing conducted among some patients has linked D68 to cases of AFM, however not all patients have been tested for enteroviruses.

Parents and doctors should look for sudden limb weakness in children, especially from August through November. Most patients experience respiratory illness or fever first, followed by neck or back pain. However, any of these symptoms followed by neurologic symptoms should cause concern.

The CDC urges doctors and frontline workers in emergency rooms and urgent care centers to be prepared to recognize the symptoms and act quickly to hospitalize patients. Quick response leads to the best treatment, officials said.

“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,” said CDC Director Dr. Robert Redfield. “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.”