outbreaks of the polio-like illness thought to be due to a viral infection and affecting primarily children have occurred in a biennial pattern since 2012, when the centers for disease control and prevention (cdc) began tracking the disease. “mask-wearing and physical distancing restrictions related to covid-19 may have reduced the transmission of the virus linked to afm and prevented an outbreak from taking place,” said glenn rivera, who has been conducting research on afm as a resident in pediatric neurology. “while the biennial outbreaks have emerged during even years, there is the chance of an outbreak in 2021 once covid-19 restrictions are lifted,” rivera said. in a minority of cases, the onset of weakness is preceded by fever alone, gastroenteritis or hand, foot and mouth disease.
“the parent may tell you a history of several days of weakness and viral-like symptoms,” says rivera. “or the kid was getting better and now the child has not been using his arm, is having difficulty walking or appears lethargic — all signs pointing to the possibility of afm.” pediatricians, rivera notes, can perform a quick screen for weakness by asking a child to raise his or her arms and legs to assess anti-gravity function in all four limbs. “how can we as general pediatricians decrease the rate of misdiagnosis and find that needle in the haystack?” says rivera. “the susceptible population is likely higher than ever, so it’s essential that we remain vigilant.” rivera has been conducting afm-related research with pediatric neurologist matthew elrick and neurosurgeon allan belzberg.
it can cause sudden weakness in the arms or legs, loss of muscle tone, and loss of reflexes. most children have a mild respiratory illness or fever caused by a viral infection about one to four weeks before developing symptoms of acute flaccid myelitis. hospitalization is needed and sometimes a ventilator is required for breathing support. since experts began tracking acute flaccid myelitis following initial clusters in 2014, outbreaks in the united states have occurred in 2016 and 2018. outbreaks tend to occur between august and november. acute flaccid myelitis might be caused by an infection with a type of virus known as an enterovirus.
respiratory illnesses and fever from enteroviruses are common — especially in children. it’s not clear why some people with an enterovirus infection develop acute flaccid myelitis. the symptoms of acute flaccid myelitis can look similar to those of the viral disease polio. but none of the acute flaccid myelitis cases in the united states have been caused by poliovirus. however, preventing a viral infection can help reduce the risk of developing acute flaccid myelitis.
annual maps represent only cases for whom information was sent to and confirmed by cdc as of . patients under investigation are still being outbreaks of the polio-like illness thought to be due to a viral infection and affecting primarily children have occurred in a biennial pattern know the possible symptoms of acute flaccid myelitis (afm), a rare but serious condition that affects young children., .
afm is characterized by flaccid weakness in one or more limbs and distinct abnormalities of spinal cord gray matter on mri. since symptoms can acute flaccid myelitis (afm) is a disabling, polio-like illness mainly affecting children. outbreaks of afm have occurred across multiple the clinical presentation of flaccid and often profound muscle weakness (which can invoke respiratory failure and other critical complications), .
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