4 Facts You Need to Know About Acute Flaccid Myelitis

DECEMBER 27, 2016
Acute flaccid myelitis (AFM) is a rare condition that affects the nervous system and can be caused by viral infections.  Unfortunately, this illness is on the rise in the United States. Check out these 4 facts about AFM to help keep you up-to-date on this concerning condition.
  1. AFM affects the nervous system.
AFM affects the nervous system – specifically the spinal cord  – and can result in the following symptoms:
  • Sudden limb weakness
  • Loss of muscle tone and reflexes
  • Facial droop/weakness
  • Difficulty moving the eyes
  • Drooping eyelids
  • Difficulty swallowing or slurred speech
  • Arm or leg pain
  • Difficulty urinating
  • Respiratory failure requiring ventilator support
  1. The number of patients with AFM has increased.

According to the CDC, there were 108 people in 36 states across the United States with confirmed AFM as of October 2016.1  Data show that most cases have occurred in children. AFM can be caused by several viruses including enteroviruses (polio and non-polio), West Nile virus (virus transmitted through mosquitos), and adenoviruses (respiratory illnesses). Other potential causes include environmental toxins, genetic disorders, and Guillain-Barré syndrome. 

 
However, the exact cause of the recent AFM outbreak has not been determined. There was also a spike in AFM cases in 2014 that was associated with a national outbreak of severe respiratory illness caused by enterovirus D68 (EV-D68).1 The CDC is actively monitoring for patients with AFM and encourages healthcare providers to report cases to state health departments. The CDC is testing specimens including stool, blood, and cerebrospinal fluid from individuals with confirmed AFM to investigate the illness. Additionally, the CDC is collaborating with medical facilities to review MRI scans from the past 10 years to determine the number of AFM cases that occurred before 2014.1
  1. There is no specific treatment for AFM.
Unfortunately, there is no specific treatment for AFM, just supportive care to alleviate the symptoms. Neurologists can treat patients on a case-by-case basis. Children experiencing sudden weakness in the arms or legs should be evaluated immediately.
  1. There are ways to prevent AFM.
AFM is currently considered a mysterious illness; however, there are strategies that may help to prevent the condition.  Encourage patients and their families to keep up-to-date with all recommended vaccines. Educate patients to use mosquito repellent to prevent West Nile virus. Standing water from nearby property should be removed to decrease the number of mosquitoes.  It is also important to prevent the spread of viruses with the following tips:
  • Wash hands frequently with soap and water.
  • Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.
  • Avoid close contact with individuals who are sick.
  • Clean contaminated surfaces with a disinfectant.
       Educate patients to scrub their hands with soap and water for at least 20 seconds when performing the following tasks:1
  • Before, during, and after food preparation,
  • Before eating food,
  • Before and after caring for someone sick,
  • Before and after treating a cut or wound,
  • After using the restroom,
  • After changing diapers,
  • After coughing or sneezing,
  • After touching an animal, animal feed, or animal waste,
  • After handling pet food,
  • After touching garbage,
 
Reference
  1. Acute flaccid myelitis.  CDC website.  https://www.cdc.gov/acute-flaccid-myelitis/index.html.  Accessed December 20, 2016.


Jennifer Gershman, PharmD, CPh
Jennifer Gershman, PharmD, CPh
Jennifer Gershman, PharmD, CPh, received her PharmD degree from Nova Southeastern University (NSU) College of Pharmacy in 2006 and completed a 2-year drug information residency. She served as a pharmacy professor at NSU’s College of Pharmacy for 6 years, managed the drug information center, and conducted medication therapy management reviews. Dr. Gershman has published research on prescription drug abuse, regulatory issues, and drug information in various scholarly journals. Additionally, she received the Sheriff’s Special Recognition Award for her collaboration with the Broward, Florida Sheriff’s Office to prevent prescription drug abuse through a drug disposal program. She has also presented at pharmacist and physician continuing education programs on topics that include medication errors, prescription drug abuse, and legal and regulatory issues. Dr. Gershman can be followed on Twitter @jgershman2
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