Sarah Bennett
Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system, causing muscle weakness and sometimes leading to permanent paralysis. While AFM shares similarities with polio, including lesions in the grey matter of the spinal cord and flaccid limb weakness, it is not caused by the poliovirus. Currently, there is no vaccine specifically for AFM, although the CDC recommends staying up-to-date on polio vaccinations as a preventive measure, as polio can cause acute flaccid paralysis. Research is ongoing to develop vaccines against viruses associated with AFM, and inactivated EV-A71 vaccines have been approved for use in China to prevent hand, foot, and mouth disease.
| Characteristics | Values |
|---|---|
| What is Acute Flaccid Myelitis (AFM)? | A rare but serious neurologic condition that causes muscle weakness, sometimes leading to permanent paralysis. |
| AFM symptoms | Sudden onset of arm or leg weakness, loss of muscle tone, and loss of reflexes. Other symptoms include facial droop or weakness, difficulty moving the eyes, drooping eyelids, difficulty swallowing, or slurred speech. |
| AFM diagnosis | AFM can be difficult to diagnose because its symptoms are similar to other neurologic diseases. A healthcare provider will review the patient's medical history, perform a physical exam, and may order testing of cerebrospinal fluid, respiratory fluid, blood, and stool. |
| AFM treatment | Treatment focuses on reducing spinal cord inflammation, managing symptoms, and preventing complications. Some patients see improvements in muscle function over time, while others do not improve and remain weak or paralyzed. |
| AFM vaccine | There is currently no vaccine for AFM. However, the CDC recommends staying up-to-date on vaccines, such as the polio vaccine, to prevent other severe diseases. |
| AFM cases | AFM cases have been reported in increasing numbers since 2014, with most cases occurring in children. |
| AFM cause | The exact cause of AFM is still unknown, but it is believed to be associated with enteroviruses, including enterovirus D-68 (EV-D68). |
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What You'll Learn
There is no vaccine for acute flaccid myelitis (AFM)
There is currently no vaccine for acute flaccid myelitis (AFM), a rare but serious neurological condition that causes muscle weakness and sometimes leads to permanent paralysis. AFM was first discovered in 2014 and has since been reported in increasing numbers biennially, typically occurring in the late summer and early fall. The exact cause of AFM is still unknown, but it predominantly affects children from 6 months of age through young adulthood, with a median age of 5 years.
The Centers for Disease Control and Prevention (CDC) has stated that there is no preventive vaccination available for AFM. However, the CDC recommends staying up-to-date on all recommended vaccinations, including the polio vaccine, to prevent other severe diseases. Polio is caused by the poliovirus and can lead to acute flaccid paralysis. While polio and AFM share some similarities, such as lesions in the grey matter of the spinal cord and flaccid limb weakness, the poliovirus has not been found in people diagnosed with AFM.
AFM can be difficult to diagnose due to its similar symptoms to other neurological diseases. Healthcare providers will review the patient's medical history, perform a physical exam, and may order additional tests on cerebrospinal fluid, respiratory fluid, blood, and stool specimens. Treatment for AFM focuses on reducing spinal cord inflammation, managing symptoms, and preventing complications. Some patients see improvements in muscle function over time, with a few achieving a full recovery, usually around four months after symptoms begin. However, some patients do not improve and remain weak or paralyzed.
While there is no vaccine specifically for AFM, the development of vaccines against viruses associated with AFM is an attractive preventive strategy. Inactivated EV-A71 vaccines, for example, have been shown to be safe and effective in preventing hand, foot, and mouth disease and are approved for use in China. Other potential platforms for vaccine development include the use of virus-like particles (VLPs) and respiratory viruses that do not cause disease in humans, such as the Newcastle disease virus (NDV).
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Polio vaccinations can help protect against AFM
Acute flaccid myelitis (AFM) is a rare but serious neurological condition that causes muscle weakness and can lead to permanent paralysis. It was first discovered in 2014 and has since been reported in increasing numbers biennially, with most cases occurring in young children. AFM is similar to polio in that they both affect the spinal cord's grey matter and cause flaccid limb weakness. However, the poliovirus has not been found in people diagnosed with AFM.
While there is currently no specific vaccination for AFM, the CDC recommends staying up-to-date on polio vaccinations as one way to protect against the disease. Polio can be prevented by two types of vaccines: the inactivated polio vaccine (IPV) and the oral polio vaccine (OPV). IPV provides protection against viremia and prevents the development of paralytic poliomyelitis, while OPV more effectively induces mucosal immunity and breaks the transmission cycle.
The CDC has found no evidence to suggest that vaccinations cause AFM. In 2018, AFM occurred in children who had received vaccines and also in those who had not. Among the AFM patients reviewed in 2018, about 85% had no recorded vaccinations in the 30 days prior to the onset of their limb weakness. This indicates that polio vaccinations do not increase the risk of developing AFM.
In addition to polio vaccinations, the CDC suggests mosquito protection to avoid the West Nile virus, another potential cause of AFM. The development of vaccines against viruses associated with AFM is an attractive preventive strategy that is currently being explored. For example, inactivated EV-A71 vaccines have been shown to be safe and effective in preventing EV-A71-associated hand, foot, and mouth disease and are approved for use in China.
In summary, while there is no vaccine specifically for AFM, polio vaccinations can help protect against the disease by reducing the risk of polio, which has similar symptoms and complications. Staying up-to-date on polio vaccinations, as recommended by the CDC, is a crucial step in protecting against AFM, especially for young children who are most vulnerable to the disease.
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AFM is a rare, polio-like illness
Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system. It was first discovered in 2014 and since then, cases have been reported in increasing numbers biennially. AFM is an uncommon neurological condition that causes muscle weakness and sometimes leads to permanent paralysis. It predominantly affects children from 6 months of age through young adulthood, with a median age of 5 years. The natural history of AFM consists of three phases: prodromal illness, acute neurological injury, and a convalescent phase. The prodromal illness typically presents as an acute febrile illness associated with symptoms such as a cough, congestion, and sore throat. Vomiting and diarrhea are reported in some cases.
The onset of neurological injury, following the prodromal illness, commonly begins with fever, meningeal symptoms, and pain in a limb, followed by the rapid onset of flaccid limb weakness, which can vary from mild to complete paralysis. The upper extremities are affected more often than the lower ones. Convalescence can last several months or years, and many patients continue to experience muscle weakness and atrophy. AFM is similar to polio in that they both affect the spinal cord's grey matter and cause flaccid limb weakness. However, the poliovirus has not been found in people diagnosed with AFM.
Currently, there is no vaccine for AFM. The CDC recommends staying up-to-date on all recommended vaccinations, including the polio vaccine, to prevent other severe diseases. The inactivated polio vaccine is the only polio vaccine that has been administered in the United States since 2000. Oral polio vaccines are used in other countries. While there is no vaccine to prevent AFM, the CDC suggests mosquito protection to avoid the West Nile virus.
The CDC and health departments work together to collect medical information, spinal cord MRI images, and patient specimens for testing to increase the possibility of finding the cause of AFM. The specimens are tested for enteroviruses, West Nile virus, and other infectious etiologies associated with AFM. The CDC has received information on a total of 404 confirmed cases of AFM from August 2014 through October 2018, with most cases occurring in children.
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AFM is a serious neurologic condition causing muscle weakness
Acute flaccid myelitis (AFM) is a rare but serious neurological condition that causes muscle weakness and sometimes leads to permanent paralysis. It was first discovered in 2014 and is characterised by a sudden onset of arm or leg weakness, loss of muscle tone, and loss of reflexes. The muscle weakness in AFM can begin in the legs or arms, and it often affects the upper limbs. In some cases, AFM can also affect the muscles required for breathing, which can lead to respiratory failure and even death. Therefore, it is crucial to seek immediate medical attention if any symptoms of AFM develop.
AFM primarily affects young children, with an estimated 90% of cases occurring in children aged 1 to 7. However, adults can also develop AFM. The exact cause of AFM remains unknown, but researchers believe that viruses, particularly non-polio enteroviruses, play a role in its development. There is currently no vaccine or specific treatment for AFM. Prevention focuses on reducing the risk of viral infections through proper hand hygiene, avoiding close contact with sick individuals, and disinfecting frequently touched surfaces.
The diagnosis of AFM can be challenging due to its similarity to other neurological diseases. Healthcare providers will typically review the patient's medical history, perform a physical examination, and may order additional tests on cerebrospinal fluid, respiratory fluid, blood, and stool samples. Treatment for AFM is primarily supportive, focusing on reducing spinal cord inflammation, managing symptoms, and preventing complications. Some patients may experience improvements in muscle function over time, with a small number making a full recovery, usually around four months after the onset of symptoms.
While polio and AFM share some similarities, they are distinct conditions. Poliomyelitis refers to the syndrome of acute flaccid limb weakness and lesions in the grey matter of the spinal cord. Polio can be prevented by vaccination, and stool specimens from AFM patients are tested for the poliovirus. If poliovirus is detected, the case is classified as polio rather than AFM. It is important to note that there is no evidence suggesting that vaccinations cause AFM.
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AFM mostly affects children
Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system. It was first discovered in 2014 and there is currently no vaccine for it. The condition mostly affects young children, with the average age being around 5 years. However, AFM has also been observed in older children and adults.
AFM is characterised by sudden weakness in one or more limbs, poor muscle tone and reflexes, pain in the limbs, neck or back, and weakness in the face, which can cause problems with swallowing, breathing, or speaking. These symptoms can worsen rapidly and become life-threatening, hence the need for immediate medical attention. The exact cause of AFM is still unknown, but it may be linked to a certain type of virus called an enterovirus. Children infected with an enterovirus seem to be at a higher risk of developing AFM.
The diagnosis of AFM can be challenging due to its similarity to other neurologic diseases. Healthcare providers will typically review the patient's medical history, perform a physical examination, and may order tests such as MRI, lumbar puncture, and studies to assess nerve and muscle function. Treatment options are limited, focusing on supportive care, symptom management, and preventing complications. Some patients show improvements in muscle function over time, while others may not recover and continue to experience weakness or paralysis.
To prevent AFM, the CDC recommends practising good infection control, such as handwashing, avoiding touching the face with unwashed hands, and maintaining distance from individuals who are sick. These precautions are similar to those advised for preventing COVID-19 and other illnesses like the flu.
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Frequently asked questions
No country has a vaccine for acute flaccid myelitis (AFM). However, the CDC recommends staying up-to-date on all other vaccinations to prevent other diseases.
Acute flaccid myelitis is a rare but serious condition that affects the nervous system. The most common symptoms are sudden onset of arm or leg weakness, loss of muscle tone, and loss of reflexes. If you or your child are experiencing these symptoms, seek medical care immediately.
Contact your state or local health department as soon as possible for instructions on how to report the suspected case. You can also direct urgent questions to the CDC Emergency Operations Center.
