As if worrying about the coronavirus isn’t enough, the Centers for Disease Control and Prevention (CDC) is warning of a particularly severe season of acute flaccid myelitis (AFM) in 2020. A mysterious polio-like illness affecting mostly children, AFM is a rare but serious neurologic condition causing weakness in the arms or legs. Thought to be caused by enteroviruses, the disease has spiked every two years in the U.S. between August and November since 2014.
The CDC anticipates 2020 to be another peak year for AFM — especially because of its overlap with COVID-19. “Recognition and early diagnosis are critical,” CDC Director Dr. Robert Redfield said in a statement.
Neurologist Dr. Riley Bove knows the seriousness of the condition firsthand. Her 4 year-old son was diagnosed in 2014 with AFM after developing symptoms following a seemingly normal 10 day cold. Bove described her son's experience to the New York Times, as “head-to-toe paralysis, where he could kind of move his eyes a little bit and one side of his face.”
What is acute flaccid myelitis (AFM) and what are symptoms to look out for?
What to do if you think your child has AFM
At the moment, it is unknown how the pandemic and social distancing may affect circulation of the viruses suspected to cause AFM. Additionally, it is uncertain how COVID-19 will impact both the health care system’s ability to diagnose or respond to AFM. According to the CDC, even if you live in an area with high COVID-19 activity, if you or your child develop any of the symptoms, seek medical care immediately.
AFM diagnosis
Doctors can determine if your child has AFM by:
- Reviewing their medical history
- Check for places on the body with weakness, poor muscle tone, and diminished reflexes
- Perform an MRI to examine the brain and spinal cord
- Conduct lab tests on the fluid surrounding the brain and spinal cord
- Check how the nerves conduct impulses and respond along the nerve fiber
AFM can be difficult to diagnose because many symptoms overlap with other neurologic conditions like transverse myelitis and Guillain-Barre syndrome. However, if doctors can diagnose AFM early enough, neurologists may advise treatments on a case-by-case basis such as physical or occupational therapy to help with weakness in the limbs.
Keep it in perspective
Lisa Coyne, a clinical psychologist at Harvard Medical School, cautions against worrying excessively about your child contracting AFM, as it is very rare. During this pandemic, “stress and anxiety these days are fellow travelers with us,” she told the New York Times. Coyne, who has written about managing anxiety during COVID, suggests keeping the symptoms in mind but don't obsess about the possibility of your child getting AFM.
