AFM: What We Know – and Don’t Know – About the Polio-Like Virus Affecting Kids

One hundred ninety-six people, most of them children, were diagnosed with Acute Flaccid Myelitis (AFM) in 2018.

By Michael Crupain, MD, MPH
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The Mysterious Illness Paralyzing Children (3:35)

One hundred ninety-six people, most of them children, were diagnosed with Acute Flaccid Myelitis (AFM) in 2018. 

The polio-like illness is marked by sudden weakness in the arms and or legs following an upper respiratory or stomach illness (fever, runny nose, cough, vomiting, and diarrhea). In the most severe cases AFM can cause paralysis of the muscles that control breathing, resulting in the need for mechanical ventilation. The progression of weakness is terrifyingly rapid, with some reports noting it occurring over a period of hours. 

Many questions remain unanswered about AFM, but doctors and scientists are beginning to learn more about the virus. 

What We Know

  • The illness appears to be seasonal, with most cases appearing between August and October and increasing every other year. This means we shouldn’t expect to see new occurrences until the end of the summer.
  • Based on the presentation and the seasonality, AFM is most likely caused by a virus that affects the area of the spinal cord that controls movement.

What We Don’t Know

  • Scientists have not identified the specific virus responsible for AFM. Until that happens, we will not be able to develop a vaccine to prevent it. 
  • When it comes to treatment, we don’t know what works. Physicians have been using treatments intended for analogous neurological conditions like steroids, antiviral medications, immunomodulating drugs, as well as procedures that “clean” the blood like plasmapheresis. At this time there is not enough evidence to say whether these treatments work or not. 
  • The rarity of the condition and relative lack of familiarity with it amongst clinicians and the general public have contributed to the challenge of identifying the virus. Researchers have been examining spinal fluid from patients with the condition, because that is the most likely place to find the virus. To date, scientists have failed to identify any virus in the vast majority of cases. One reason for this could be that by the time samples are collected the virus is gone. That’s why it’s very important for both patients and clinicians to recognize the symptoms and act quickly. Unfortunately, based on recent conversations with parents on The Dr. Oz Show, we know that the diagnosis took a long time for many affected children. 

Despite these challenges, more answers may be on the horizon. 

On our show we spoke with virus hunter Dr. Ian Lipkin from the Columbia Mailman School of Public Health. Dr. Lipkin is optimistic that we will identify the virus before the season picks up again because of the steady progress scientists are making and the increasing recognition of the condition.

The most important thing right now, while we wait for CDC and researchers to unravel this mystery, is to recognize the symptoms and act quickly. If your child has the sudden onset of weakness anywhere in their body consult your doctor and be sure to ask them if it could be AFM. You and your doctor can learn more about the condition – and what to do about it – here on the CDC website.

Related: 

What to Know About the Rare Polio-Like Disease

The Top 10 Ways to Not Get Sick This Season

What to Know About the Flu Vaccine

Article written by Michael Crupain, MD, MPH
Michael Crupain, MD, MPH is the Chief of Staff of the Medical Unit at The Dr. Oz Show.