FIVE THINGS TO KNOW ABOUT ACUTE FLAC­CID MYELI­TIS

Ottawa Citizen - - Navigator -

Par­ents and pe­di­a­tri­cians should be on alert for a rare neu­ro­log­i­cal con­di­tion af­flict­ing chil­dren that can lead to long-term paral­y­sis and, in­fre­quently, death, the U.S. Cen­ters for Dis­ease Con­trol and Preven­tion warned Tues­day. While acute flac­cid myeli­tis has been around for years at low lev­els, se­ri­ous out­breaks be­gan in 2014, when 120 chil­dren in the U.S. were af­flicted. Since then, it’s struck in ris­ing num­bers ev­ery other year in

late sum­mer and fall.

1

EN­TEROVIRUS SUS­PECT

It has al­ready started to emerge this year, with 16 chil­dren in the U.S. di­ag­nosed and one death as of the end of July. Another 38 cases are un­der in­ves­ti­ga­tion. AFM is be­lieved to be a com­pli­ca­tion of a vi­ral in­fec­tion, most likely an out­break strain of en­terovirus D68, though the ex­act cause

hasn’t been con­firmed.

2

IMMEDIATE ATTENTION

The biggest red flag for the con­di­tion is muscle weak­ness, and chil­dren who de­velop it should be rushed to the hos­pi­tal, CDC di­rec­tor Robert Red­field said Tues­day. “AFM is a med­i­cal emer­gency that re­quires immediate care,” he said. AFM is a se­ri­ous con­di­tion of the spinal cord; paral­y­sis can de­velop within hours.

3

GO TO THE HOS­PI­TAL

The agency is con­cerned that

par­ents might hes­i­tate in tak­ing their kids to the doc­tor amid the coro­n­avirus out­break,

in­stead wait­ing to see if they re­cover at home. That would be a mis­take, Red­field said. While many chil­dren do suf­fer per­ma­nent weak­ness or paral­y­sis, early and ag­gres­sive phys­i­cal ther­apy may help them strengthen

the function they do re­tain.

4

KEEP AN EYE OUT

Most cases are pre­ceded by fever or res­pi­ra­tory trou­bles, which can com­pli­cate spot­ting it since those are com­mon to other ill­nesses. In­creased vig­i­lance spurred by COVID-19 could help spot it ear­lier, while steps that are be­ing taken to avoid coro­n­avirus may avert, re­duce or de­lay the ex­pected out­break of AFM in 2020, Red­field said.

5

HITS THE YOUNG

While the con­di­tion is sim­i­lar to po­lio, pa­tients test neg­a­tive for the po­liovirus, which has been elim­i­nated thanks to vac­cines. This year could be the worst to date, as there has been a ris­ing

num­ber of cases with each out­break. More than half of the 238 chil­dren af­fected in 2018 needed in­ten­sive care, and a quar­ter of them were placed on a ven­ti­la­tor. The av­er­age age

was five. There is no cure.

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