Acute Flaccid Myelitis

Acute Flaccid Myelitis

There are three categories of urgency levels when we get notices from the public health department: Health Alert conveys the highest level of importance and warrants immediate action or attention. Health Advisory provides important information for a specific incident or situation, this may not require immediate action Health update provides updated information regarding an incident or situation. This is unlikely to require immediate action This week we got a Health Advisory from the California Department of Public Health regarding the national increase in reports of suspected Acute Flaccid Myelitis cases. The Media has been all over this and it is scary indeed. It is hard not to get nervous. Of course I have had some calls about it. It is NOT my intent to fan the flames and make folks panic, I just want to give you some basic knowledge and share what is currently known about it.   Acute Flaccid Myelitis (AFM) is a very rare neurological condition that is characterized by sudden onset of weakness in one or more limbs. An MRI will show distinct abnormalities of the spinal cord gray matter.   Nationally, from January 1 through October 16, 2018 the Center for Disease Control and Prevention (CDC) has reported 62 confirmed cases in patients from 22 US states. They are investigating other possible cases at this time, so the numbers will likely change. More than 90% of the cases occur in patients who are under the age of 18 years old. Some lucky folks have recovered quickly and completely while others continue to experience paralysis and weakness.   There were similar episodes making the rounds a few years ago that were associated with Enterovirus D68 . This time around patients have been tested for that strain of enterovirus. It has not been consistently detected in every patient with AFM, so there isn't a clear connection, but many experts still think that D68 is the most likely cause and that the virus has mutated to make it harder to detect. Other thoughts are that it could be connected with a mosquito borne illness. The investigations continue. AFM is NOT thought to be contagious from person to person.   While I don’t want folks losing sleep over this, (our odds of winning the current giant lottery are on par with having to deal with this) seek immediate medical attention if you see any of these symptoms: Difficulty moving the eye or drooping eyelid Facial droop or weakness Difficulty swallowing or slurred speech Sudden arm or leg weakness   https://www.cdc.gov/acute-flaccid-myelitis/infographic.html   If we are suspicious of AFM, further testing and likely an ER visit would be the next steps.