What Is Acute Flaccid Myelitis? Rare Polio-Like Illness Reported In 24 States

The Texas Department of State Health Services on Tuesday said three people, two from Travis County and one from Hays County, developed acute flaccid myelitis (AFM). So far this year, the illness has been reported in 24 states around the country.

AFM is a rare but serious condition which can affect the nervous system, specifically the spinal cord of a person and cause muscles and reflexes to stop working.

State officials said as of Oct. 16, a total of 16 people across Texas developed AFM, according to a report in the Statesman. In 2017, there were only five cases in the state, it added.

According to the U.S. Centers for Disease Control and Prevention (CDC), there have been 72 confirmed cases of AFM in 24 states across the country so far in 2018. Children are the most affected by the disease.

The agency said the condition affects an area of the spinal cord called gray matter, which results in the weakening of muscles and reflexes in the body. There has been a steady increase in the number of cases reported in the U.S. since 2014. CDC estimates less than one in a million people in the United States will get AFM every year.

There are various possible causes for AFM such as viruses and environmental toxins. A report in People said some doctors believed a virus called enterovirus D68, or EV-D68 was the main cause for the condition. But the CDC hasn't confirmed it.

“We have not been able to find the cause for the majority of these AFM cases,” Dr. Nancy Messonnier, the director of the National Center for Immunization and Respiratory Diseases at the CDC, said. “There’s a lot we don’t know about AFM, and I am frustrated that despite our efforts we haven’t been able to identify the cause of this mystery illness.”

The condition can sometimes be hard to diagnose as similar symptoms are also found in other neurological illnesses like transverse myelitis and Guillain-Barre syndrome. The symptoms of the illness are most often compared to polio, but all of the AFM cases have tested negative for poliovirus. The CDC lists a number of symptoms to watch out for including a sudden onset of arm or leg weakness and loss of muscle tone and reflexes, facial droop/weakness, drooping eyelids, difficulty in moving the eyes, or difficulty with swallowing or slurred speech.

The most severe symptom, according to CDC, is respiratory failure. It happens when muscles involved in breathing become weak. In rare cases, the processes in the body which triggered AFM can also trigger other serious neurologic complications. This could sometimes lead to death.

There is no specific treatment or cure for the illness yet. CDC recommends people to protect themselves from polio and West Nile viruses through vaccines and avoid getting bitten by mosquitoes to avoid contracting the illness.

According to the CDS, there were 396 confirmed cases of AFM across the U.S. from August 2014 through October 2018. A graph showed that the illness spiked every consecutive year since 2014, around August. In 2014, 120 people across 34 states were diagnosed with AFM. It decreased to 22 in 17 states in 2015 but again spiked to 149 in 39 states across the U.S. and Washington, D.C in 2016. In 2017, the number of reported cases again shrunk to 33 in 16 states.