Ask The Doctors: Polio-like illness rare, not fully understood

Dear Doctor: I’ve been reading about a new illness that’s a lot like polio and is making children in parts of the country very sick. What is it, and should my family and I be worried?

Dear Reader: You’re referring to acute flaccid myelitis, also known as AFM, a rare neurological disease that affects the spinal cord. The symptoms mimic those of polio.

Before we get into specifics, we want to stress that AFM is quite rare. Despite the sudden spate of alarming news reports that have, quite understandably, caused you concern, the rate of infection is extremely low – one person per million. As of last November, there were 120 confirmed cases of AFM in the United States in 2016.

So what exactly is AFM? It’s a syndrome that can cause the muscles and reflexes in the body to stop working normally. Symptoms often arise quickly. What begins as a fever or respiratory illness gives way to weakness in the limbs, including a possible loss of muscle tone. In several reported cases, the first symptom in a child diagnosed with AFM was a sudden limp. Some patients have slurred speech or facial drooping. In the most serious cases, acute weakness in the muscles that control breathing has led to respiratory difficulties.

At this time, the causes of AFM are not fully understood. Officials at the Centers for Disease Control and Prevention suspect a range of viruses may be involved. These include West Nile virus, enteroviruses that enter the body through the intestines, and adenoviruses, which can cause coldlike symptoms, including sore throat, bronchitis, pneumonia, diarrhea and pink eye.

Research into the causes of AFM, which affects children in greater numbers, is a national priority.

If you believe you or your child has symptoms that correspond with those of AFM, call your family doctor. The findings from a careful examination of the nervous system, with accurate mapping of the muscles and reflexes affected, and diagnostic tests such as an MRI and analysis of the cerebrospinal fluid, will allow a correct diagnosis.

Several germs are suspected in AFM, so the CDC recommends your family is up-to-date on polio and all recommended vaccinations, and you protect yourself from mosquito-borne viruses by using insect repellents.