Acute Flaccid Myelitis Update from the CDC
Node Smith, ND
The CDC has updated its report on Acute Flaccid Myelitis (AFM) this month, and voices its concern for the condition, which causes serious weakness in the arms and legs of predominantly children.
CDC has reported 386 confirmed cases of AFM in the United States
Over the last 4 years (August 2014 to September 2018) the CDC has reported 386 confirmed cases of AFM in the United States; most cases have been children. It is important to remember that these cases are isolated to the United States because the illness presents very similar to polio, though all of the 386 cases have been negative for poliovirus. Since poliovirus is something that is still seen worldwide, and causes similar symptoms, this distinction is important.
AFM still remains a very rare condition
The CDC reports that even though there has been an increase in AFM over the past 4 years it still remains a very rare conditions, affecting less than 1 in a million individuals each year in the United States. The cause is not known in most cases.
Acute flaccid myelitis (AFM) affects the nervous system
Acute flaccid myelitis (AFM) is a condition that affects the nervous system, specifically the spinal cord, causing weakness in one or more extremities. The causes of AFM, and other neurologic conditions like it are varied and symptoms can arise from viruses, environmental toxins or genetic disorders.
CDC is actively investigating these cases
The CDC reports that since August 2014, it has not confirmed the cause of the majority of the cases of AFM. However, it is actively investigating these cases and continues to gain information about suspected AFM cases. They acknowledge that the patient’s symptoms have been most like symptoms seen with infections of the nervous system caused by certain viruses, such as poliovirus, enteroviruses, adenoviruses, and West Nile virus.
All testing of AFM suspected cases negative for poliovirus
All testing of AFM suspected cases has been negative for poliovirus. The CDC has tested for many different known pathogens in AFM cases. To date, no pathogen has been consistently identified in the spinal fluid.
Increase in AFM did coincide with an outbreak of severe respiratory illness caused by enterovirus D68
The CDC does report that in 2014, the increase in AFM did coincide with an outbreak of severe respiratory illness caused by enterovirus D68 (EV-D68). However, among those with confirmed AFM, EV-D68 was not consistently detected in every patient. During 2015, the CDC did not receive any information significant of any large EV-D68 outbreaks in the United States, and in 2016, there were only few localized outbreaks.
Much is unknown, but one thing is consistent
There is much that is unknown, but one thing is consistent, that children are most affected. Physicians should be aware of this potential concerning condition and contact the CDC and health authorities with suspected cases.
Node Smith, ND, is a naturopathic physician in Portland, OR and associate editor for NDNR. He has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp-out where naturopathic medicine and medical philosophy are experienced in nature. Four years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.