We know we aren’t supposed to panic every time we hear about some scary new disease in the news no matter how rare it is. (Remember when flesh-eating bacteria made headlines and we swore we’d never let our kids swim again? Well we did and they still have all their flesh intact.) But we’re moms and we can’t help ourselves, so when we heard about the “spike” in recent cases of acute flaccid myelitis (AFM), which causes polio-like muscle weakness or paralysis mainly in kids, we couldn’t help but freak out. So far this year, 62 cases have been confirmed in 22 states, including three in New Jersey, so we wanted to set ourselves straight on what it is, how to prevent it, and whether we should be worried. We turned to Ashwin Jathavedam, MD, chief of infectious diseases at Englewood Hospital, to answer all of our questions, and we must admit: We feel better. You will too, so read on ...
What is acute flaccid myelitis?
It’s a neurologic response. Lots of things can trigger these neurologic syndromes but this particular one has been linked to a particular enterovirus infection. Nobody knows exactly how it occurs, but it’s kind of a trigger. Other viruses can rarely have these types of triggers but this for this enterovirus outbreak, AFM is the response that causes the paralysis and the weakness.
And what exactly is an enterovirus?
Enteroviruses have many different strains and most of them are pretty benign. They can cause coughs, colds, things like that. In these cases we’ve seen in this current outbreak it’s the usual history: The child gets sick, fever, sniffles, but then it’s later on they develop the weakness and some of the neurologic symptoms.
Who is most at risk?
It’s usually in younger patients and usually in kids who sometimes haven’t been exposed to a lot of viruses and may not have protective antibodies.
What should parents look out for?
There’s no way to know the difference upfront. There’s no easily implemented blood test or swab or anything that would tell you. Statistically speaking, it’s extraordinarily unlikely you’ll end up with that syndrome, but the features to look for are if the child does exhibit any neurologic symptoms after they recover from the cold. If they start to say their leg is weak, arm is weak. It’s generally not subtle. Most parents will recognize something is wrong and that’s what should prompt getting attention right away.
How long do symptoms last?
It’s variable. It’s a very wide spectrum. Some people may get it and don’t get any neurologic symptoms. And for some patients it’s very severe, landing them in the hospital. And in extreme cases it can affect muscles that help you breathe and things like that.
Does it run a risk of permanent disability or death?
It can. Nerves recover very slowly, depending on the degree of nerve damage. Some patients recover fully, other patients are left with chronic disability. There’s no way to predict it, unfortunately.
Should parents be worried?
Even with this outbreak, it’s still an extraordinarily rare occurrence. Think about the number of people who get colds and coughs. The CDC will tell you it’s like 1 in a million risk. It’s very low-risk. Because so many people get colds, this small increase causes the numbers to spike. The overall risk is still very, very low. I wouldn’t advise anyone to panic if their kid has a cold.
But is there anything we should still be doing to prevent it?
The best prevention is preventing the initial infection in the first place. Easier said than done with kids because they don’t wash their hands as regularly. They’re playing together. The key is to teach your children to cover your mouth when you sneeze, wash hands regularly, use Purell, things like that.
How long do you expect this outbreak to last?
This isn’t the first time there’s been an outbreak like this. There’s been other enterovirus outbreaks. Generally, they do die out. It’s not something I expect to continue very long. It’s usually seasonal kind of infection more often in the fall and winter months. I do expect it will burn itself out. This season I’d worry more about the flu.