Researchers Continue Seeking AFM Trigger

By Terrey L. Hatcher, Editorial Group Manager

Although reports of acute flaccid myelitis (AFM) affecting children have dropped since the recent peak in fall 2018, clinicians are still on alert for the rare and severe disease and continue seeking a definitive cause.

AFM is a neurological illness that primarily affects children and manifests with rapid onset of severe weakness or paralysis. CDC data released Jan. 4, 2019, show 193 confirmed cases of AFM in 2018.

Olwen Murphy, MB, BCH, MRCP, and a team of researchers at The Johns Hopkins Transverse Myelitis Center in Baltimore are studying AFM to detect disease patterns and craft the best treatment strategies. Murphy, who is a James T. Lubin Fellow at the Johns Hopkins center, is also involved with a working group that is an informal network of interested healthcare professionals seeking to understand and treat the disease based on research.

AFM usually occurs immediately after a viral illness. Patients tend to have fever, respiratory symptoms, and diarrhea. The paralysis often affects one or more of the child’s limbs, and the disease can also affect muscles essential for breathing, speaking, and swallowing.

In a recent Relias Media podcast, Murphy discusses observations about the polio-like illness. “It’s vital that healthcare providers are aware that focal limb weakness can suggest AFM,” she says. “In a typical case, a child goes from being completely normal to a state of severe weakness or paralysis within hours to days.”

AFM cases have spiked every two years since 2014, when the CDC first began tracking the disease. Researchers suspect that AFM may be triggered by certain viruses in the enterovirus family, yet they are not sure how. Experts at the Johns Hopkins center are seeking to find the definitive cause of AFM and the pathological processes underlying the disease, Murphy notes.

Providers can find more information about diagnosing and treating AFM in the podcast and in the January issue of ED Management.