What RTs Need to Know About Acute Flaccid Myelitis

 Updated: January 30, 2019

  Tags: Patients

image of AFM disease

The CDC has been monitoring cases of acute flaccid myelitis (AFM) on a state-by-state basis since 2014 when the disease was first identified among children across the country.

In 2018, 201 confirmed cases were reported in 40 states, the vast majority of them in children age 18 and younger.

Due to the rise in the number of cases, the CDC has now established an AFM Task Force to assist in the ongoing investigation into the causes of AFM and search for better ways to treat it and improve outcomes for patients.

What is acute flaccid myelitis and how might respiratory therapists be involved in the care of children diagnosed with the condition? According to the CDC –

  • AFM is a rare but serious condition affecting the nervous system, causing muscle weakness and weakness in the body’s reflexes, including sudden onset of arm or leg weakness and loss of muscle tone and reflexes; difficulty moving the eyes or drooping eyelids; facial droop or weakness; and difficulty with swallowing or slurred speech.
  • The most severe symptom of AFM is respiratory failure, which occurs when the muscles involved in breathing become weak; urgent mechanical ventilation may be required.
  • Certain viruses, including poliovirus, enterovirus A71, and West Nile virus, are known to cause the condition.
  • More than 90 percent of patients with AFM developed the disease after having a mild respiratory illness or fever consistent with a viral infection.
  • Most patients develop the disease between August and October.
  • The disease is diagnosed by reviewing images of the spinal cord and MRIs of the patient’s brain and spinal cord, lab tests on the cerebrospinal fluid, and checks of nerve conduction.
  • Cases have been increasing every two years since 2014.

Detailed information on AFM for clinicians and health departments appears on the CDC website, including case definitions, specimen collection instructions, data collection information for patients under investigation for AFM, interim considerations for the clinical management of patients, and FAQs geared to health care providers.

Clinicians are also invited to listen to a recent Clinical Outreach and Communication Activity Call outlining what health care providers need to know about the condition.

The AARC encourages respiratory therapists to take a few moments to review these materials on this growing public health threat.