CDC expects 2020 outbreak of life-threatening AFM in children

Henrietta Brewer
August 6, 2020

The US Centers for Disease Control and Prevention said that it "anticipates that 2020 will be another peak year for cases of acute flaccid myelitis (AFM)".

"We are concerned that in the midst of a [COVID-19] pandemic that cases might not be recognized with AFM, or we're concerned that parents might be anxious about taking their child to the doctor if they develop something as serious as limb weakness", Thomas Clark, the deputy director of CDC's Viral Diseases Division, said on the call with U.S.News.

AFM is a medical emergency and patients should seek immediate medical care, even in areas with high novel coronavirus incidence. About 25% required a ventilator. Also, symptoms can include fever, headache, back or neck pain, respiratory illness, and neck or facial swelling, among other things, the report said.

If parents see these symptoms develop in children, they should contact a doctor.

In 2018, 238 cases of AFM were reported to the CDC, up from 149 cases in 2016, and the largest outbreak since the CDC began surveillance in 2014. Cases of the condition have spiked every 2 years in the United States since 2014, affecting more Americans with each outbreak.

Most patients had a fever and/or respiratory illness approximately six days before limb weakness onset. "CDC will continue to investigate how enteroviruses, including EV-D68, might cause or trigger AFM".

While many children will recover to their usual state of health after AFM, unfortunately, many kids will have permanent disability.

As of July 31, there have been 16 confirmed cases, and 38 patients under investigation for the disease, this year so far.

Most patients were hospitalized within a day of experiencing weakness but about 10 percent were not hospitalized for more than four days, possibly because of failure to recognize the syndrome, the report said.

At a media briefing on Tuesday, Thomas Clark, deputy director of CDC's division of viral diseases, said there is concern about the peak of AFM amid coronavirus outbreak.

CDC alerted health care providers to a possible outbreak this year. Other common early symptoms were difficulty walking, neck or back pain, fever, and limb pain.

"We are concerned in the midst of a COVID-19 pandemic that cases [of AFM] might not be recognized or that parents might be concerned about taking their kids to the doctor", Clark said.

"Pediatricians and frontline providers in emergency departments and urgent care centres should be prepared to quickly recognize symptoms of AFM and immediately hospitalize patients".

He warned parents not to hesitate to hospitalize their child despite the COVID-19 pandemic if they show symptoms.

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