Doctors urged to look for early signs of polio-like acute flaccid myelitis in kids

The Centers for Disease Control and Prevention on Tuesday urged doctors to learn to recognize early signs of a polio-like condition in children, called acute flaccid myelitis (AFM), and move quickly to collect lab samples for investigators.

AFM is a rare condition that affects the nervous system and causes limb weakness. Some children have become severely disabled with paralysis, and some have required the help of a ventilator to breathe.

The cause of AFM is unknown, but the CDC suspects a virus is the likely culprit. But part of what makes that virus difficult to pin down is that symptoms of the condition often don’t show up until after kids start to recover from the infection. And the viral infection itself may only cause mild symptoms, like a head cold.

That’s why the CDC is urging doctors to collect lab samples as soon as possible when they suspect cases of AFM.

“When specimens are collected as soon as possible after symptom onset, we have a better chance of understanding the causes of AFM and developing a diagnostic test,” Dr. Anne Schuchat, the CDC’s principal deputy director, said in a call with reporters.

The CDC pointed to several clues that doctors can look out for: Cases of AFM tend to show up in late summer and early fall, between August and October. The average patient is around age five. And most patients have respiratory symptoms or fever consistent with a virus less than a week before developing limb weakness.

If doctors suspect AFM, the CDC says they should immediately collect lab specimens, including cerebrospinal fluid, and alert the health department if an MRI shows a spinal lesion.

Early identification can also help with recovery.

“Early and aggressive physical therapy and rehabilitation hold good promise to help kids strengthen the function that they have after AFM and regain as much strength and function as possible,” Dr. Tom Clark, a pediatrician and leader of the CDC’s team investigating AFM, said.