Acute Flaccid Myelitis



Recently, there is a growing concern for Acute Flaccid Myelitis (AFM) especially in the United States of America.
So far, the CDC has reported over 62 cases across 22 States including Wisconsin, Minnesota and Iowa.
The AFM is a rare condition that affects the nervous system, precisely the area of the spinal cord called the grey matter.
This disease usually causes the muscles and reflexes in the body to become weak.
This illness usually starts suddenly and is common in children.


Although the illness is not new, the rising trend since 2014 is new.
The CDC estimates that less than one in a million people will get AFM every year.

Causes
A variety of possible causes of AFM include:
  • Viruses (Such as polio virus, non-polio enteroviruses, adenoviruses, and West Nile virus)
  • Enviromental Toxins
  • Genetic Disorders

The September 26, 2014 CDC health Advisory that decided the cases identified enterovirus 68, a member of the enterovirus D species as a suspected cause.



Signs and Symptoms

Some of the signs and symptoms of Acute Flaccid Myelitis include:
  1. Sudden arm or leg weakness
  2. Facial droop or weakness
  3. Difficulty moving the eyes or drooping eyelids
  4. Difficulty with swallowing or slurred speech
  5. Numbness or tingling(rarely)
  6. Inability to pass urine (in some patients)
  7. Respiratory failure (worse symptom when the muscles involved with breathing are involved)
In the worse case scenario, it is possible that the process that triggered AFM in the body can also cause neurological complications that can lead to death.

Diagnosis

AFM is diagnosed by examining a patient’s nervous system together with reviewing images of the spinal cord.
Also a doctor can examine a patient’s nervous system and the parts on the body where he or she has weakness, poor muscle tone, and decreased reflexes. 
Furthermore, a doctor can do an MRI (magnetic resonance imaging) to look at a patient’s brain and spinal cord, do lab tests on the cerebrospinal fluid (the fluid around the brain and spinal cord), and may check nerve conduction (impulse sent along a nerve fiber) and response.


Treatment
There is no specific treatment for AFM. Treatment is largely symptomatic. A neurologist may recommend certain interventions on a case-by-case basis. 
Some patients may benefit from physical or occupational therapy to help with arm or leg weakness caused by AFM. 
We do not know the long-term outcomes (prognosis) of people with AFM. Hence the need to pay attention to possible prevention.

Prevention
  1. Be up to date with vaccinations.You can protect yourself and your children from poliovirus (which is one of the presumed causes of AFM) by getting vaccinated. Polio vaccine contains inactivated (not live) virus, and protects against poliovirus. This vaccine does not protect against other viruses that may cause AFM.

 
   2.  You can protect against bites from mosquitoes, which can carry West Nile virus, by using mosquito repellent, staying indoors at dusk and dawn (when bites are more common), and removing standing or stagnant water near your home (where mosquitoes can breed).


3. Washing your hands often with soap and water is one of the best ways to avoid getting sick and spreading germs to other people. This may probably be effective in preventing AFM. In my house, there is a mantra we chime when the children come back home from school and it is : "Take your shoes off, socks off, wash hands and then treat". 




Prevention they say is better than cure. There is a need to be aware of what is going on around us ,and make a conscious effort to take responsibility for our own health.
Every child deserves a healthy and happy life.




“Healthy citizens are the greatest asset any country can have.” Winston Churchill


Warm regards,
Dr Funmi.

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