Acute flaccid myelitis: What parents should know

We know how alarming it can feel for parents to hear news reports about a medical emergency known as acute flaccid myelitis. This Q&A with CHOC pediatric experts offers answers to your frequently asked questions, including what to do if you suspect your child has acute flaccid myelitis.

What is acute flaccid myelitis?

Acute flaccid myelitis (AFM) is a rare condition that affects the spinal cord, which can lead to muscle weakness. It usually affects children and happens following a fever or cold symptoms.

What causes acute flaccid myelitis?

The cause is not known for sure but experts believe that viruses, including enteroviruses, might cause AFM. Most cases occur between August and November.

AFM is not a new problem, but many people are just learning about it in news reports because of recent outbreaks.

AFM is still very rare, with fewer than one in 1 million people per year being diagnoses in the U.S. It usually affects children.

What are the signs and symptoms of acute flaccid myelitis?

A child with AFM usually has progressive weakness in the arms and legs that may be rapid over hours to days. Their face may also be affected. Other symptoms of AFM include:
~ Drooping eyelids
~ Pain or numbness in one or more limbs
~ Difficulty walking
~ Headache
~ Back or neck pain
~ Difficulty talking or swallowing
~ Neck or facial weakness

Most children with AFM will have a fever or respiratory illness about six days before weakness occurs. For this reason, AFM has been associated with certain types of viruses, and specifically one called enterovirus D68.

What should I do if I think my child has acute flaccid myelitis?

If you or your child have any symptoms of AFM, get medical care right away. With AFM, a patient’s health can decline quickly, resulting in paralysis or the need for a ventilator. AFM can sometimes lead to permanently disability.

It is safe to seek the emergency and preventive care you and your children need despite the ongoing COVID-19 pandemic.

When AFM is caught early, doctors can hospitalize patients and provide optimal medical management and rehabilitation.

What is the treatment for AFM?

If doctors suspect your child has AFM, they will be hospitalized and cared for by a team of multidisciplinary specialists which may include primary care, neurology, infectious disease, physical therapy and occupational therapy. Doctors will review your child’s medical history, perform a physical exam and use an MRI to review your child’s spinal cord.

Scientists are still studying possible treatments for AFM. Possible treatments that may be used include:
~ Corticosteroids, used to treat inflammation
~ Intravenous immunoglobulin, used to treat immune disorders
~ Plasmapheresis, used to remove antibodies from the blood

Physical rehabilitation could help improve long-term outcomes. Some patients may receive nerve transfer surgery to repair nerve injuries.

Talk to your child’s doctor about specific questions you have for their care.

Can you prevent acute flaccid myelitis?

Viruses might cause AFM, so you can avoid spreading germs by:
~ Washing your hands well and often
~ Keeping up to date on vaccinations
~ Preventing mosquito bites
Keeping sick children home from school

Is acute flaccid myelitis contagious?

No, AFM is not contagious.

Hand Sanitizers: Fact or Fiction?

Hand sanitizer gels are ubiquitous these days – and so are the myths surrounding these products.

Today, a CHOC infectious disease specialist comes clean on what’s fact and what’s fiction when it comes to hand sanitizing gels.Hand Sanitizer Tips

Fact: Hand sanitizers are a good option for removing some germs from hands.

“Washing your hands with soap and water is an effective way to keep clean, but hand sanitizers are useful when you are not near a sink and you can’t wash your hands,” Dr. Felice Adler says. “Sanitizers are also easy to take with you and pack on a trip. Sometimes you just don’t have a sink handy.”

Fiction: All hand sanitizers are created equal.

“It’s recommended that you look for an alcohol-based hand sanitizer with at least 60 percent alcohol,” Dr. Adler says. “Studies have shown that hand sanitizers with alcohol content between 60-95 percent are more effective at killing germs than those with lower alcohol content and non-alcohol based hand sanitizers.”

hand hygiene tips Fiction: Hand sanitizers remove dirt or grease better than soap and water.

While hand sanitizers will help to kill many (but not all) bacteria and viruses, they will not remove stubborn dirt or clean really filthy hands, Dr. Adler says. Hand washing with soap and water is preferred before preparing or eating food, after using the toilet, after handling animals or their food or waste, and when hands are visibly dirty.

The bottom line:

When it comes to keeping hands germ-free, there’s nothing like a good, old-fashioned vigorous hand washing with soap and water. However, a squirt of an alcohol-based hand sanitizer can be a good alternative.

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