Cincinnati Children's Expects to See Return of Acute Flaccid Myelitis Cases

Physicians want to increase awareness about rare enterovirus that peaks every two year

Thursday, August 13, 2020

While the coronavirus (COVID-19) has been on the minds of many, doctors at Cincinnati Children’s also want parents to be aware of a different kind of virus that is expected to peak in the fall of 2020. Acute flaccid myelitis (AFM) is a rare, but serious, illness that affects the nervous system, mostly in children between the ages of 3 to 10-years-old.

“Acute flaccid myelitis first emerged in the fall of 2014,” said Marissa Vawter-Lee, MD, a neurologist at Cincinnati Children’s. “We saw it again in 2016, 2018, and so history tells us we expect to see this specific enterovirus again this fall. An enterovirus is a virus that can give you a cold, runny nose, or a cough. What we don’t know is how COVID-19 will have an impact, so we really just want parents to be aware.”

AFM is related to a viral infection that in some children triggers an abnormal immune response. As a result, it causes changes in the child’s spinal cord and brain which can result in a sudden onset of weakness in the arms and legs.

In 2018, 3-year-old Elijah Peacock of Northern Kentucky was admitted to Cincinnati Children’s after both of his legs had suddenly gone weak.

“It all started with a cold. Normal sniffles and a cough,” said Alex Voland, Elijah’s mom. “The biggest concern was that he kept tripping. He’d walk a few steps and then would fall over. A few days later he couldn’t walk at all.”

Elijah was in the Intensive Care Unit before getting better and released from the hospital. Now age 5, he is in a wheelchair and takes part in physical therapy at Cincinnati Children’s twice a week to strengthen his legs.

“Today, he’s doing 10 times better,” said Voland. “He can crawl, he can walk with support for short periods. We are leaps and bounds from when we began this AFM journey.”

Researchers are still trying to determine what causes AFM. Cincinnati Children’s is one of the national sites working with the Centers for Disease Control to get answers. While AFM has been called a polio like illness, doctors say it’s not polio. In severe and rare cases, AFM will impact a child’s breathing muscles causing them to become weak or paralyzed which is why doctors say it’s important to seek help right away.

“For parents, I don’t think this is something you need to be at home worrying about all the time but you should have a basic understanding of what specifically to look out for in your child,” said Ben Kerrey, MD, attending physician in the Division of Emergency Medicine, at Cincinnati Children’s. “It’s going to be a dramatic, obvious difference in your child than what you would normally see. Specifically, sudden weakness in the extremities.”

The best way to prevent any viral infection is to practice standard precautions: good hand washing, avoiding those who are ill, and staying home if you are the one who is ill. Doctors also remind parents to get their children a flu vaccine.

“With COVID-19 precautions already in place, we hope to see fewer AFM cases since people are already washing hand frequently and practicing social distancing. But, even with those measures in place, we want parents to be aware of what AFM looks like should their child have symptoms,” said Vawter-Lee.