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CDC warns of possible outbreak of polio-like illness AFM in children this fall

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The Centers for Disease Control and Prevention issued a new warning for parents that it expects 2020 to be another peak year for cases of acute flaccid myelitis, or AFM.

The disease is an uncommon, but very serious neurologic condition that affects mostly children. It impact the nervous system, specifically the area of the spinal cord called gray matter, which causes the muscle and reflexes to become weak.

The CDC said doctors and parents should suspect AFM if a child experiences sudden limb weakness, especially during August through November. AFM peaks every two years between August and November, the CDC said. Additionally, the CDC said recent respiratory illness or fever and the presence of neck or back pain or any neurologic symptom should heighten their concern.

Complicating the issue is the CDC said in 2018, the last year of an outbreak, 35 percent of patients were not hospitalized until two or more days after limb weakness. The CDC said any delay in treatment can be problematic because AFM progresses rapidly in hours or days and can lead to permanent paralysis and/or life-threatening complication of respiratory failure in previously healthy patients.

“All clinicians should remain vigilant for AFM and promptly evaluate patients,” said Thomas Clark, M.D., deputy director of CDC’s Division of Viral Diseases. “During the COVID-19 pandemic, this may require adjusting practices to perform clinical evaluations of patients by phone or telemedicine. However, clinicians should not delay hospitalizing patients when they suspect AFM.”

According to the CDC, it’s not known how COVID-19 and social distancing measures may affect the circulation of viruses that can cause AFM, of if COVID-19 will impact the health care system to quickly recognize and treat AFM. Experts said if social distancing helps decrease circulation of enteroviruses, which are believed to cause AFM, the total number of cases or an outbreak may be delayed.

The last major outbreak of AFM was in 2018 when 238 cases were reported in 42 states. The CDC said 76 percent of those diagnosed sought care within 24 hours of onset of symptoms and 64 percent went to emergency rooms. Ninety-eight percent of those with AFM were hospitalized with 54 percent of those admitted to intensive care and 25 percent required ventilators to breathe.

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