Pediatric Acute Flaccid Myelitis

Although acute flaccid myelitis is sometimes referred to as a “polio-like” condition, it is not caused by poliovirus . Instead, experts believe it is usually caused by enteroviruses , particularly D68, or EV-D68. The virus typically strikes between August and November.

Acute flaccid myelitis cases have been increasing in the United States every other year since 2014. The last outbreak, in 2018, resulted in 238 cases in 42 states. The virus tends to come in two-year cycles. Fortunately, acute flaccid myelitis itself is not contagious, and only a few people who get the EV-D68 virus will get acute flaccid myelitis.

The most common symptoms of acute flaccid myelitis are sudden onset of arm or leg weakness, loss of muscle tone and loss of reflexes. This often follows a fever or respiratory illness.

Other symptoms include:

• Drooping eyelids or difficulty moving the eyes
• Facial droop or weakness
• Difficulty talking or swallowing
• Severe pain or numbness in arms or legs
• Pain in neck or back
• Difficulty breathing

You should seek medical care right away if your child develops these symptoms.

Currently, there is no specific treatment for acute flaccid myelitis, but doctors may recommend different treatments based on each patient. Physical and occupational therapy helps with arm or leg weakness, and antivirals or immunoglobulin can help the body fight off the virus and reduce neuroinflammation. Often treatment in an intensive care unit is needed. Research is underway to improve understanding of acute flaccid myelitis and develop better treatments.

Because experts believe acute flaccid myelitis is caused by a virus, the same preventive actions that reduce a person's risk for COVID-19 infection — frequent handwashing, physical distancing, mask wearing and cleaning and disinfecting high-touch surfaces — can also help prevent acute flaccid myelitis.