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Second case of acute flaccid myelitis found in Michigan

ev-d68-illustration.jpg
Yue Liu and Michael G. Rossmann, Purdue University
/
https://www.cdc.gov/
An electron microscopy image of enterovirus D68, one of the suspected causes of acute flaccid myelitis.

A child from Oakland County has been confirmed as the second case of acute flaccid myelitis in Michigan in 2018. The first case, confirmed earlier this month, was a child from Wayne County.

Nine suspected cases in Michigan are still under investigation. Acute flaccid myelitis is a rare but serious illness similar to polio that causes muscle weakness. AFM has been under surveillance by the Centers for Disease Control since 2014. Cases have been increasing since then, but as yet the cause and mode of transmission has not yet been identified.

Most patients with AFM had a mild respiratory infection before the onset of muscle weakness. That has led public health agencies to theorize that AFM could be a complication of a common viral infection.

Lynn Sutfin is with the Michigan Department of Public Health.

She says, “We don't want folks to panic. We do want them to be aware, to talk to their health care providers if they have concerns, and to take their child to the emergency room immediately if they start having facial drooping, slurring of speech, or sudden onset of muscle weakness.”

The CDC has confirmed 158 cases of AFM across the country in 36 states. Most of the patients are children. At current rates, the CDC estimates that less than one in two million children will get AFM annually.

An unusual feature of AFM is that it has been observed to occur in two year cycles, peaking between August and October. Some viruses have been detected in the spinal fluid of a few AFM patients. However, most patients have not tested positive for viruses.

There is no known effective treatment for AFM. According to the CDC, a long list of treatments such as corticosteroids, antiviral medications, and intravenous immunoglobulin have not been found effective. Currently, treatment is based on symptoms.