AFM: The Polio-Like Mystery Illness

AFM: The Polio-Like Mystery Illness

AFM: The Polio-Like Mystery Illness


by Dr. Rebecca Butler
of Lantana Pediatrics

Acute flaccid myelitis (AFM) refers to a polio-like neurologic disease first reported in 2012 in California in a child with evidence of enterovirus D68 in respiratory tract specimens. An increase in reported cases has been observed in the late summer and fall of subsequent years, including 2014, 2016, and 2018. As of November 2018, federal health officials have confirmed over 100 cases of acute flaccid myelitis (AFM) in the United States. Most of these cases have been in children around 4 years old. Despite extensive laboratory testing, the exact cause of AFM has not been confirmed and it remains unclear whether the illness is the direct result of the viral illnesses or an autoimmune response in some individuals who contract these viral illnesses. While this sounds frightening, the American Academy of Pediatrics (AAP) reminds parents that AFM is very rare. The chances of a child getting it are less than one in a million.

The best thing you can do to protect your children from getting sick is to keep up with what you are already doing:

  • Frequent handwashing
  • Staying up to date on routine immunizations
  • Keeping household surfaces clean by regular sanitizing and disinfecting
  • Keeping your children home from daycare or school when they are sick
  • Wearing insect repellant when mosquitos are near

Characteristic features of this disorder are a febrile or respiratory illness before the onset of neurologic symptoms and a presentation similar to poliomyelitis, with limb weakness, and variable facial weakness, eye weakness, speech disturbances. Patients usually present first with a respiratory or gastrointestinal illness accompanied by fever, chills and body aches. Weakness typically progresses rapidly, most often reaching maximum severity over the course of a few hours to a few days. The average onset of neurologic symptoms was 7 days into the viral illness.

Remember, AFM is different than polio! While AFM is often called a “polio-like illness,” polio is very different. Prior to the polio vaccine which was introduced in 1955, polio was very common in the United States. It paralyzed and killed thousands of people every year. Thanks to the vaccine, polio has been eliminated in the United States. But it still occurs in other parts of the world. Why to keep getting children vaccinated for polio: It would only take one person infected with polio coming from another country to bring the disease back here if we were not protected by vaccination. If the effort to eliminate the disease from the world is successful, some day we won’t need polio vaccine. Talk with your pediatrician if you are concerned about your child’s health. Seek immediate medical care if your child has sudden weakness, loss of muscle tone, a droopy face, or difficulty swallowing or speaking.


940.455.7200 | www.LantanaPediatrics.com74 McMakin Rd., Ste. 100 • Bartonville, TX 76226
Mon, Tues, Thurs: 7:30am-5pm • Wed: 7:30am – 12:30pm | Fri: 7:30 – 4pm • Sat: 9am – 12pm


An overview of CDC information and resources for AFM in the United States is found at

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