People in 16 states have come down with a rare polio-like illness this year — here's what to know about it

acute flaccid myelitis

  • People in 16 states have come down with a rare illness called acute flaccid myelitis (AFM) this year, and most cases occur in kids
  • AFM may lead to paralysis and, very rarely, death. 
  • The signs of AFM include sudden arm or leg weakness, drooping eyelids, facial weakness or drooping, difficulty swallowing, or slurred speech.
  • Anyone displaying those signs should get medical help right away. 


On October 4, health officials in Minnesota announced that six children have contracted acute flaccid myelitis (AFM), a rare illness that can cause paralysis, since September 20. Typically, the state sees only one case per year at most. 

But Minnesota isn’t the only place where kids are coming down with the condition. On Tuesday, UPMC Children’s Hospital of Pittsburgh announced it was caring for three children with suspected AFMColorado health officials said in a statement there have been 14 cases of AFM in the state this year.  And nine cases of AFM have been reported in northern Illinois since mid-September, the state’s department of public health has said. 

From January through September of 2018, there have been 38 confirmed cases of AFM across 16 states, according to the Centers for Disease Control and Prevention (CDC), and that number may rise given recent cases reported in the news. 

This is actually part of a larger trend. The CDC has been investigating an increase in AFM cases that began back in August 2014, but doesn’t know it’s happening. Most of the 362 cases so far have been in children. 

The illness truly is rare — one Minnesota health official told CBS News kids have „about one in a million“ chance of getting it — but it is crucial that any child displaying the signs get medical attention right away, the CDC says. 

INSIDER spoke with pediatrician Dr. Natasha Burgert to learn more about AFM and its telltale symptoms. Here’s what you need to know. 

The causes of AFM are still unclear


AFM affects the nervous system, particularly the spinal cord, causing muscles and reflexes across the body to become weak, the CDC explains. It’s often described as „polio-like“ because polio also affects the nervous system, causing neurological changes, Burgert said.

AFM can happen in adults but tends to be more common in kids, she added. But the cause of the disease still isn’t known. 

„That’s why it’s so scary,“ Burgert said. „This is a potentially life-threatening illness and we don’t know the cause, and if we don’t know the cause, we can’t predict it.“

But it’s thought that AFM may be a communicable disease.

„Because there does seem to be a seasonal pattern and it does seem to happen in clusters, that makes us lean towards it being a communicable disease or an infectious disease,“ Burgert added.

The CDC says that certain viruses — including the polio virus, enteroviruses, adenoviruses, and West Nile Virus — may cause AFM or conditions that are extremely similar to AFM.

But so far, after testing many AFM patients, the CDC has not been able to find any consistent evidence of viruses or other pathogens that appear to cause the disease. It’s possible that environmental toxins or genetics play a role, too. 

Anyone with AFM symptoms should see a doctor ASAP

Most people with AFM will experience sudden arm or leg weakness with a loss of reflexes and muscle tone, according to the CDC. Some people may also have facial drooping and weakness, drooping eyelids, difficulty swallowing, and slurred speech.

These signs may be a little harder to spot in young children, Burgert said, since they aren’t always able to articulate their symptoms.

„Since we know that this disease involves loss of muscle tone, I’m watching how [kids] are walking, how they’re drawing, how they’re using their utensils. For example, if they’re right-handed and now they’re only using their left arm, that’s going to be a huge red flag,“ she said. „I would also look at their smile. A kid’s smile should always be symmetric.“

afm symptoms infographic

The most serious symptom of ADM is respiratory failure, the CDC says, which can happen when the muscles you use to breath become weakened. This is what makes AFM a potentially deadly disease, Burgert said. 

But she stressed that breathing difficulties won’t be the first sign of AFM. The initial symptoms like limb and facial weakness do come on suddenly, but it takes some time for the disease to progress to the point where it affects breathing. 

„Any astute parent with an appropriate level of concern will be able to reach hospitals and clinics for evaluation before that would happen,“ Burgert said. „It’s not like they’re going to stop breathing in the middle of the night [because of AFM]. We just have to be attuned to the first signs.“ 

Finally, most recent reports have shown that AFM seems to happen two to three weeks after a child has a viral illness like a cold or flu, Burgert explained.  But that doesn’t mean every kid who gets temporarily sick will end up with AFM. 

„It’s important to know that this is still very rare and that the vast, vast majority of kids are going to have these normal cold and flu viruses with no complications,“ she said. 

There’s no specific treatment, but people with AFM can get supportive care in the hospital

kid getting vaccine shot

There’s no specific treatment for AFM, according to the CDC. 

„It’s not something you can go to a hospital and get a medicine for right now,“ Burgert said. 

Instead, she explained, people with AFM get supportive care in the hospital. Doctors will monitor their bodily functions, for example, and make sure patients who need breathing assistance get it. This care continues until the body starts to fight the infection on its own, Burgert said. After that, it’s a matter of recovery. 

Since AFM attacks the neurons in the spinal cord, affecting neurological function, recovery from the condition is an attempt to regain that compromised function, Burgert explained. 

„For kids that’s less of a worry,“ she said. „Kids are so malleable, and kids with amazing neurological deficits can still regain that function as their brain and nervous system are growing and changing. In adults, when we have a neurological injury, it’s a lot harder to repair.“

Recovery interventions may vary on a case-by-case basis, the CDC explains. For example, some doctors may recommend physical or occupational therapy to help a patient recover from arm or leg weakness. Unfortunately, we still don’t know the long-term health outcomes for people who get AFM

And because experts still don’t know the causes of AFM, it’s not exactly clear how to prevent it, either. But there are some steps that could help.

The CDC says that both polio virus and the mosquito-borne West Nile Virus may lead to AFM. The polio vaccine will protect kids against polio, of course, and to avoid mosquito bites, you can use insect repellent, stay inside at dusk and dawn when it’s more common to get bitten, and remove any standing water near your home, since mosquitoes can breed in it. 

The CDC also recommends frequent hand washing with soap and water. Though it’s not known if hand washing can prevent AFM, it‘ still a proven way to reduce the spread of germs between people. 

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