ABC News recently carried an article describing an anticipated surge in the latter part of 2020 of acute flaccid myelitis. Thankfully, it did not occur.
The disease is caused by a virus called enterovirus D68 (EV-D68) and can paralyze children. The CDC issued a warning of a surge in the virus, but it appears that our children escaped.
In September 2020 the CDC announced a Health Alert Network Advisory warning of an uptick in enterovirus D68 (EV-D68) cases. The virus has been associated with a neurological condition that causes paralysis in children.
The agency then reported in the latter part of September that 26.4% of children and adolescents had sought emergency care or required hospitalization due to acute respiratory illnesses. Of this number, 17.4% tested positive for EV-D68.
The condition is rare and attacks the central nervous system. It causes the child’s muscles and reflexes to weaken, potentially becoming paralyzed. Previously, outbreaks occurred in 2014, 2016, and 2018.
And then in December 2022, the CDC issued a reported acute flaccid myelitis (AFM) did not reach the projected surge in cases.
AFM Cases in 2022
Dr. Janell Routh, who leads the CDC’s Division of Viral Disease team, reports that the AFM numbers were low in 2022. That was in spite of the rise in EV-D68 infections that climbed to 56% by the middle of August.
Dr. Routh commented that this is the first year recording such a large discrepancy between EV-D68 and AFM since it was first reported in 2014.
She said that 30 cases of AFM confirmed by the CDC this year appear to be in line with numbers of other non-outbreak years. The enteroviruses generally circulate at the end of the summer or in the early fall. Yet the CDC remains on alert as cases have appeared in the latter part of 2021 and 2022.
Dr. Routh acknowledged that no one knows why the pattern established by the CDC did not play out. She suspects that there could be a host of factors that changed over the course of the last few years.
Dr. Amy Moore, of the Wexner Medical Center, works with AFM patients. She also finds the dip in AFM cases baffling. Although the new cases have outnumbered those in 2021 and 2022, they are still well under the anticipated surge.
The Dangers of AFM
Dr. Robert Redfield, a former CDC director, explained that AFM progresses quickly. Patients may be paralyzed within a few hours or days, requiring a ventilator. Dr. Redfield warned that some patients can become permanently disabled. The virus appears to arrive in two-year cycles.
