November 8, 2018

Acute Flaccid Myelitis: What to Know about the Rare Condition

By Chelsea Ragland, MD

News headlines of a “polio-like illness” affecting children across the United States have many parents in western North Carolina worried. Acute flaccid myelitis (AFM) is a rare condition that results in weakness or paralysis in children, usually following a respiratory virus. While the particular virus in the current outbreak has not been identified, past outbreaks have been attributed to a particular strain of enterovirus, a “common cold” virus.

In addition to causing respiratory symptoms such as runny nose, sneezing and cough, in some children the virus also attacks the nerves and spinal cord. It is important to note that the vast majority of children who contract colds this fall and winter will not develop this complication. Even amidst the current rise in cases, the odds of your child developing acute flaccid myelitis are around one in a million.

All suspected cases of AFM are reported to the local health department and the CDC.

Signs of AFM to look for include sudden onset weakness of an arm or leg, a facial droop or weakness of the muscles used for swallowing. Rarely, AFM can cause weakness of the muscles used for breathing. If your child develops these signs, they should be evaluated in the hospital. Work-up for acute flaccid myelitis may include bloodwork, a lumbar puncture and an MRI of the brain and spinal cord.

The long-term prognosis of AFM varies from one child to another. Some children quickly make a full recovery, while others may continue to have residual weakness for months or years after diagnosis. Most children will require ongoing work with occupational and physical therapists to regain strength and skills after discharge from the hospital.

The best thing you can do to protect your child this fall and winter is to teach them about simple ways to prevent the spread of disease: wash your hands, don’t eat or drink after your friends and cover your nose and mouth when you sneeze or cough.

Chelsea Ragland, MD, is a pediatric hospitalist for Mission Children’s Hospital.

Learn more about protecting yourself against infections at Learn more about pediatric care and services at Mission Health at