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• #1 Acute flaccid myelitis (AFM) in children – Children’s Health Neurology

  https://www.childrens.com/specialties-services/conditions/acute-flaccid-myelitis

  Acute flaccid myelitis (AFM) in children is a rare, serious neurological disease. It affects a part of the spinal cord called gray matter and causes muscles to become weak. It is a type of transverse myelitis. […] AFM causes weakness and paralysis in children by damaging the lower motor neurons. These nerve cells stretch from the spinal cord to muscles in the body. When the nerve cells within the spinal cord are damaged, they cause a flaccid paralysis (the muscles are loose, not tight). The paralysis can appear very quickly. […] Different types of AFM can be distinguished based on what causes them and which parts of the spinal cord are affected. Although the paralysis resembles polio, acute flaccid myelitis in children is usually caused by other viral infections of the spinal cord and not the specific virus that causes polio.

• #2 Pediatric Acute Flaccid Myelitis – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/acute-flaccid-myelitis

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system. […] Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system. Specifically, it targets the area of the spinal cord called gray matter and causes the body’s muscles and reflexes to become weak. It can lead to paralysis which is sometimes permanent. […] Although acute flaccid myelitis is sometimes referred to as a polio-like condition, it is not caused by poliovirus. Instead, experts believe it is usually caused by enteroviruses, particularly D68, or EV-D68. […] Acute flaccid myelitis cases have been increasing in the United States every other year since 2014.

• #3 Acute flaccid myelitis (AFM) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-flaccid-myelitis/symptoms-causes/syc-20493046

  Acute flaccid myelitis might be caused by an infection with a type of virus known as an enterovirus. Respiratory illnesses and fever from enteroviruses are common especially in children. Most people recover. It’s not clear why some people with an enterovirus infection develop acute flaccid myelitis. […] The symptoms of acute flaccid myelitis can look similar to those of the viral disease polio. But none of the acute flaccid myelitis cases in the United States have been caused by poliovirus.

• #4 Acute Flaccid Myelitis (AFM) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/acute-flaccid-myelitis

  Acute flaccid myelitis (AFM) is a condition that affects the nervous system, usually in young children. AFM affects the motor neurons in the spinal cord or brainstem and can progress rapidly. The most common symptoms are the sudden onset of weakness in the arms and legs. In rare cases, the loss of muscle tone and reflexes can lead to complete paralysis in one or more limbs. If you suspect your child has AFM, contact your doctor. […] Since 2014, there has been an increase in AFM cases every year. Most cases occur between August and October and coincide with the seasonal circulation of viruses, including enteroviruses. Enteroviruses, specifically D68 and A71, are possible causes of the condition. Although AFM is often described as polio-like, recent cases of AFM are not caused by the poliovirus.

• #5 What Causes Acute Flaccid Myelitis | Acute Flaccid Myelitis (AFM) | CDC

  https://www.cdc.gov/acute-flaccid-myelitis/causes/index.html

  AFM can be caused by viruses, including enteroviruses. […] AFM can also be caused by other viruses, including flaviviruses (West Nile virus, Japanese encephalitis virus), herpesviruses, and adenoviruses. […] These spikes in cases are thought to be caused by enterovirus D68 (EV-D68). […] AFM can also be caused by other viruses, including flaviviruses (West Nile virus, Japanese encephalitis virus), herpesviruses, and adenoviruses. […] The increase in 2014 coincided with a national outbreak of severe respiratory illness caused by EV-D68, and increased circulation of EV-D68 was observed in 2016 and 2018. […] EV-D68 was the most common virus detected in specimens from patients with AFM, usually in respiratory specimens. […] AFM patients had antibodies against enteroviruses in their spinal fluid more often than those without AFM. Having antibodies against a virus means that a person was previously infected with that virus. […] We have found coxsackievirus A16, EV-A71, and EV-D68 in the spinal fluid of a small number of patients with AFM. […] CDC and partners are continuing to investigate how AFM develops and why a small number of people develop AFM after getting a virus infection.

• #6 Acute Flaccid Myelitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK606127/

  Acute flaccid myelitis (AFM) is a rare but serious neurological condition that primarily affects the spinal cord, leading to sudden muscle weakness and loss of reflexes. […] The exact cause of AFM remains uncertain, though it is often associated with viral infections, particularly enteroviruses. […] The exact cause of AFM is not fully understood, but the link to certain viruses (eg, enterovirus D68, enterovirus A71, West Nile virus, adenovirus) has been observed. […] The exact cause of AFM remains elusive. AFM has been associated with various viral infections, particularly non-polio enteroviruses D68 and A71. Other viruses like adenovirus and West Nile virus have also been implicated. […] Evidence supporting the causative role of enterovirus D68 in AFM in animal models includes loss of spinal cord motor neurons in affected limbs, virus detection in motor neurons of the spinal cord, and development of paralysis by injecting the virus-containing serum from affected mice into healthy ones, fulfilling Koch postulates, and preventing AFM by administering serum with enterovirus D68 antibodies from previously infected mice.

• #7 Acute Flaccid Myelitis: MedlinePlus

  https://medlineplus.gov/acuteflaccidmyelitis.html

  Acute flaccid myelitis (AFM) is a neurologic disease. […] AFM can be caused by several different viruses. Researchers think that enteroviruses have been causing the recent increases in the number of children with AFM. AFM can also be caused by other viruses, including flaviviruses, herpesviruses, and adenoviruses. […] Most people with AFM had a mild respiratory illness or fever (like you would get from a viral infection) before they got AFM.

• #8 Acute Flaccid Myelitis | Wisconsin Department of Health Services

  https://www.dhs.wisconsin.gov/disease/afm.htm

  Acute flaccid myelitis (AFM) is also called acute flaccid paralysis with anterior myelitis or polio-like syndrome. It is rare and mainly found in children. It affects the bodys nervous system, specifically the spinal cord. AFM can be caused by some viruses, environmental toxins, and genetic disorders. […] Viruses that can cause AFM include enteroviruses (polio and non-polio) and flaviviruses such as West Nile Virus, Japanese Encephalitis virus, or St. Louis encephalitis virus. Other viruses that may cause AFM are herpesviruses (such as cytomegalovirus and Epstein-Barr virus) and adenoviruses. […] Even with testing, sometimes the cause of AFM is never found.

• #9 Acute flaccid myelitis (AFM) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/acute-flaccid-myelitis-afm

  Acute flaccid myelitis (AFM) is a polio-like illness that affects the nerve cells (motor neurons) in the gray matter of the spinal cord. It is thought to be due to a viral infection. […] Recent increases in AFM have been linked to the virus enterovirus D68. There are other viruses that may rarely cause AFM, including other enteroviruses, West Nile Virus (WNV), and adenoviruses. […] At Childrens Hospital of Philadelphia, we are actively engaged in research to better understand the function and causes of AFM and to identify more effective treatments.

• #10 Acute Flaccid Myelitis

  https://www.aap.org/en/patient-care/acute-flaccid-myelitis/?srsltid=AfmBOopBqfIhNDFT8_UOIfR_6Bq3GzXrMeuLK-IiwDM0VtJsdp5VW8f1

  Acute flaccid myelitis (AFM) is a rare but serious neurological illness that causes muscle weakness, sometimes leading to paralysis. Early detection and collection of specimens can help identify cases and causes of AFM. […] Increases in cases of AFM have occurred between August and November in the United States in 2014, 2016, and 2018. These spikes in cases have been attributed to enterovirus outbreaks, particularly EV-D68. […] It is unclear when or if spikes in AFM cases will occur again.

• #11 Acute flaccid myelitis – Wikipedia

  https://en.wikipedia.org/wiki/Acute_flaccid_myelitis

  Acute flaccid myelitis (AFM) is a serious condition of the spinal cord. Symptoms include rapid onset of arm or leg weakness and decreased reflexes. The cause of most cases is unclear as of 2018. More than 90% of recent cases have followed a mild viral infection such as from enteroviruses. While polio can cause AFM, since 2014, it has not been involved in cases in the United States. The underlying mechanism involves damage to the spinal cord’s grey matter. As of October 2018, the U.S. CDC regarded the cause of AFM as having „a variety of possible causes such as viruses, environmental toxins, and genetic disorders”, listing poliovirus, nonpolio enteroviruses, West Nile virus, and adenoviruses among the potential causes. More than 90% of people with AFM reported having symptoms consistent with a mild viral infection before the onset of AFM.

• #12 Acute Flaccid Myelitis (AFM): What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17991-acute-flaccid-myelitis

  AFM causes inflammation in the gray matter of your spinal cord. […] Researchers don’t know the exact cause of acute flaccid myelitis, but they think that viruses, especially non-polio enteroviruses, play a role in causing the condition. Most people with AFM had a mild respiratory illness (such as the common cold) or fever before they developed AFM. […] Researchers and healthcare providers have suspected enterovirus D68 and enterovirus A71 in many AFM cases. Enterovirus D68 most often causes a respiratory illness and circulates in the United States during the summer and fall every other year.

• #13 Acute Flaccid Myelitis (AFM) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/acute-flaccid-myelitis

  There is no single cause of acute flaccid myelitis. Most patients with AFM had a respiratory illness or fever that might have been caused by a viral infection before they were diagnosed with AFM. Enteroviruses are common viral infections in children and, in rare cases, can also cause neurologic illness. It is not currently known why some patients with viral infections develop AFM while others recover. AFM is often compared to polio, which is a viral infection of the motor neurons. However, no recent U.S. cases have been linked to the poliovirus.

• #14 Acute Flaccid Myelitis (AFM)

  https://www.health.ny.gov/diseases/conditions/acute_flaccid_myelitis/

  Acute Flaccid Myelitis is a rare but serious condition that affects the nervous system. It was first discovered in 2014. Acute Flaccid Myelitis mostly occurs in young children and targets the gray matter in the spinal cord, making muscles and reflexes in one or more limbs weak. This weakness happens quickly, often affects one side of the body more than the other and can lead to paralysis. […] Acute Flaccid Myelitis is similar to polio because both affect the spinal cord’s gray matter and cause floppy limb weakness. In some cases, the weakness may lead to permanent paralysis. However, the polio virus has not been found in people diagnosed with Acute Flaccid Myelitis. […] The exact cause of Acute Flaccid Myelitis is still unknown. Most patients had mild respiratory or gastrointestinal (stomach) symptoms, or a fever, 1-2 weeks before their limb weakness started. This may suggest a viral infection. Non-polio enteroviruses, such as enterovirus D-68, are thought to be linked to Acute Flaccid Myelitis.

• #15 Acute Flaccid Myelitis (AFM) | Peter O’Donnell Jr. Brain Institute | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/acute-flaccid-myelitis-afm/

  AFM is a rare but serious condition that affects the spinal cord and can cause paralysis, primarily in children. […] The exact causes of AFM aren’t fully known, but research has shown that enterovirus D68, a respiratory virus, is the most likely cause for the alternating-year outbreaks. […] Several types of viruses have been linked with AFM, particularly when considering causes throughout the year. […] Current models suggest that the virus can spread from the lungs to a person’s spinal cord, infecting the lower motor neurons and causing death. This process might also draw out an immune response that can cause damage to the spinal cord. […] AFM is often described as a polio-like illness, but in the U.S., AFM cases since 2014 have not been caused by poliovirus, a type of enterovirus. All the stool specimens from AFM patients that the CDC has received have tested negative for poliovirus.

• #16 About AFM | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/about-afm/

  AFM is a neurological condition characterized by a rapid onset of flaccid muscle weakness, with associated abnormalities on the radiological imaging of the spinal cord (MRI). […] We are still learning about what causes this unusual illness, and how is it causing the paralysis. There is evidence that supports a connection between the recent outbreaks of AFM with non-polio enterovirus infections as potential causative agents. The most commonly associated virus is enterovirus D68, but other enteroviruses like enterovirus A71, and some coxsackie virus strains have also been reported. […] Although this reinforces the idea of a virus as a driving agent of the disease, the mechanism by which the virus might cause injury to the spinal cord is not well understood. Direct neuronal infection and indirect immunological response have been proposed as potential explanations. Finally, in many patients with AFM, no viruses are detected in routine samples. This could be explained by shortcomings of the tests themselves, but also by the possibility of other viruses that we still have not identified.

• #17 Research probes cause of acute flaccid myelitis in children – VUMC News

  https://news.vumc.org/2022/06/08/research-probes-cause-of-paralyzing-illness-in-children/

  Research that began at Vanderbilt University Medical Center has found evidence that a viral infection followed by a robust immune response is the cause of a polio-like paralyzing illness in children called acute flaccid myelitis (AFM). […] The suspect virus, enterovirus D68 (EV-D68), can cause mild to severe symptoms including runny nose, wheezing, cough, body aches, and muscle aches. EV-D68 has been detected in respiratory specimens from AFM patients, but firm evidence of direct causation was lacking until now. […] By examining autopsy specimens from a 5-year-old boy who died from AFM in 2008, the researchers discovered the virus, EV-D68, had directly infected neurons in the spinal cord. They also noted the presence of cytolytic CD8+ T cells, immune cells that normally kill infected cells during a viral infection. […] Sometimes when theres an immune response to an infection, it can cause lasting damage to the infected tissues, even affecting surrounding cells that are not infected, Vogt said in a news release.

• #18 ACUTE FLACCID MYELITIS: A POLIO-LIKE ILLNESS PARENTS SHOULD KNOW ABOUT | Mya Care

  https://myacare.com/blog/acute-flaccid-myelitis-a-poliolike-illness-parents-should-know

  Some theories that suggest how viral infections may play a role in the development of the condition include: AFM may be triggered by an abnormal immune response to certain viral infections. These may cause the immune system to overreact and chronically attack the nerves in the spinal cord, leading to inflammation and damage. […] Some studies suggest that genetic variation or gene mutations involved in immune function or nerve development may make some individuals more prone to developing AFM when exposed to viral infections. […] It is important to note that while these theories provide some insight into the possible mechanisms of AFM, they are not yet fully confirmed. Further research is needed to uncover the exact mechanisms behind this condition.

• #19 Acute Flaccid Myelitis: Symptoms, Causes, and Treatment

  https://www.healthline.com/health/acute-flaccid-myelitis

  Acute flaccid myelitis (AFM) is a rare neurological condition that can cause paralysis. […] The exact cause of AFM is still unknown. However, an increase in the occurrence of AFM often links to a rise in illnesses due to the enterovirus EV-D68, which can cause a cold-like illness. […] We don’t know how exactly EV-D68 may cause AFM. It’s possible that the damage in the gray matter, which leads to the symptoms of AFM, could be due to the virus itself, the immune system’s response to the infection, or both. […] Experts generally believe that a viral infection may trigger AFM, specifically with the enterovirus EV-D68. However, why some people develop AFM while others do not is currently unclear.

• #20 A guide to AFM, the rare, polio-like illness making young children sick | Hub

  https://hub.jhu.edu/2018/10/19/guide-to-paralyzing-illness-acute-flaccid-myelitis/

  Acute flaccid myelitis, or AFM, starts out as a respiratory condition and may quickly progress to physical disability within hours. […] The cause of AFM is unclear, leaving parents wondering how to protect their children. […] AFM could be caused by one or more viruses, Pardo-Villamizar told HealthDay, with Enterovirus D68a virus from the same family as polio as the chief suspect. […] The damage caused by AFM could also be caused by the immune system, Pardo-Villamizar says in an interview with Kaiser Health News. „At this moment, we don’t know if it’s a virus that is coming and producing direct damage of the gray matter in the spinal cord, or if a virus is triggering immunological responses that produce a secondary damage in the spinal cord.”

• #21 Acute Flaccid Myelitis (AFM) | Living With Paralysis

  https://www.christopherreeve.org/todays-care/living-with-paralysis/health/causes-of-paralysis/afm/

  AFM is thought to be caused by viral infections, environmental toxins and/or genetic disorders. […] A particular strain of this virus, enterovirus D68 (EV-D68), was identified in 1962 in California as a non-polio virus. […] It has been thought that AFM is a variation of diseases such as Transverse Myelitis (TM) or Guillain Barr Syndrome (GBS). […] Environmental toxins: Toxins in our surroundings have been associated with AFM. […] Genetic disorders: Diseases that are connected through family inheritance have been related to AFM.

• #22 Acute Flaccid Myelitis (AFM)

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/afm.html

  Acute flaccid myelitis can be caused by a variety of pathogens, including several viruses: […] AFM is one of a number of conditions that can result in neurologic illness with limb weakness. Such illnesses can result from a variety of causes, including viral infections, environmental toxins, genetic disorders, and Guillain-Barre syndrome, a neurologic disorder caused by an abnormal immune response that attacks the bodys nerves. Oftentimes, however, despite extensive laboratory testing, a cause for AFM is unable to be identified.

• #23 Acute flaccid myelitis (AFM): What parents need to know – Boston Children’s Answers

  https://answers.childrenshospital.org/acute-flaccid-myelitis/

  AFM appears to be linked to several fairly common viruses, including enterovirus D68, enterovirus A71, and others. Direct viral infection of the spinal cord or parts of the brainstem is most likely responsible for the clusters of patients that have been seen in the fall every other year since 2014. […] However, an autoimmune condition called MOG antibody associated disease has been reported to cause very similar symptoms. […] We don’t yet know why some people with these viruses develop AFM while most don’t. A group of researchers are currently doing genetic testing in children who have developed AFM and their family members to see if there’s something in certain people’s genes that makes them predisposed to AFM.

• #24 Acute Flaccid Myelitis | Orange County California – Health Care Agency

  https://www.ochealthinfo.com/page/acute-flaccid-myelitis

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system, specifically the spinal cord, and causes sudden onset of weakness in limbs (one or more arms or legs) and loss of muscle tone. Other symptoms may include facial weakness, droopy eyelids, difficulty moving eyes, swallowing or speaking. There are several possible causes of AFM such as viruses (e.g., poliovirus, other enteroviruses, adenoviruses, and West Nile Virus), environmental toxins, genetic disorders, and some immune-mediated conditions. […] Even with aggressive testing, a cause for AFM may not be identified. […] Treatment is supportive; no specific treatment for AFM is available.

• #25 :: JCN :: Journal of Clinical Neurology

  https://thejcn.com/DOIx.php?id=10.3988/jcn.2020.16.3.376

  Acute flaccid myelitis (AFM) is a sudden-onset polio-like neuromuscular disability found commonly in young children. […] Although enterovirus A71 (EV-A71) is known to cause AFP and other neurological diseases, the exact causes of AFM are still unclear. […] A temporal association of EV outbreaks with increases in AFM cases has been reported in the USA, Australia, Norway, and France. […] Despite a possible association of EV with AFM due to the co-occurrence of increased AFM incidence and EV-D68 circulation in the same years, the virus has not been consistently detected in the biofluids of AFM patients. […] In addition to nonpolio EV, infections with herpes, dengue, West Nile, and Zika viruses as well as the inactivated polio vaccine have been proposed as the likely triggers of AFM. […] It is known that the host response that forms part of the antiviral defense to a viral pathogen can often itself cause significant neurological damage.

• #26 Acute flaccid myelitis: cause, diagnosis, and management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/33357469/

  Acute flaccid myelitis (AFM) is a disabling, polio-like illness mainly affecting children. Outbreaks of AFM have occurred across multiple global regions since 2012, and the disease appears to be caused by non-polio enterovirus infection, posing a major public health challenge. […] Future research directions include further studies evaluating host and pathogen factors, including investigations into genetic, viral, and immunological features of affected patients, host-virus interactions, and investigations of targeted therapeutic approaches to improve the long-term outcomes in this population.

• #27 Acute Flaccid Myelitis (AFM): Frequently Asked Questions

  https://blog.cincinnatichildrens.org/rare-and-complex-conditions/acute-flaccid-myelitis-frequently-asked-questions/

  Reports of children who’ve contracted acute flaccid myelitis (AFM) have been in the news lately. […] The actual cause of AFM is not known. It is likely started by a viral infection, although the CDC has not narrowed it down to a specific virus. Since so few people progress to AFM, there are likely host and possibly environmental factors involved as well. […] Although we think it is likely started by a viral infection, AFM does not appear to be contagious. There have been no reports of the siblings of children affected with AFM developing AFM. Nor have there been reports of children in similar social settings to a child with AFM (such as the same school or church) going on to develop AFM.

• #28 Acute Flaccid Myelitis (AFM) Diagnosis & Treatment

  https://www.gillettechildrens.org/conditions-care/acute-flaccid-myelitis-afm

  AFM is not contagious and cant be spread from person to person, however, the viruses that are believed to cause AFM may be contagious from one person to another or may be spread by a mosquito or other ways, depending on which virus causes the AFM. These viruses can be avoided with proper and frequent hand washing, especially during cold and flu season, and covering coughs or sneezes.

• #29 Acute Flaccid Myelitis | PM&R KnowledgeNow

  https://now.aapmr.org/acute-flaccid-myelitis/

  No exact cause has been specifically identified; however, it has temporally and geographically been noted to be associated with Enterovirus 68 (EVD68) and, to a lesser extent, Enterovirus A71 and coxsackie A16. AFM is not caused by polio. […] While exact cause and pathology has yet to be identified, pathogenesis is likely initially infectious and immune-mediated. […] A possible viral cause is enterovirus which is a respiratory virus closely related to rhinovirus infrequently occurring in US until late 2000s. […] It has been proposed that the initial inflammation that occurs in the anterior horn cells may spill into adjacent white matter. This may explain presentation of mixed upper motor neuron and lower motor neuron signs. […] As discussed previously, no exact cause has been specifically identified; but due to its possible association with EVD68, Enterovirus A71, and coxsackie A16, assessing recent illness or travel is warranted. […] There is no specific definite cause of AFM. […] Vaccine development, drug therapy targeting and further virus specific testing development is greatly needed.

• #30 Causes, diagnosis and management of acute flaccid myelitis – Children’s National

  https://innovationdistrict.childrensnational.org/causes-diagnosis-and-management-of-acute-flaccid-myelitis/

  Acute flaccid myelitis (AFM) is a disabling, polio-like illness mainly affecting children. Outbreaks of AFM have occurred across multiple global regions since 2012, and the disease appears to be caused by non-polio enterovirus infection, posing a major public health challenge. […] Future research directions include further studies evaluating host and pathogen factors, including investigations into genetic, viral and immunological features of affected patients, host-virus interactions and investigations of targeted therapeutic approaches to improve the long-term outcomes in this population.

• #31 NC DPH: Acute Flaccid Myelitis (AFM)

  https://epi.dph.ncdhhs.gov/cd/diseases/afm.html

  Acute flaccid myelitis (AFM) is a condition that affects the nervous system, specifically the spinal cord, which can result from a variety of causes including viral infections. […] There is no specific treatment for acute flaccid myelitis, but a doctor who specializes in treating brain and spinal cord illnesses (neurologist) may recommend certain interventions on a case-by-case basis.

• #32 Acute Flaccid Myelitis (AFM)- What You Need to Know | Lurie Children’s

  https://www.luriechildrens.org/en/blog/acute-flaccid-myelitis-afm-what-you-need-to-know/

  Acute flaccid myelitis, or AFM for short, is an illness that has been around for a long time. […] The exact cause of the recent increase in numbers of AFM cases is not yet known. Some proposed viral causes of AFM include enteroviruses, adenoviruses, and West Nile virus. […] Importantly, the CDC has not identified poliovirus in any patients with AFM in this current outbreak. Thus, poliovirus is NOT a suspected cause of AFM in the current AFM outbreak.

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