Be Alert—Acute Flaccid Myelitis May Be Returning with a Vengeance

The Centers for Disease Control and Prevention initiated a Health Alert Network bulletin last week concerning an uptick in severe respiratory illness attributed to both rhinovirus and Enterovirus in children across the country. Some of the Enterovirus patients tested positive for EV-D68, which has been associated with acute flaccid myelitis (AFM), a neurologic complication found to induce polio-like symptoms. Consequently, the CDC “urge(s) healthcare providers to consider EV-D68 as a possible cause of acute, severe respiratory illness (with or without fever) in children” and warned “of the potential for an increase in AFM cases in the coming weeks.” Symptoms of EV-D68 infection include cough, shortness of breath, and wheezing, with fever reported in roughly half of cases. Children with AFM may exhibit sudden weakness in the arms or legs; drooping of the eyelids or face; difficulty in moving the eyes; slurred speech; or difficulty swallowing.