In western Pennsylvania and around the country, there have been numerous cases of acute flaccid myelitis (AFM), a very rare, acute neurological disorder that mainly affects children.
A new National Institutes of Health-funded study that was reported this week looked at samples from patients with and without AFM and provides evidence of an association between AFM and infection with non-polio enteroviruses.
I was not a part of the study, but the findings of antibodies to enteroviruses, and especially enterovirus D68 (EV-D68), in the spinal fluid, strongly suggest to me that these viruses caused the AFM. This is important, because EV-D68 and enterovirus season overlaps with AFM season, which has suggested to many in the field that EV-D68 and other enteroviruses cause AFM.
However, viruses have not been detected in the majority of patients with AFM, perhaps because the viruses were already gone. These antibodies show the “footprints” of the virus and show that the child had been infected with the enteroviruses, which is strong circumstantial evidence.
This does not change how patients would be treated, because we don’t have specific antiviral medicines for EV-D68 or other enteroviruses, but if it can be proved that these viruses cause AFM, antiviral drugs and vaccines could be developed.
Most germs, including almost all enterovirus infections, don’t cause serious disease, and I reassure my patients’ parents that conditions like AFM are very rare and they should let their kids be kids.
Don’t keep them in a bubble! That said, most germs are transmitted by hand contact. Hand washing or hand sanitizer gel are the most important ways to prevent common as well as rare infections.
ABOUT THE AUTHOR: John Williams, MD, is the chief of the Division of Pediatric Infectious Diseases at UPMC Children’s Hospital of Pittsburgh.