Today's Medicine

AFM Update: 3 Nebraska Cases of Rare Polio-like Condition Are Confirmed

A scary but very rare condition is back in the news and close to home.

The Centers for Disease Control and Prevention (CDC) has confirmed 182 cases of acute flaccid myelitis (AFM) in 39 states this year. 

There have been three confirmed cases in Nebraska, according to the state Department of Health and Human Services. In one case, a child in the Douglas County Health Department jurisdiction was hospitalized and released. In each of the other two cases, a child in the Sarpy/Cass Health Department jurisdiction was hospitalized and released. An additional reported case is undergoing testing by the CDC.

AFM can have devastating effects for some people, causing polio-like symptoms. Other people make full recoveries. Anyone can get it, but the CDC says 94 percent of confirmed cases have been in children under age 18, with a median age of 4.

While the condition is rare – the CDC estimates less than one in a million Americans will get it each year – it can be life-threatening.

What is AFM? 

AFM affects the nervous system – specifically the spinal cord. The result is sudden and mysterious muscle weakness and loss of muscle tone and reflexes. While those symptoms appear suddenly, over three quarters of AFM patients report experiencing in the preceding week or two relatively common symptoms of illness. They include fever, runny nose, cough, vomiting and diarrhea.

The damage from AFM can be long-term and potentially disabling. In addition to weakness in the limbs, some people may experience:

  • Facial droop or weakness
  • Difficulty moving the eyes
  • Drooping eyelids
  • Difficulty with swallowing
  • Slurred speech
  • Pain in the arms and legs
  • Respiratory failure
  • Life-threatening neurologic conditions

There are a lot of unknowns when it comes to AFM. We don’t know why cases started to increase in 2014, who might be at higher risk for the condition or why, or what the long-term effects are.

The exact cause of most AFM cases remains a mystery, too. But possible causes include:

Often, despite extensive testing, the cause of a patient’s AFM can’t be identified.

AFM prevention and treatment

There is no cure or specific treatment for AFM. We can only treat the symptoms. There are also no vaccines specifically for its prevention. The best way to protect yourself is to continue healthy habits such as:

  • Getting your recommended vaccinations, including the poliovirus vaccine
  • Protecting yourself from mosquito bites and West Nile virus
  • Covering your mouth when you cough and sneeze
  • Not going to work or school when you're sick
  • Remaining vigilant about proper handwashing

Treating AFM symptoms is tailored to each case. For example, physical or occupational therapy may be recommended for patients who experience weakness in their limbs. However, the long-term prognosis for AFM patients is unknown.

Read about AFM diagnosis, treatment, prognosis and more at

Again, cases of AFM are uncommon but not unheard of. If you have any concerns about your child’s health or notice any sudden onset of muscle weakness, contact your Methodist Physicians Clinic primary care provider right away. 

Updated on Dec. 21, 2018.

About the Author

Dr. Rudolf Kotula is a board-certified infectious disease physician. He specializes in areas such as antibiotic resistance, travel medicine and infection prevention.

You can visit Dr. Kotula at Methodist Physicians Clinic.

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