Health officials across the country are monitoring the latest outbreak of Acute Flaccid Myelitis or AFM — including about a half-dozen reported cases in Dallas, Tarrant, Collin and Parker counties as of Oct. 18.
The state health department said that, as of Oct. 18, there were six North Texans diagnosed with AFM in Dallas, Tarrant, Collin and Parker counties.
About one in a million people get AFM, so it’s considered rare. But it's also considered common because it’s caused by a small family of viruses known as enteroviruses.
“They’re around every month. They cause the common cold,” says Dr. Benjamin Greenberg, a neurologist who directs the transverse myelitis center at UT Southwestern Medical Center and Children’s Health in Dallas.
“You may not even know it when you’re infected, or you may have minimal symptoms or a common cold. But there’s a very select but unfortunate few where the virus then invades the spinal cord and causes paralysis."
Greenberg doesn’t expect the current outbreak in North Texas to expand into anything major. He says the best thing to avoid AFM is what you do to avoid a common cold: hand washing, good hygiene, and avoid work or school when sick. In other words — stay home.
The current outbreak: What we’re tracking is a certain neurologic event: Children coming in with weakness or paralysis. All indications are is that that syndrome is being caused by a virus or a small family of viruses known as the enteroviruses.
And they’re around every month. They cause the common cold. There’s almost a hundred different types of enteroviruses, and at different times of year, different subtypes of enterovirus will be prevalent.
What we’re seeing is between the months of August and October, there is a specific enterovirus that seems to peak and now looks to be associated with causing paralysis.
Rare, but common: Millions of people get infected with these enteroviruses. They’re extremely common. You may not even know it when you’re infected, or may only have minimal symptoms or a common cold. There’s only a very select but unfortunate few where the virus then invades the spinal cord and causes paralysis.
Treatment: We don’t have a specific drug to treat the virus, and so our treatments fall into two categories:
- One is limiting the amount of damage to the spinal cord from swelling or inflammation.
- The other is working with children and families on rehabilitation techniques, to try to build back up the nerves and muscles and bring back function.
Polio-like illness: AFM is nearly the exact syndrome we saw in polio-myelitis outbreaks. The difference is a different viral cause. It’s a cousin of the polio virus. These enteroviruses and the polio virus all belong to the same family of viruses. In the world of polio viruses, they would give individuals a GI (gastrointestinal) illness — diarrhea — then in one in every 100 cases, the virus would invade the spinal cord.
This specific group of enteroviruses gives a cold, cough, runny nose. Simple symptoms of a respiratory infection. And then, in one of every 100,000 cases, it invades the spinal cord.
Chances of a major outbreak: As of right now, if we look at the history of 2014, 2016 and 2018, there is not a reason to expect that this outbreak will blossom in a dramatically higher fashion than where it is now. We expect for us to turn the corner, in terms of numbers of cases, in the next eight weeks, based on the natural seasonality of the virus.
We should be getting close to the peak of our cases.
To avoid AFM: Try to avoid common colds: handwashing, good hygiene. Also, as individuals get sick — parents or children — don’t go to work and don’t go to school.
You are doing us a favor by staying home.