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October 19, 2018

Confirmed case of Acute Flaccid Myleitis in Skagit County; 6 in state

On October 11, 2018 Skagit County Public Health was notified of a child with sudden-onset of paralysis of one or more limbs, diagnosed as Acute Flaccid Myelitis (AFM). This is the sixth case in Washington being investigated for AFM. Other cases are in King County (2), Pierce County (1), Lewis County (1), and Snohomish County (1). The Washington State Department of Health is working with experts in neurology from the Centers for Disease Control and Prevention (CDC) to confirm whether these cases are AFM.

AFM is a rare condition with sudden onset of weakness in one or more limbs (arms or legs) sometimes accompanied by weakness in the face or eye muscles (such as facial drooping or difficulty speaking). In severe cases, breathing muscles can be affected. AFM can cause a range of types and severity of symptoms, but the commonality among them is a loss of strength or movement in one or more arms or legs.  

To date, all cases are among infants and children under age six who all reportedly had symptoms of a respiratory illness in the week prior to developing symptoms of AFM. Five of the six had fever of 100.4 F or greater.

“At this point there isn’t evidence that would point to a single source of illness among these cases,” said Dr. Scott Lindquist, state infectious disease epidemiologist at the Department of Health. “We’re working closely with medical providers and public health agencies. We’ll continue to investigate and share information when we have it.” 

Some viruses and germs have been linked to AFM, including common germs that can cause colds and sore throats, and respiratory infections. It can also be caused by poliovirus and non-polio enteroviruses, mosquito-borne viruses (such as West Nile virus or Zika virus) and possibly by non-infectious conditions. The cause of any individual case of AFM can be hard to determine, and often, no cause is found. CDC specialists will make the final determination if these cases are AFM.

While there are no specific recommendations for avoiding AFM, you can help protect yourself from known causes of AFM by taking the following steps:

  • Wash your hands often with soap and water
  • Avoid close contact with sick people
  • Clean surfaces with a disinfectant, especially those that a sick person has touched.
  • Make sure you and your family are up-to-date on recommended vaccinations, including poliovirus (a disease that can cause AFM.) Check with your doctor to make sure your family is up to date on all recommended vaccines and be sure to get recommended vaccine before international travel.

For more information, see the FAQ developed by Dr. Jeff Duchin, Health Officer of King County. https://publichealthinsider.com/2016/11/01/dr-duchin-what-you-should-know-about-acute-flacid-myelitis-afm/