Children's Hospital Colorado

Children’s Hospital Colorado Contributes to AFM Paper in The Lancet

Children's Hospital Colorado | January 13, 2021

Children’s Hospital Colorado doctors who specialize in acute flaccid myelitis (AFM), a condition that causes limb weakness and paralysis, contributed to a global consensus research paper in The Lancet that outlines new clinical diagnostic criteria and management recommendations for the disease.

Children’s Colorado is a global leader in researching and treating AFM

When AFM emerged in 2014 with children experiencing sudden unexplained limb weakness and paralysis, physicians and researchers at Children’s Colorado and the University of Colorado School of Medicine linked the symptoms to an outbreak of a respiratory virus called enterovirus D68 (EV-D68). They were the first to report the link to the Centers for Disease Control and Prevention and immediately began researching how the virus causes AFM.

“Once we started to understand the disease and long-term effects of AFM, we created a multidisciplinary clinic at Children’s Colorado consisting of dedicated physicians from neurology, rehabilitation medicine, physical therapy, occupational therapy and psychology to provide specialized, comprehensive care to our patients,” said Kevin Messacar, MD, a pediatric infectious disease doctor and researcher. “Our clinic was the first in the nation dedicated to the treatment of children with AFM, and we have become one of the top research centers in the world on this condition because of our steadfast approach to the study of this rare disease and the multilayered care we are able to provide.”

Children’s Colorado AFM clinic aims to improve treatment and eventually prevent AFM

Since 2014, there have been peaks of AFM cases between August and October every two years. Though there wasn’t the expected peak in 2020 due to COVID-19 mitigation efforts that work against other viruses, researchers predict AFM will return in 2021 or beyond. They want to be as prepared as possible so they can best treat and eventually prevent the disease.

“Many of our patients have sustained long-term neurologic injury as a result of AFM,” said Joyce Oleszek, MD, associate professor of physical medicine and rehabilitation. “While it’s inspiring to see so much resilience as they work hard to compensate for their deficits, we’re hopeful more research will help us find ways to optimize functional outcomes and someday prevent AFM.”

AFM working group and Children’s Colorado see The Lancet paper as an important step forward

The AFM working group that drafted the paper for The Lancet included doctors from Children’s Colorado who do research for the University of Colorado School of Medicine, as well as specialists from the Johns Hopkins University School of Medicine and international collaborators supported by the Siegel Rare Immunologic Diseases network.

With 131 members, the working group includes relevant medical specialties such as neurology, pediatrics, infectious diseases, and critical care medicine, as well as surgery and physical medicine & rehabilitation. The group also features scientists with expertise in epidemiology, genetics, virology and immunology, as well as AFM patients.

“We are thrilled that our collective paper was published in The Lancet because it helps to provide consensus and raise awareness about this uncommon and concerning neurological disease that lacks known effective treatment strategies at this time,” said Teri Schreiner, MD, MPH, a pediatric neurologist at Children’s Colorado and the University of Colorado School of Medicine. “Working with the extraordinarily talented team of physicians and researchers that make up the AFM working group to publish this paper was a great honor for me. The work continues, but we are making great strides in both research and clinical care to improve outcomes and hopefully prevent AFM someday.”