enteroviruses

What are viruses?

Viruses are very tiny germs. They are made of genetic material (either DNA or RNA) inside of a protein coating. There are a huge number of viruses on earth. Only a small number of them can infect humans. Those viruses can infect our cells, which may cause disease. Some of the diseases that viruses can cause include the common cold, the flu, COVID-19, and HIV.

How are viruses spread?

Viruses can be spread in different ways:

• Through droplets and particles that are breathed out by someone who has the infection. You might breathe in the droplets or particles, or they could land on your mouth, nose, or eyes.
• By touching surfaces or objects that have the virus on them and then touching your mouth, nose, or eyes.
• From the pregnant parent to the baby during pregnancy.
• Through contaminated food or water.
• By being bitten by an infected insect or animal.
• Through sexual contact (usually vaginal, anal and oral sex) with someone who has the infection.

How do viruses cause disease?

Viruses are like hijackers. They invade living, normal cells. They then use those cells to multiply (make copies of themselves). This process is also called replication. The process can kill, damage, or change the infected cells. Sometimes this can make you sick. The symptoms can range from mild to very severe. Other times, your immune system may be able to fight it off and you may not have any symptoms.

Each different virus usually only infects one type of cell in your body. For example, hepatitis viruses affect the cells in the liver. HIV infects a certain type of immune system cell.

What are the treatments for viral infections?

For most viral infections, treatments can only help with symptoms while you wait for your immune system to fight off the virus. There are antiviral medicines to treat some viral infections. Antibiotics do not work for viral infections.

Can viral infections be prevented?

Vaccines can help prevent you from getting many viral diseases. You may be able to prevent some viral infections by:

• Proper hand washing.
• Paying attention to food safety.
• Cleaning surfaces that may be infected with germs.
• Avoiding contact with wild animals.
• Preventing insect bites by using insect repellent when you go outdoors. If you travel to an area that has a high risk of diseases from insect bites, also wear long pants, shirts, and socks.
• Practicing safe sex (using a condom every time you have anal, vaginal, or oral sex).
• Avoiding close contact with people who are sick.

What is acute flaccid myelitis (AFM)?

Acute flaccid myelitis (AFM) is a neurologic disease. It is rare, but serious. It affects an area of the spinal cord called gray matter. This can cause the muscles and reflexes in the body to become weak.

Because of these symptoms, some people call AFM a "polio-like" illness. But it is different from polio. AFM is not caused by polioviruses.

What causes acute flaccid myelitis (AFM)?

AFM can be caused by several different viruses. Researchers think that enteroviruses have been causing the recent increases in the number of children with AFM. AFM can also be caused by other viruses, including flaviviruses, herpesviruses, and adenoviruses.

Most people with AFM had a mild respiratory illness or fever (like you would get from a viral infection) before they got AFM.

Who is more likely to develop acute flaccid myelitis (AFM)?

Anyone can get AFM, but most cases (more than 90%) have been in young children.

What are the symptoms of acute flaccid myelitis (AFM)?

Most people with AFM will suddenly have:

• Arm or leg weakness
• A loss of muscle tone and reflexes

Some people also have other symptoms, including:

• Facial drooping/weakness
• Trouble moving the eyes
• Drooping eyelids
• Trouble swallowing
• Slurred speech
• Pain in the arms, legs, back, or neck

Sometimes AFM can weaken the muscles that you need for breathing. This can lead to respiratory failure, which is very serious. If you get respiratory failure, you may need to use a ventilator (breathing machine) to help you breathe.

If you or your child develops any of these symptoms, get medical care right away.

How is acute flaccid myelitis (AFM) diagnosed?

AFM causes many of the same symptoms as other neurologic diseases, such as transverse myelitis and Guillain-Barre syndrome. This can make it difficult to diagnose. To find out if you have AFM, your doctor may use:

• A neurologic exam, including looking at where there is weakness, poor muscle tone, and decreased reflexes
• An MRI to look at the spinal cord and brain
• Lab tests on the cerebrospinal fluid (the fluid around the brain and spinal cord)
• Nerve conduction and electromyography (EMG) studies. These tests check nerve speed and the response of muscles to the messages from the nerves.

It is important that the tests are done as soon as possible after the symptoms start.

What are the treatments for acute flaccid myelitis (AFM)?

There is no specific treatment for AFM. A doctor who specializes in treating brain and spinal cord illnesses (neurologist) may recommend treatments for specific symptoms. For example, physical and/or occupational therapy may help with arm or leg weakness. Researchers do not know the long-term outcomes of people who get AFM.

Can acute flaccid myelitis (AFM) be prevented?

There is no specific way to prevent AFM. But you can take steps to prevent getting sick from a virus by:

• Washing your hands often with soap and water
• Avoiding touching your face with unwashed hands
• Avoiding close contact with people who are sick
• Cleaning and disinfecting surfaces that you frequently touch, including toys
• Covering coughs and sneezes with a tissue or upper shirt sleeve, not hands
• Staying home when sick

Centers for Disease Control and Prevention