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Investigators call for accelerated research on acute flaccid myelitis (AMA), which is badociated with infections that can cause sudden muscle paralysis.
Acute flaccid myelitis is a condition badociated with recent infection, including poliovirus or non-polio enterovirus, which causes sudden muscle paralysis. Polioviruses were once the main causes of AFD, but now represent almost no case, as poliomyelitis is almost eradicated worldwide.
The world of acute flaccid myelitis
Posted in mbio, experts at the National Institute of Allergy and Infectious Diseases (NIAID), belonging to the National Institutes of Health, explain how acute flaccid myelitis (AMF) presents significant challenges, not only for patients, but also for researchers, and that more needs to be done to learn more about the condition.
The authors note that the term AFM has been coined in recent years, but that the disease itself represents a subset of cases of a syndrome known for a long time called acute flaccid paralysis.
The AFM has unexpectedly re-emerged worldwide as an epidemic in 2014 and appears to occur at the same time and place as outbreaks of the enterovirus D68 (EV-D68), a disease originally obscure, which causes generally benign respiratory diseases, and EV-A71, another enterovirus.
Experts have yet to prove definitively that EV-D68 is a major cause of acute flaccid epidemic myelitis. However, epidemiological evidence implicating the virus is increasing, say the authors.
Therapy to help improve muscle paralysis
There is no vaccine to prevent non-polio AFM and no specific treatment is currently available to cure the disease. However, it has been proven that early intensive physical therapy, which has helped polio patients to improve, could be beneficial for other AFM patients and should be considered as early as possible for children with symptoms of acute flaccid myelitis.
Many questions remain about the AFM's reoccurrence factors, especially if the AFM outbreak results solely from widespread epidemic circulation of viruses such as EV-D68 and EV-A71, or because these viruses evolve rapidly to become more pathogenic.
Outbreaks of AFM have also occurred in areas where children have already developed anti-EV-D68 neutralizing antibodies. The authors note that individual immunity to other circulating enteroviruses may lead to an evolution of EV-D68, possibly explaining this disconcerting observation.
Need to act quickly
AFM research efforts are limited by the sporadic occurrence of cases, difficulty diagnosing a viral infection potentially related to AFM cases, and lack of understanding of the natural history and pathogenesis of the disease .
The authors call for collaborative research to develop diagnostics, epidemiological studies, and non-specific animal models for nonpolio enteroviruses, to study the neurological manifestations of enteroviruses and to develop treatments. drug.
They emphasize the importance of this research because past case history indicates that the problem of flaccid acute myelitis is likely to worsen.
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