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Acute flaccid myelitis (AMF) presents significant challenges not only for patients, but also for researchers. We must accelerate efforts to learn more about the disease. Experts from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health Research, write in a new perspective published in mbio.
AFM 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. There is no vaccine to prevent non-polio AFM and no specific treatment is currently available to cure the disease. However, it has been shown that early intensive physical therapy, which has helped polio patients to be cured, may be beneficial to other patients with FMD and should be considered as early as possible for children with symptoms of poliomyelitis. the disease, according to the authors.
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 conclusively that EV-D68 is a major cause of AFD epidemics. However, epidemiological evidence implicating the virus is increasing, say the authors.
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.
The AFM's research efforts are limited by the sporadic occurrence of cases, the difficulty in diagnosing a viral infection potentially linked to AFM cases and the lack of understanding of the history natural 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 stress the importance of this research because the past trajectory of cases indicates that the problem of MFA will worsen.
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Material provided by NIH / National Institute of Allergy and Infectious Diseases. Note: Content can be changed for style and length.
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