Parents should be cautious, as health officials are expecting another outbreak of acute flaccid myelitis (AFM), an uncommon but serious neurological condition that mostly affects children, according to the Centers for Disease Control and Prevention (CDC) in a recent press release.

Since 2014, this polio-like disease has peaked in the United States every two years between August and November. Officials believe the peak in cases is due to non-polio enteroviruses, specifically EV-D68, which may also cause symptoms of a cold or the flu.

The most common symptom of AFM is limb weakness and paralysis. Other signs and symptoms include fever, headache, back or neck pain, difficulty talking or swallowing, neck or facial weakness, recent or current respiratory illness, pain or numbness in the limbs and difficulty walking.

If doctors don’t recognize symptoms or hospitalize patients immediately, AFM can result in permanent paralysis or respiratory failure in even the healthiest of patients.

A CDC Vital Signs report found that some patients experienced a delay in care during an AFM peak in 2018. An estimated 35% of patients weren’t hospitalized until two or more days after limb weakness. Other findings showed that 94% of patients with AFM were hospitalized, 76% requested medical care within one day and 64% were sent to the emergency room. Additionally, about 55% of patients were dispatched to intensive care units, and one in four patients needed a ventilator to help them breathe.

Nearly all these cases (94%) occurred in children, and AFM onset occurred in about 86% of patients during August through November.

“As we head into these critical months, CDC is taking necessary steps to help clinicians better recognize signs and symptoms of AFM in children,” said Robert Redfield, MD, the CDC’s director. “Recognition and early diagnosis are critical. CDC and public health partners have strengthened early disease detection systems, a vital step toward rapid treatment and rehabilitation for children with AFM.”

Currently, there are no specific tests, proven treatments or prevention methods for AFM, according to the health agency. This is why CDC experts stress that clinicians should remain vigilant for AFM, promptly evaluate patients and not delay hospitalizing them when AFM is suspected.

“During the COVID-19 pandemic, this may require adjusting practices to perform clinical evaluations of patients by phone or telemedicine,” said Thomas Clark, MD, deputy director of the CDC’s Division of Viral Diseases.

For related coverage, read “Yes, Kids Can Get the New Coronavirus” and “Prioritizing Children in the COVID-19 Response.”