AFM Chapter 
A. Agent
AFM can result from a variety of causes, including viral infections.
B. Clinical Description
Most patients will have sudden onset of limb weakness and loss of muscle tone and reflexes. Some patients, in addition to the limb weakness, will experience:
- facial droop/weakness,
- difficulty moving the eyes,
- drooping eyelids, or
- difficulty with swallowing or slurred speech.
Numbness or tingling is rare in patients with AFM, though some patients have pain in their arms or legs. Some patients with AFM may be unable to pass urine. The most severe symptom of AFM is respiratory failure that can happen when the muscles involved with breathing become weak. This can require urgent ventilator support (breathing machines).
C. Reservoirs
Conditions like AFM can be caused by a variety of germs, including several viruses. Therefore, potential reservoirs are varied.
D. Modes of Transmission
Conditions like AFM can be caused by a variety of germs, including several viruses. Therefore, modes of transmission are varied.
E. Incubation Period
Conditions like AFM can be caused by a variety of germs, including several viruses. Therefore, incubation periods are varied.
F. Period of Communicability or Infectious Period
Conditions like AFM can be caused by a variety of germs, including several viruses. Therefore, communicability periods are varied.
G. Epidemiology
This condition is not new, but the increase in cases we saw starting in 2014 is new. Still, CDC estimates that less than one in a million people in the United States will get AFM every year. There are a variety of possible causes of AFM, such as viruses, environmental toxins, and genetic disorders. Most of the cases that CDC has learned about have been in children.
H. Bioterrorism Potential
None.