As the late summer/early fall “season” for acute flaccid myelitis (AFM) nears, the Centers for Disease Control and Prevention (CDC) is calling on medical professionals to quickly recognize AFM symptoms and report all suspected cases to their health department. Early recognition and reporting are critical for providing patients with appropriate care and rehabilitation, and better understanding AFM, according to a new Vital Signs report.
The majority of AFM patients are previously healthy children who had respiratory symptoms or fever consistent with a viral infection less than a week before they experienced limb weakness. Since AFM can progress quickly from limb weakness to respiratory failure requiring urgent medical intervention, rapidly identifying symptoms and hospitalizing patients are important.
“CDC continues to pursue the definitive cause and mechanisms that define this disease and we sincerely appreciate the important contributions of the AFM Task Force in helping us get closer to critical answers,” said CDC director Robert Redfield, MD. “I urge physicians to look for symptoms and report suspected cases so that we can accelerate efforts to address this serious illness.”
The CDC began tracking AFM in 2014, when the first outbreak of 120 cases occurred. Another outbreak occurred in 2016 with 149 cases, and again with 233 patients in 41 states in 2018– the largest outbreak so far. AFM cases have so far followed a seasonal and biennial pattern, spiking between August and October every other year.
In an analysis of cases confirmed in 2018, CDC detected enteroviruses and rhinoviruses in nearly half of respiratory and stool specimens. Of the 74 cases with a cerebral spinal fluid specimen, only two were positive for enteroviruses (EV-A71 and EV-D68). CDC and other scientists continue to investigate how enteroviruses, including EV-D68, might initiate AFM. All specimens tested negative for poliovirus, a related enterovirus that can cause AFM.
“Our thorough investigation of AFM will help lead to more answers about this severe disease,” said Tom Clark, MD, MPH, deputy director of the Division of Viral Diseases. “We are monitoring AFM trends and the clinical presentation, conducting research to identify possible risk factors, using advanced lab testing and research to understand how viral infections may lead to AFM, and tracking long-term outcomes of AFM patients.”
The CDC, with experts from the National Institutes of Health, academia, health departments, and parent advocacy groups, says it is committed to increasing awareness of AFM, and moving national priorities forward to advance our understanding of AFM and its prevention, treatment, and outcomes.
To read more about the Nationwide Outbreak of Acute Flaccid Myelitis—United States, 2018 and the entire Vital Signs report, visit www.cdc.gov/vitalsigns