Doctors Urged to Rapidly Recognize and Report AFM Cases

Atlanta, GA–As the late summer/early fall “season” for acute flaccid myelitis (AFM) nears, 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.

“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, M.D. “I urge physicians to look for symptoms and report suspected cases so that we can accelerate efforts to address this serious illness.”

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 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.

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