Materiały źródłowe

• #1 Surveillance for Acute Flaccid Myelitis – United States, 2018-2022 – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38300829/

  Acute flaccid myelitis (AFM) is a serious neurologic condition primarily affecting children; AFM can cause acute respiratory failure and permanent paralysis. AFM is a rare but known complication of various viral infections, particularly those of enteroviruses (EVs). Increases in AFM cases during 2014, 2016, and 2018 were associated with EV-D68 infection. This report examines trends in confirmed AFM cases during 2018-2022 and patients’ clinical and laboratory characteristics. The number of AFM cases was low during 2019-2022 (28-47 cases per year); the number of cases remained low in 2022 despite evidence of increased EV-D68 circulation in the United States. Compared with cases during the most recent peak year (2018), fewer cases during 2019-2021 had upper limb involvement, prodromal respiratory or febrile illness, or cerebrospinal fluid pleocytosis, and more were associated with lower limb involvement. It is unclear why EV-D68 circulation in 2022 was not associated with an increase in AFM cases or when the next increase in AFM cases will occur. Nonetheless, clinicians should continue to suspect AFM in any child with acute flaccid limb weakness, especially those with a recent respiratory or febrile illness. […] National surveillance for acute flaccid myelitis – United States, 2018-2020. […] Epidemiology of acute flaccid myelitis in children in the Netherlands, 2014 to 2019. […] Enterovirus infection and acute flaccid myelitis.

• #1 AFM Statistics | Georgia Department of Public Health

  https://dph.georgia.gov/afm-statistics

  The Centers for Disease Control and Prevention (CDC) has requested states provide information on suspect Acute Flaccid Myelitis (AFM) cases since the fall of 2014, when clusters of pediatric cases with AFM were identified in Colorado and Kansas. States have been reporting suspect AFM cases to CDC and submitting specimens for testing since the fall of 2014. […] Most cases occurred between August and November. CDC thinks viruses, including enteroviruses, likely play a role in AFM in the United States. Most reported cases in the U.S. have been in children, but people of any age can get AFM. […] As of December 2, 2024, In the United States there have been 15 confirmed cases out of 30 patients under investigation (PUIs) in 2024 and 18 confirmed cases out of 40 PUIs in 2023. There have been a total of 760 confirmed cases since CDC began tracking AFM in August of 2014. […] From August 2014 to December 2, 2024, 760 confirmed AFM cases were reported from 49 states and the District of Columbia. […] Continuing routine surveillance for AFM in Georgia is necessary to determine the burden of this syndrome and establish baseline incidence.

• #1 AFM Cases & Outbreaks | Acute Flaccid Myelitis (AFM) | CDC

  https://www.cdc.gov/acute-flaccid-myelitis/cases/index.html

  As of May 5, 2025, there have been 774 confirmed cases since CDC began tracking AFM in August of 2014. […] Cases of AFM have occurred in 49 states and the District of Columbia. […] Most patients developed AFM between August and November, with increases in AFM cases in 2014, 2016, and 2018. […] Confirmed AFM cases by CDC from August 2014 through May 5, 2025. Case counts are subject to change. […] The data shown from August 2015 to present are based on the AFM case definition adopted by the Council of State and Territorial Epidemiologists (CSTE): acute onset of focal or flaccid limb weakness and an MRI showing spinal cord lesion largely restricted to gray matter and spanning one or more spinal segments, regardless of age.

• #1 Surveillance for Acute Flaccid Myelitis ― United States, 2018–2022 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7304a1.htm

  Acute flaccid myelitis (AFM) is a serious neurologic condition that has been associated with enterovirus-D68 (EV-D68) infection. Biannual increases in cases were observed in the United States during 2014, 2016, and 2018. […] The number of AFM cases has remained low since 2018, including during 2022, when an increase in EV-D68 respiratory disease was observed. […] Why increased EV-D68 circulation in 2022 was not associated with an increase in AFM cases or when AFM will peak again is unknown. […] The number of AFM cases was low during 2019-2022 (2847 cases per year); the number of cases remained low in 2022 despite evidence of increased EV-D68 circulation in the United States. […] It is unclear why EV-D68 circulation in 2022 was not associated with an increase in AFM cases or when the next increase in AFM cases will occur. […] Current trends do not indicate when the next increase of AFM might be expected.

• #1 About AFM | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/about-afm/

  AFM is a neurological condition characterized by a rapid onset of flaccid muscle weakness, with associated abnormalities on the radiological imaging of the spinal cord (MRI). […] Although sporadic cases of non-polio infantile paralysis have been reported in the medical literature in the past, it was not until 2012 in California and 2014 in Colorado when unusual but significant clusters of pediatric patients with a polio-like illness started rising quickly in the USA. This prompted the CDC to begin collecting surveillance data on the disease we now call AFM. Between August 2014 and June 2020, there have been 626 confirmed cases across the USA. AFM cases have also been reported in multiple regions worldwide including Canada, Europe, Asia, Australia, and South America. […] Thanks to the epidemiological surveillance efforts, it was noted that this disease usually follows a particular seasonal biennial pattern, with notable peaks of cases between August and October every 2 years (2014, 2016, 2018, and maybe 2020!). […] Over 90% of cases of AFM occur in children (median age of 6 years), and no racial or ethnic predispositions have been clearly identified. A slight predisposition to males has been reported.

• #1 Acute flaccid myelitis (AFM) in Canada, 2018 to 2019, CCDR 46(10) – Canada.ca

  https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2020-46/issue-10-october-1-2020/acute-flaccid-myelitis.html

  This study describes the preliminary analysis of AFM in Canada for the years 2018 and 2019, using data from the Canadian Acute Flaccid Paralysis Surveillance System (CAFPSS). […] A small proportion (10%) of the cases reported from 2018 and 2019 met the 2018 CDC case definition for confirmed AFM, with the majority having onset of paralysis in the late summer and early fall of 2018. […] This coincides temporally with the cyclical increase in AFM cases observed in the United States, suggesting that a similar trend might be occurring in Canada. […] Enterovirus or rhinovirus/enterovirus was detected in non-cerebrospinal fluid specimens of half of the confirmed AFM cases, a greater proportion than seen in any of the other AFM categories.

• #1 Acute Flaccid Myelitis | Orange County California – Health Care Agency

  https://www.ochealthinfo.com/page/acute-flaccid-myelitis

  Increases in AFM have been reported from several different areas of the U.S. in 2018. CDC continues to actively investigate the AFM cases, monitor disease activity and test specimens. […] AFM is a very rare condition with less than one case in a million people in the United States reported every year, even with the recent increase. […] Suspect cases should be reported to Orange County Epidemiology at 714-834-8180 or fax records to 714-560-4050. Specimens on suspect AFM cases that meet criteria may be submitted for testing for specific infectious etiologies through Orange County Public Health.

• #1 Acute Flaccid Myelitis | AFM Surveillance | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/acute-flaccid-myelitis/afm-surveillance.html

  CDC is concerned about AFM, a serious illness that we do not know all the cause of or how to prevent. […] CDC is actively investigating AFM cases. In 2016, 144 people in 37 states and DC were confirmed to have AFM. […] Even with an increase in cases in 2016, AFM remains a very rare disease (less than one in a million). […] Since August 2014, CDC has been made aware of an increased number of people across the United States with AFM for which no cause could be found. […] The increase in AFM cases in 2014 coincided with a national outbreak of severe respiratory illness among people caused by enterovirus D68 (EV-D68). […] Despite extensive testing, CDC does not yet know the cause of these AFM cases. […] CDC is actively investigating AFM cases and monitoring disease activity. […] CDC activities include: urging healthcare providers to be vigilant for AFM among their patients, and to send information about suspected cases to their health departments. […] CDC actively investigates the AFM cases, risk factors, and possible causes of this illness.

• #1 Acute Flaccid Myelitis | PM&R KnowledgeNow

  https://now.aapmr.org/acute-flaccid-myelitis/

  AFM cases curiously were low during the 2019-2022 time frame, notably low despite growing circulation of EV-D68. […] There are no cases reported of recurrence after initial diagnosis. […] A preceding viral illness was reported in 90% of patients in 2018 and prior. Proceeding viral illness was present in 57% and 63% in 2019 and 2020 respectively. […] Suspected cases should be reported to CDC. […] Difficulty in performing placebo-controlled trials limits the ability to definitively identify treatment options. […] Centers for Disease Control and Prevention AFM Investigation 2019.

• #1 Airborne and Direct Contact Diseases – Group B Strep – Disease Surveillance Epidemiology Program – MeCDC; DHHS Maine

  https://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/acute-flaccid-myelitis.shtml

  Acute flaccid myelitis (AFM) is a rare but serious condition. It affects the nervous system causing the muscles and reflexes in the body to become weak. Most AFM cases occur in late summer and early fall between August and October. More than 90% of cases have been in young children. […] Clinicians should report all patients suspected to have AFM, especially after respiratory illness or fever to Maine Center for Disease Control and Prevention (Maine CDC) as soon as possible. […] Most patients with AFM had a mild respiratory illness or fever with a viral infection before they developed AFM. […] It is unknown why a small number of people develop AFM after a respiratory illness. […] Federal CDC has tested many specimens from AFM in attempt to determine the cause of AFM. For most cases, federal CDC did not find any pathogens in the spinal fluid. […] All stool samples from AFM patients tested negative for poliovirus.

• #1 Acute flaccid myelitis (AFM) in Canada, 2018 to 2019, CCDR 46(10) – Canada.ca

  https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2020-46/issue-10-october-1-2020/acute-flaccid-myelitis.html

  Starting in 2014, biennial clusters of acute flaccid myelitis (AFM), frequently described as polio-like illness, have been reported across the United States and elsewhere, often linked to enteroviruses. […] To assess AFM trends in Canada, we reviewed the Canadian Acute Flaccid Paralysis Surveillance System (CAFPSS) for cases reported during the 2018 and 2019 calendar years that meet the Centers for Disease Control and Prevention case definitions for AFM. […] At the time of writing this report, 2020 AFM data were not yet available; it is unknown if a spike in AFM cases will be seen in 2020. […] The seriousness of the condition as well as the lack of clear knowledge about the etiology of the disease underscore the need to better understand the epidemiology of AFM to further identify prevention and patient management measures.

• #1 CDC: Biennial Surge in Acute Flaccid Myelitis Has Come to a Halt | MedPage Today

  https://www.medpagetoday.com/infectiousdisease/generalinfectiousdisease/108563

  Acute flaccid myelitis (AFM) cases remained low in 2022, despite increased circulation of the enterovirus D68 (EV-D68) in the U.S., according to an analysis of CDC data. […] AFM cases ranged from 28 to 47 per year from 2019 to 2022 — far lower than the 238 confirmed cases in 2018, Sarah Kidd, MD, from the CDC’s National Center for Immunization and Respiratory Diseases in Atlanta, and colleagues reported in Morbidity and Mortality Weekly Report. […] As part of national surveillance of AFM, which began in 2014, U.S. health departments have submitted case reports of acute flaccid limb weakness with any spinal cord gray matter lesion on MRI to the CDC. […] AFM cases have tended to peak in even-numbered years, due to biennial outbreaks of EV-D68. […] It is unclear why EV-D68 circulation in 2022 was not associated with an increase in AFM cases or when the next increase in AFM cases will occur, wrote Kidd and co-authors.

• #1 Acute Flaccid Myelitis Data | Texas DSHS

  https://www.dshs.texas.gov/vaccine-preventable-diseases/vaccine-preventable-disease-conditions/acute-flaccid-myelitis-afm/acute-flaccid-myelitis-data

  Acute Flaccid Myelitis (AFM) Cases and Incidence Rates in Texas, 2010-2020 […] Note: There are no AFM cases prior to 2014 since AFM was not first identified until 2014. The case definition for AFM changed in 2015, 2017, 2020 and 2021.

• #1 Acute Flaccid Myelitis: How CDC Assists States in Investigating Emerging Diseases – EveryCRSReport.com

  https://www.everycrsreport.com/reports/IN10994.html

  Concern has grown over the recent increase in Acute Flaccid Myelitis (AFM) cases around the country. According to the Centers for Disease Control and Prevention (CDC), AFM is a rare condition with no specific treatment that mostly impacts children. As of November 9, CDC has confirmed 90 cases of AFM in 27 states thus far in 2018. CDC began tracking AFM in August 2014, when there was a sudden increase in cases in the United States. Though cases have increased, AFM remains a rare disease. CDC estimates that fewer than one to two in a million children in the United States get AFM each year. […] AFM is not on the national notifiable conditions list; however, some states may voluntarily report AFM cases to CDC for further investigation. CDC has funded health departments to implement physician awareness programs on AFM. […] CDC states that evidence suggests a viral cause for AFM. On November 13, CDC reported that it has established a task force of national experts, including external academic researchers, to develop a comprehensive research agenda on AFM.

• #1 About AFMWG | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/

  The AFM Working Group was established in North America in September 2018 in response to the emergence of AFM as a disabling disease representing a significant public health threat. […] Develop and share up to date information of the epidemiology, natural history, disease mechanisms, and clinical aspects of AFM. […] Raise awareness and educate the community on AFM to increase our preparedness for potential upcoming outbreaks. […] Preserve partnership and frequent communication with the Centers for disease control AFM Surveillance Team and the National Institutes of Health.

• #1 Surveillance for Acute Flaccid Myelitis (AFM): Information for Health Professionals – MN Dept. of Health

  https://www.health.state.mn.us/diseases/afm/hcp.html

  The Minnesota Department of Health is conducting surveillance for acute flaccid myelitis/paralysis. […] Reporting of patients meeting the criteria is consistent with a case of Unexplained Critical Illness as per the Communicable Disease Reporting Rule, Chapter 4605. […] Based on clinical presentation, MDH may test for arboviruses, picornaviruses/enteroviruses, and other pathogens.

• #1 Acute Flaccid Myelitis (AFM)

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/afm.html

  As of May 1, 2025, IDPH is reporting the following number of patients under investigation during the given year and the number of cases that are confirmed, probable, and not cases according to the Centers for Disease Control and Prevention (CDC) after review of the case information provided. IDPH is continually working with the health care providers and local health departments to collect necessary information to send to the CDC for AFM case classification. […] The Illinois Department of Public Health (IDPH) is re-emphasizing the importance of continued vigilance in identifying cases of AFM among all age groups, irrespective of enterovirus status. Reporting of these cases will help public health officials monitor for increases in this illness and better understand potential causes, risk factors, and preventive measures or therapies. We are asking all clinicians to report AFM cases to the local health department, governing the jurisdiction where the patient lives.

• #1 Acute Flaccid Myelitis (AFM) | Washington State Department of Health

  https://doh.wa.gov/public-health-provider-resources/notifiable-conditions/afm

  AFM is considered a medical emergency as some patients can experience rapid respiratory failure and may require ventilator support. […] To identify cases of AFM and establish an incidence baseline and burden of the condition in Washington State. […] To help identify causes of AFM in the United States. […] To understand the impact of AFM among all age groups. […] Health care providers and Health care facilities: notifiable to local health jurisdiction within 24 hours. […] Local health jurisdictions: notifiable to the Washington Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) within 7 days of case investigation completion or summary information required within 21 days.

• #1

  https://hip.phila.gov/disease-control/diseasesconditions/acute-flaccid-myelitis/

  Report any illness to PDPH that meets all of the current Council of State and Territorial Epidemiologists (CSTE) case definition criteria: A person with acute onset of focal limb weakness, AND A magnetic resonance image showing a spinal cord lesion largely restricted to gray matter*+, and spanning one or more vertebral segments OR Cerebrospinal fluid (CSF) with pleocytosis (CSF white blood cell count 5 cells/mm3); CSF protein may or may not be elevated […] Providers should also remember to routinely report any patient (suspected or confirmed) with the following conditions and infections that cause neurologic symptoms to PDPH: Encephalitis or meningitis regardless of etiology, Guillain-Barr syndrome, West Nile virus and other arboviral infections, Lyme disease, Varicella and herpes zoster.

• #1 Acute Flaccid Myelitis Reporting | Texas DSHS

  https://www.dshs.texas.gov/vaccine-preventable-diseases/vaccine-preventable-disease-conditions/acute-flaccid-myelitis-afm/acute-flaccid-myelitis-reporting

  Acute flaccid myelitis (AFM) is not nationally notifiable; CDC relies on clinician recognition and health department reporting of suspected AFM cases to learn more about AFM and what causes it. Texas is participating in enhanced AFM surveillance. […] Clinicians should continue to be vigilant and send all information about patients that meet the clinical criteria (sudden onset of flaccid limb weakness) for AFM to their state or local health department. Since AFM is a relatively new condition, we need information on all patients to help us better understand the spectrum of AFM illness, all possible causes, risk factors, and outcomes for this condition. […] Clinicians should send information on patients who meet the clinical criteria regardless of any laboratory results or MRI findings. […] Information should be sent to the local or state public health department regardless of any laboratory and MRI results. […] Per CDC request please submit all above requested information to your local health department.

• #1

  https://content.govdelivery.com/accounts/WIDHS/bulletins/3306905

  The Wisconsin Department of Health Services, Division of Public Health (DPH) has identified 17 confirmed and 6 probable case of AFM in Wisconsin residents since 2014 and will continue to investigate other potential cases. […] AFM is a reportable condition in Wisconsin. Report all cases of acute flaccid limb weakness to the Wisconsin Division of Public Health (DPH) within 24 hours (after hours reporting not required) by calling the Bureau of Communicable Diseases (BCD) at 608-267-9003. […] Strongly consider AFM in patients with acute flaccid limb weakness, especially after respiratory illness or fever, and between the months of August and November 2022. […] Collect specimens from multiple sources (cerebrospinal fluid [CSF], serum, stool, and a nasopharyngeal [NP] or oropharyngeal [OP] swab) from patients presenting with possible AFM as early as possible and preferably on the day of onset of limb weakness.

• #1 NC DPH: Acute Flaccid Myelitis (AFM)

  https://epi.dph.ncdhhs.gov/cd/diseases/afm.html

  Acute flaccid myelitis (AFM) is a condition that affects the nervous system, specifically the spinal cord, which can result from a variety of causes including viral infections. […] CDC: AFM Surveillance […] Testing nerve response can also be helpful in supporting a diagnosis of AFM; it is important that the tests are performed at the appropriate time (e.g., 7-10 days after onset of weakness) to be helpful.

• #1 Health Alert: Acute Flaccid Myelitis

  https://www.snohd.org/CivicSend/ViewMessage/message/183540

  From January 1, 2022, through September 6, 2022, CDC has received 35 reports of suspected acute flaccid myelitis (AFM) in persons from 17 U.S. states; 13 have been classified as confirmed cases of AFM, 2 as probable, 6 as not cases, 1 as suspect, and 13 are waiting information or classification. […] Reports from possible cases of AFM will be submitted to CDC as part of surveillance to help track AFM, understand the spectrum of the disease, detect outbreaks, and inform research. […] Case classification status (i.e., confirmed, probable, suspect, not a case) is for surveillance purposes and based on consistent and specific criteria to ensure cases being tracked are similar.

• #1 :: JCN :: Journal of Clinical Neurology

  https://thejcn.com/DOIx.php?id=10.3988/jcn.2020.16.3.376

  Acute flaccid myelitis (AFM) is a sudden-onset polio-like neuromuscular disability found commonly in young children. […] There is an increasing incidence of confirmed AFM cases in the USA and other countries in recent years, and in association with nonpolio enterovirus infection. […] The incidence of AFM was first identified in the USA in 2014, and has steadily increased in 2019 to become recognized as a serious threat to public health. […] Up to 2019, there were 607 confirmed cases of AFM recorded out of many hundreds of reports from several states, with the incidence peaking in 2018. […] According to the World Health Organization, the surveillance of AFM cases is critically important to rule out the association of AFM with the polio vaccine in polio-free countries. […] It might be necessary to design novel alternative or degenerate primers to amplify unknown sequences from mutant variants associated with AFM pathogenesis.

• #1 Acute Flaccid Myelitis – JETem

  https://jetem.org/acute-flaccid-myelitis/

  AFM is a disease that occurs in a biennial pattern and needs to be recognized and reported appropriately. […] AFM MRI abnormalities demonstrate brainstem and spinal cord lesions with a predominance of gray matter affected while a GBS MRI demonstrates ventral root abnormalities without any spinal cord or brainstem lesions. Without the MRI results, a patient may be assigned the incorrect diagnosis upon admission. […] Reaching the appropriate diagnosis allows the emergency medicine physician to communicate more accurately with worried parents, providing them with correct information on treatment and progression of the disease.

• #1 :: JCN :: Journal of Clinical Neurology

  https://thejcn.com/DOIx.php?id=10.3988/jcn.2020.16.3.376

  The current methods for detecting viral genomes solely by PCR using infected cells isolated from biofluids appear to be suboptimal or inefficient. […] Laboratory-based investigative biomedical research is urgently needed to accurately determine the underlying causes and mechanistic details of AFM.

• #1

• #1 Acute Flaccid Myelitis: Current Status and Diagnostic Challenges

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7354978/

  Acute flaccid myelitis (AFM) is a sudden-onset polio-like neuromuscular disability found commonly in young children. There is an increasing incidence of confirmed AFM cases in the USA and other countries in recent years, and in association with nonpolio enterovirus infection. […] The incidence of AFM was first identified in the USA in 2014, and has steadily increased in 2019 to become recognized as a serious threat to public health. […] Up to 2019, there were 607 confirmed cases of AFM recorded out of many hundreds of reports from several states, with the incidence peaking in 2018. […] According to the World Health Organization, the surveillance of AFM cases is critically important to rule out the association of AFM with the polio vaccine in polio-free countries.

• #1 Asthma Syndromic Surveillance for EV-D68 & acute flaccid myelitis (AFM) | Colorado Environmental Public Health Tracking

  https://coepht.colorado.gov/blog-post/asthma-syndromic-surveillance-for-ev-d68-acute-flaccid-myelitis-afm

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system, causing limb weakness and paralysis, mostly in children. […] While EV-D68 is thought to be a cause of AFM, current surveillance systems do not capture when, where, and to what extent EV-D68 is circulating, so preparing for increases in AFM is challenging. […] The model has not produced an alarm signal during an increase of COVID, RSV, or influenza. It has only alarmed during increased EV D68 circulation. […] This confirmation then allowed CHCO to activate its preparedness plan, which included increases in staffing schedules, securing the supply chain for asthma medications, and alerting providers to the possibility of cases of AFM. Ongoing asthma surveillance continued to help inform EV-D68 preparedness throughout August and September.

• #1 Clinician Guidance for Acute Flaccid Myelitis (AFM) – Nevada Public Health | The Office of State Epidemiology

  https://nvose.org/clinician-guidance-for-acute-flaccid-myelitis-afm/

  As the winter season approaches, an increase in the circulation of respiratory pathogens, including enteroviruses, is expected. Enterovirus D-68 (EV-D68) is believed to be the main enterovirus responsible for the uncharacteristic increase in acute flaccid myelitis (AFM) cases observed during 2014, 2016, and 2018, which are referred to as peak years. […] Although there has been an increase in EV-D68 detections in the United States this year, the number of reported cases of AFM has remained relatively low, to date. […] As of November 1, 2024, the Centers for Disease Control and Prevention (CDC) has received 26 reports of suspected AFM, with 15 confirmed cases in 11 states. […] In past years, increases in EV-D68 respiratory disease have preceded cases of AFM by about 2 weeks. Therefore, vigilance for possible increases in EV-D68 respiratory disease and AFM is important.

• #1

  https://www.nvhd.org/acute-flaccid-myelitis-afm/

  Most patients are children. […] The increase in AFM cases in 2014 coincided with a national outbreak of severe respiratory illness among people caused by enterovirus D68 (EV-D68). […] The cause of most of the AFM cases remains unknown. […] We dont know what caused the increase in AFM cases starting in 2014. […] We have not yet determined who is at higher risk for developing AFM, or the reasons why they may be at higher risk. […] We do not yet know the long-term effects of AFM.

• #1 Acute Flaccid Myelitis – JETem

  https://jetem.org/acute-flaccid-myelitis/

  Although a somewhat rare disease, acute flaccid myelitis (AFM) can cause death, and for those pediatric patients that survive, less than 10% have full recovery. A cluster of cases that resembled polio was first described in California in 2012. After 120 cases of the disease were confirmed in 2014 in a 5-month period, the Centers for Disease Control and Prevention (CDC) began surveillance of the disease. Since surveillance began, clusters of cases have occurred in a biennial pattern, usually late summer and early fall. There were 218 cases between 2015 to 2017, 238 cases in 2018, 47 cases in 2019, and 32 in 2020. AFM has become recognized as a global disease with cases reported across many countries. The CDC has noted that the most common location of the first medical encounter of pediatric patients presenting with AFM is the emergency department in every year that surveillance occurred. Most of the children that are diagnosed with AFM are admitted to the hospital and of those admitted, 30% require intubation. Deaths related to AFM are due to respiratory involvement and complications. With appropriate recognition and supportive care, mortality can be avoided.

• #2 Acute Flaccid Myelitis | AFM Surveillance | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/acute-flaccid-myelitis/afm-surveillance.html

  CDC is concerned about AFM, a serious illness that we do not know all the cause of or how to prevent. […] CDC is actively investigating AFM cases. In 2016, 144 people in 37 states and DC were confirmed to have AFM. […] Even with an increase in cases in 2016, AFM remains a very rare disease (less than one in a million). […] Since August 2014, CDC has been made aware of an increased number of people across the United States with AFM for which no cause could be found. […] The increase in AFM cases in 2014 coincided with a national outbreak of severe respiratory illness among people caused by enterovirus D68 (EV-D68). […] Despite extensive testing, CDC does not yet know the cause of these AFM cases. […] CDC is actively investigating AFM cases and monitoring disease activity. […] CDC activities include: urging healthcare providers to be vigilant for AFM among their patients, and to send information about suspected cases to their health departments. […] CDC actively investigates the AFM cases, risk factors, and possible causes of this illness.

• #2 About AFM | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/about-afm/

  AFM is a neurological condition characterized by a rapid onset of flaccid muscle weakness, with associated abnormalities on the radiological imaging of the spinal cord (MRI). […] Although sporadic cases of non-polio infantile paralysis have been reported in the medical literature in the past, it was not until 2012 in California and 2014 in Colorado when unusual but significant clusters of pediatric patients with a polio-like illness started rising quickly in the USA. This prompted the CDC to begin collecting surveillance data on the disease we now call AFM. Between August 2014 and June 2020, there have been 626 confirmed cases across the USA. AFM cases have also been reported in multiple regions worldwide including Canada, Europe, Asia, Australia, and South America. […] Thanks to the epidemiological surveillance efforts, it was noted that this disease usually follows a particular seasonal biennial pattern, with notable peaks of cases between August and October every 2 years (2014, 2016, 2018, and maybe 2020!). […] Over 90% of cases of AFM occur in children (median age of 6 years), and no racial or ethnic predispositions have been clearly identified. A slight predisposition to males has been reported.

• #2 Acute Flaccid Myelitis (AFM) – MN Dept. of Health

  https://www.health.state.mn.us/diseases/afm/index.html

  Acute flaccid myelitis (AFM) is a rare but serious condition. CDC began tracking AFM in 2014. Since then, AFM cases have followed a seasonal and biennial pattern, spiking between August and October every other year. However, cases can occur year-round. […] Since surveillance for AFM began in 2014, Minnesota has seen between 0 and 11 cases per year. We work closely with health care providers and the Centers for Disease Control (CDC) to gather information on all cases. […] AFM cases confirmed by the CDC, Minnesota 2014-2023. […] Information for Health Professionals: Ongoing Surveillance for Acute Flaccid Myelitis Clinical guidance, surveillance, testing, and reporting information for health professionals.

• #2 Acute flaccid myelitis – Wikipedia

  https://en.wikipedia.org/wiki/Acute_flaccid_myelitis

  Acute flaccid myelitis (AFM) is a serious condition of the spinal cord. The condition is rare and occurs most commonly in children. Fewer than one in 500,000 children is affected per year in the United States. Although the illness is not new, an increase in cases has been seen since 2014 in the United States. In 2018, 233 cases were confirmed in the United States. A seasonal pattern is seen in outbreaks, with a marked increase in cases reported in the late summer and early fall. The CDC has determined and submitted to GenBank complete or nearly complete genomic sequences for three known strains of the virus, which are „genetically related to strains of EV-D68 virus that were detected in previous years in the United States, Europe, and Asia.” While rates of paralytic symptoms appear to be correlated with the number of respiratory infections, in initial anecdotal reports, the cases are not clustered within a family or school, suggesting that the paralysis per se is not directly contagious, but arises as a very rare complication of the common respiratory infection. Cases of similar illnesses have been reported in Canada, Northern Europe, and Japan. Over 90% of reported cases are in children. CDC sees 2018 as a record year, annual documented cases of AFM reached a record 238 nationwide. The relatively lower circulation in 2020 may reflect the use of COVID-19 pandemic infection mitigation measures. Because of the EV-D68 surge in 2022 Health Alert Network (HAN) released a notice for Healthcare providers and hospitals. The CDC warned clinicians that EV-D68 detections have continued to be high. „Sentinel surveillance sites are reporting a higher proportion of EV-D68 positivity in children who are [rhinovirus and/or enterovirus] positive compared to previous years,” the agency wrote. Clinicians should be aware of „the potential for an increase in AFM cases in the upcoming weeks.” CDC urges healthcare providers to consider EV-D68 as a possible cause of acute, severe respiratory illness and a potential increase in AFM cases.

• #2 CDC: Biennial Surge in Acute Flaccid Myelitis Has Come to a Halt | MedPage Today

  https://www.medpagetoday.com/infectiousdisease/generalinfectiousdisease/108563

  Acute flaccid myelitis (AFM) cases remained low in 2022, despite increased circulation of the enterovirus D68 (EV-D68) in the U.S., according to an analysis of CDC data. […] AFM cases ranged from 28 to 47 per year from 2019 to 2022 — far lower than the 238 confirmed cases in 2018, Sarah Kidd, MD, from the CDC’s National Center for Immunization and Respiratory Diseases in Atlanta, and colleagues reported in Morbidity and Mortality Weekly Report. […] As part of national surveillance of AFM, which began in 2014, U.S. health departments have submitted case reports of acute flaccid limb weakness with any spinal cord gray matter lesion on MRI to the CDC. […] AFM cases have tended to peak in even-numbered years, due to biennial outbreaks of EV-D68. […] It is unclear why EV-D68 circulation in 2022 was not associated with an increase in AFM cases or when the next increase in AFM cases will occur, wrote Kidd and co-authors.

• #2 Acute Flaccid Myelitis | PM&R KnowledgeNow

  https://now.aapmr.org/acute-flaccid-myelitis/

  Acute Flaccid Myelitis (AFM) is a rapidly progressive immune and infectious mediated disease process that causes flaccid weakness of one or more limbs. […] AFM outbreaks occur every 2 years (since 2014) and primarily between the months of August and October. There were 120 cases reported in 2014, 149 cases in 2016, 238 cases in 2018, 47 in 2019, 33 in 2020, 28 in 2021 and 47 in 2022. […] Children represent over 90% of the reported AFM cases. […] There are no specific actions that have been identified to prevent AFM apart from decreasing risk of acquiring and spreading viral infections. […] 2019 and 2020 case numbers were more consistent with non-peak years, and it is possible that non-pharmacologic measures instituted against COVID 19 (ex. Masks, hand hygiene, physical distancing and virtual schooling) have helped decrease the spread of respiratory viruses including the Enterovirus class.

• #2 Acute Flaccid Myelitis (AFM) | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/acute-flaccid-myelitis-afm

  This condition is not new, but the increase in cases we saw starting in 2014 is new. […] CDC estimates that less than one in a million people in the United States will get AFM every year. […] Most of the cases that CDC has learned about have been in children. […] Acute flaccid myelitis was first made temporarily reportable in January, 2016 and this order was reissued on October 15, 2018.

• #2 Acute flaccid myelitis | Utah Epidemiology

  https://epi.utah.gov/acute-flaccid-myelitis/

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the spinal cord. It can cause muscle weakness that comes on suddenly and can sometimes result in permanent paralysis. Most people who have AFM experience sudden onset of weakness in 1 or more limbs and/or a loss of muscle tone and reflexes. Some people with AFM also have trouble moving their eyes or have drooping eyelids, facial weakness or droop, difficulty swallowing or slurred speech, pain in the arms or legs, and/or pain in the neck or back. AFM most commonly affects children, and does not spread person to person. […] The exact cause of AFM is still unknown. AFM happens most often after someone is infected with a virus (enterovirus) that starts in the stomach or intestines and works its way to the brain and spinal cord. Enteroviruses are very common and usually don’t cause symptoms at all or very mild flu-like symptoms. Poliovirus is a type of enterovirus. Other causes of AFM may include environmental toxins or genetic disorders, but these are still being researched. […] Acute Flaccid Myelitis in the United States—August – December 2014: Results of Nation-Wide Surveillance.

• #2 Acute Flaccid Myelitis (AFM) – HAN

  https://www.chicagohan.org/diseases-and-conditions/afm

  In 2021, the CDC updated the AFM case definition, which is used to ensure consistent and accurate case classification for surveillance purposes. All patients under investigation for AFM will receive final classification by a team of expert neurologists. […] Clinicians should continue to be vigilant and send information to Chicago Department of Public Health (CDPH) for all patients under investigation (PUI) with sudden onset of neurologic illness associated with limb weakness that meet the case definition for Acute Flaccid Myelitis.

• #2 :: JCN :: Journal of Clinical Neurology

  https://thejcn.com/DOIx.php?id=10.3988/jcn.2020.16.3.376

  Acute flaccid myelitis (AFM) is a sudden-onset polio-like neuromuscular disability found commonly in young children. […] There is an increasing incidence of confirmed AFM cases in the USA and other countries in recent years, and in association with nonpolio enterovirus infection. […] The incidence of AFM was first identified in the USA in 2014, and has steadily increased in 2019 to become recognized as a serious threat to public health. […] Up to 2019, there were 607 confirmed cases of AFM recorded out of many hundreds of reports from several states, with the incidence peaking in 2018. […] According to the World Health Organization, the surveillance of AFM cases is critically important to rule out the association of AFM with the polio vaccine in polio-free countries. […] It might be necessary to design novel alternative or degenerate primers to amplify unknown sequences from mutant variants associated with AFM pathogenesis.

• #2 Health Alert: Acute Flaccid Myelitis

  https://www.snohd.org/CivicSend/ViewMessage/message/183540

  Since the end of August 2022, CDC sentinel surveillance sites for respiratory pathogens have been reporting increases in enterovirus D-68 (EV-D68) respiratory disease. EV-D68 is also the main enterovirus responsible for cases of acute flaccid myelitis (AFM) during years when we see increases in AFM cases. AFM is a rare outcome of EV-D68 infection and is a serious neurologic condition that affects mostly children. It typically presents with sudden limb weakness that can lead to permanent paralysis. Traditionally, increases in EV-D68 respiratory disease have preceded cases of AFM by about 2 weeks. Therefore, increased vigilance for AFM is important. […] Recent respiratory illness or fever and the presence of neck or back pain or any neurologic symptom should heighten suspicion for AFM. […] Case reporting will help states and CDC monitor AFM and better understand factors associated with this illness.

• #2 Acute flaccid myelitis (AFM) in Canada, 2018 to 2019, CCDR 46(10) – Canada.ca

  https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2020-46/issue-10-october-1-2020/acute-flaccid-myelitis.html

  Starting in 2014, biennial clusters of acute flaccid myelitis (AFM), frequently described as polio-like illness, have been reported across the United States and elsewhere, often linked to enteroviruses. […] To assess AFM trends in Canada, we reviewed the Canadian Acute Flaccid Paralysis Surveillance System (CAFPSS) for cases reported during the 2018 and 2019 calendar years that meet the Centers for Disease Control and Prevention case definitions for AFM. […] At the time of writing this report, 2020 AFM data were not yet available; it is unknown if a spike in AFM cases will be seen in 2020. […] The seriousness of the condition as well as the lack of clear knowledge about the etiology of the disease underscore the need to better understand the epidemiology of AFM to further identify prevention and patient management measures.

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