acute neurologic illness with limb paralysis; acute flaccid myelitis (AFM)

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Etiology

Epidemiology

  • children
  • 51 cases in children in 23 states (2014)
  • possible cluster of AFM in Washington state fall 2016[3]
    • 2 confirmed cases, 7 suspected cases under evaluation[3]
  • 106 cases in 29 states Nov 2018
  • 158 cases in 33 states have been confirmed Dec 2018[7][8]
  • 186 cases in 39 states as of Dec 28, 2018[8]
  • 193 confirmed pediatric cases from 41 states
    • most were in 2016
    • most cases in summer & fall
    • most cases in boys
      • median age 6 years (range, 3 months - 21 years)[9]

Clinical manifestations

Diagnostic criteria

Diagnostic procedures

Radiology

Complications

Management

  • supportive
  • prognosis: spectrum of recovery is highly variable

More general terms

References

  1. Centers for Disease Control and Prevention (CDC) Investigation of Acute Neurologic Illness with Focal Limb Weakness of Unknown Etiology in Children, Fall 2014. http://www.cdc.gov/ncird/investigation/viral/sep2014.html
  2. 2.0 2.1 2.2 2.3 2.4 Sofair A, Chavey WE Cause of Acute Limb Paralysis in Children Still Unknown Physician's First Watch, Jan 9, 2015 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
    Centers for Disease Control and Prevention (CDC) Notes from the Field: Acute Flaccid Myelitis Among Persons Aged <=21 Years - United States, August 1-November 13, 2014 MMWR Weekly. January 9, 2015 / 63(53);1243-1244 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6353a3.htm
  3. 3.0 3.1 3.2 3.3 3.4 Washington State Department of Health AFM Investigation. Nov 2, 2016 http://www.doh.wa.gov/Emergencies/AFMInvestigation
  4. 4.0 4.1 Young K, Fairchild DG, Di Francesco L Acute Flaccid Myelitis Cases Confirmed in 22 States Physician's First Watch, Oct 17, 2018 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org https://www.cdc.gov/acute-flaccid-myelitis/afm-surveillance.html
  5. 5.0 5.1 5.2 5.3 McKay SL, Lee AD, Lopez AS, et al. Increase in Acute Flaccid Myelitis - United States, 2018. MMWR Morb Mortal Wkly Rep. ePub: 13 November 2018 https://www.cdc.gov/mmwr/volumes/67/wr/mm6745e1.htm
  6. Centers for Disease Control and Prevention (CDC) CDC Establishes AFM Task Force. CDC Press Releas. Nov 19, 2018 https://www.cdc.gov/media/releases/2018/p1119-cdc-establishes-afm-task-force.html
  7. 7.0 7.1 Centers for Disease Control and Prevention (CDC) Weekly Update for Number of U.S. AFM Cases. Dec 3, 2018 https://www.cdc.gov/media/releases/2018/s1203-us-afm-case.html
  8. 8.0 8.1 8.2 Lopez A, Lee A, Guo A et al. Vital Signs: Surveillance for Acute Flaccid Myelitis - United States, 2018. MMWR Morb Mortal Wkly Rep. ePub: 9 July 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31295232 https://www.cdc.gov/mmwr/volumes/68/wr/mm6827e1.htm
  9. 9.0 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 Ayers T, Lopez A, Lee A et al. Acute flaccid myelitis in the United States: 2015-2017. Pediatrics 2019 Oct 7; PMID: https://www.ncbi.nlm.nih.gov/pubmed/31591135 https://pediatrics.aappublications.org/content/early/2019/10/03/peds.2019-1619
  10. 10.0 10.1 Schubert RD, Hawes IA, Ramachandran PS et al Pan-viral serology implicates enteroviruses in acute flaccid myelitis. Nature Medicine (2019). Oct 21. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31636453 https://www.nature.com/articles/s41591-019-0613-1
  11. Centers for Disease Control and Prevention (CDC) Acute Flaccid Myelitis Home. AFM Investigation AFM in the United States. AFM Investigation https://www.cdc.gov/acute-flaccid-myelitis/afm-surveillance.html