Acute Flaccid Myelitis (AFM), 2020 Update
On August 20, 2020, NH DHHS issued a health alert update regarding acute flaccid myelitis.
Key Points and Recommendations:
- Acute flaccid myelitis (AFM) is a serious neurologic syndrome causing paralysis that predominantly affects children in the late summer and early fall.
- Since 2014 there have been biennial peaks of AFM activity, and another peak of AFM is expected this year between August and November (enterovirus season).
- Multiple viruses are known or suspected to cause AFM, including enterovirus-D68 (EVD68) and enterovirus-A71 (EV-A71).
- Clinicians should suspect AFM in any person presenting with acute onset flaccid limb weakness; most patients have a preceding febrile or viral respiratory illness in the 1-2 weeks before onset of limb weakness.
- Because AFM can progress rapidly and lead to respiratory failure requiring mechanical ventilation, patients with suspected AFM should be hospitalized, monitored for respiratory decompensation, and have a clinical and diagnostic evaluation.
- Patients suspected of having AFM should have specimens collected as soon as possible according to CDC guidance (see also Laboratory Testing recommendations below).
- Suspected cases should be promptly reported to the NH Division of Public Health Services (DPHS) at 603-271-4496 (after hours 603-271-5300).
- Clinicians should also review: