Acute Flaccid Myelitis (AFM), 2020 Update

On August 20, 2020, NH DHHS issued a health alert update regarding acute flaccid myelitis. 

NH DPHS Health AlertsKey Points and Recommendations:

  1. Acute flaccid myelitis (AFM) is a serious neurologic syndrome causing paralysis that predominantly affects children in the late summer and early fall. 
  2. 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). 
  3. Multiple viruses are known or suspected to cause AFM, including enterovirus-D68 (EVD68) and enterovirus-A71 (EV-A71). 
  4. 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. 
  5. 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
  6. Patients suspected of having AFM should have specimens collected as soon as possible according to CDC guidance (see also Laboratory Testing recommendations below). 
  7. Suspected cases should be promptly reported to the NH Division of Public Health Services (DPHS) at 603-271-4496 (after hours 603-271-5300). 
  8. Clinicians should also review: 

Full DHHS Alert