Acute Flaccid Myelitis or AFM is a neurological condition categorized by sudden onset of flaccid limb weakness, primarily in children, and typically preceded by a respiratory or febrile illness. It progresses rapidly and requires immediate hospital admission. Diagnosis is based on the completion of neurological exams, MRIs of the brain and spine, and laboratory testing.
Stay alert for AFM
Events, travel, and gatherings often brings increases in circulating respiratory pathogens, including enteroviruses. Enterovirus D‑68 (EV‑D68) has been linked to past increases in acute flaccid myelitis (AFM) cases, and although activity varies from year to year, individuals should remain vigilant for both EV‑D68 respiratory illness and AFM at any time.
While AFM remains rare, local health organizations should encourage clinicians to promptly evaluate patients with sudden onset of limb weakness. Encourage whole stool samples be collected from all patients with suspected AFM to rule out poliovirus infection, particularly if vaccination status is unknown or incomplete.
Because early recognition and reporting are essential, clinicians should report any patient meeting the AFM reporting criteria to their health department. AFM criteria include:
1.Acute onset of flaccid limb weakness, and
2.Gray matter lesions in the spinal cord.
CDC has several digital communication tools on its AFM website to increase awareness of proper specimen collection [refer to this chart] and evaluation of proximal muscle weakness [refer to this page] to work with a patient with suspected AFM. Please review these resources as necessary.
Reporting
For information on how to report a disease click here. For any questions, please contact the appropriate health authority by phone or review the website for additional information.
Carson City, Douglas and Lyon Counties
Carson City Health & Human Services (CCHHS)
(775) 887-2190
Website
Clark County
Southern Nevada Health District (SNHD)
(702) 759-1300
Website
Washoe County
Northern Nevada Public Health (NNPH)
(775) 328-2447
Website
All Other Counties
Nevada Division of Public and Behavioral Health (DPBH)
(775) 400-0333
Website
Resources
- About AFM: https://www.cdc.gov/acute-flaccid-myelitis/about/index.html
- Live case updates: https://www.cdc.gov/acute-flaccid-myelitis/cases/
- Physician consult and support portal: https://wearesrna.org/living-with-myelitis/resources/afm-physician-support-portal/
- For healthcare providers: https://www.cdc.gov/acute-flaccid-myelitis/hcp/clinical-overview/index.html
- For health departments: https://www.cdc.gov/acute-flaccid-myelitis/php/laboratories/index.html