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Important Information about the Seasonal Acute Flaccid Myelitis Outbreak

By David E. Hogan, DO, MPH, FACEP | on December 17, 2018 | 0 Comment
CME CME Now Features
Important Infrmation about the Seasonal Acute Flaccid Myelitis Outbreak

What We Don’t Know About AFM

  • The cause of AFM.
  • Why AFM has persisted seasonally since 2014.
  • Who is at higher risk for AFM or why.
  • The long-term effects of AFM.
  • The best preventive strategies.

Source: CDC

Clinical Presentation of Acute Flaccid Myelitis

Onset of extremity weakness, rapidly progressing, usually in young patients

Some patients develop:

  • Extremity pain and tingling
  • Facial palsy
  • Paresis of extraocular muscles
  • Ptosis of the eyes
  • Dysphagia
  • Slurred speech
  • Altered mental status
  • Urinary retention
  • Respiratory failure requiring ventilator management

Source: CDC

Complete the CME activity.

References

  1. Pastula DM, Aliabadi N, Haynes AK, et al. Acute neurologic illness of unknown etiology in children—Colorado, August–September 2014. MMWR Morb Mortal Wkly Rep. 2014;63(40);901-902.
  2. Greninger AL, Naccache SN, Messacar K, et al. A novel outbreak enterovirus D68 strain associated with acute flaccid myelitis cases in the USA (2012-14): a retrospective cohort study. Lancet Infect Dis. 2015;15(6):671-682.
  3. Ayscue P, Van Haren K, Sheriff H, et al. Acute flaccid paralysis with anterior myelitis–California, June 2012-June 2014. MMWR Morb Mortal Wkly Rep. 2014;63(40):903-906.
  4. Van Haren K, Ayscue P, Waubant E, et al. Acute flaccid myelitis of unknown etiology in California, 2012-2015. JAMA. 2015;314(24):2663-2671.
  5. Acute flaccid myelitis. CDC website. Accessed Nov. 19, 2018.
  6. Iverson SA, Ostdiek S, Prasai S, et al. Notes from the field: cluster of acute flaccid myelitis in five pediatric patients—Maricopa County, Arizona, 2016. MMWR Morb Mortal Wkly Rep. 2017;66(28):758–760.
  7. Bonwitt J, Poel A, DeBolt C, et al. Acute flaccid myelitis among children—Washington, September–November 2016. MMWR Morb Mortal Wkly Rep. 2017;66(31):826-829.
  8. Aliabadi N, Messacar K, Pastula DM, et al. Enterovirus D68 infection in children with acute flaccid myelitis, Colorado, USA, 2014. Emerg Infect Dis. 2016;22(8):1387-1394.
  9. Division of Viral Diseases, National Centers for Immunization and Respiratory Diseases, CDC; Division of Vector-Borne Diseases, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Children‘s Hospital Colorado; et al. Notes from the field: acute flaccid myelitis among persons aged ≤21 years — United States, August 1–November 13, 2014. MMWR Morb Mortal Wkly Rep. 2015;63(53);1243-1244.
  10. Martin JA, Messacar K, Yang ML, et al. Outcomes of Colorado children with acute flaccid myelitis at 1 year. Neurology. 2017;89(2):129-137.
  11. Sejvar JJ, Lopez AS, Cortese MM, et al. Acute flaccid myelitis in the United States, August-December 2014: results of nationwide surveillance. Clin Infect Dis. 2016;63(6):737-745
  12. Messacar K, Schreiner TL, Van Haren K, et al. Acute flaccid myelitis: a clinical review of US cases 2012-2015. Ann Neurol. 2016;80(3):326-338.
  13. Nelson GR, Bonkowsky JL, Doll E, et al. Recognition and management of acute flaccid myelitis in children. Pediatr Neurol. 2016;55:17-21.
  14. Revision to the standardized surveillance and case definition for acute flaccid myelitis. CDC Counsel of State and Territorial Epidemiologists website. Accessed Nov. 19, 2018.

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