Officials Urge Physicians to Hasten Data Collection for Acute Flaccid Myelitis (AFM)

Next wave of illness expected in 2020

One upside, if we can call it that, of outbreaks these days is our ability as healthcare professionals to foresee, anticipate, or at least predict when an outbreak might be most likely to occur. 

The obvious downside, however, comes when an outbreak is foreseen for a condition that we feel particularly unprepared to handle.

And that’s the case with acute flaccid myelitis, or AFM, a condition marked by the sudden onset of limb weakness (usually upper limb), paralysis, and spinal lesions seen on MRI scans. It most often occurs in children.

The condition first gained attention around the middle of this decade, when over 100 cases spread through 34 states. The drop to only 35 cases in 2017 was immediately mitigated the following year, when a now-record 233 cases emerged. Of these cases, almost all have required hospitalization, with over half requiring stays in intensive care and about a quarter of people with AFM requiring respiratory support.

Most troubling of all? The average age of patients since 2014 is just five years old.  

2019 is looking like the lightest year yet, with only 11 cases confirmed to this point… but that’s the exact problem. Data is weak and at times unreliable on AFM, but perhaps more information will emerge in the fall, when officials say AFM cases tend to peak. 

So will 2020 actually see the feared spike in cases? It’s too early to say for sure, but the CDC encouraged increased vigilance in last week’s release.

“The overall rarity of this condition and absence of a confirmatory test highlight the need for increased vigilance among providers seeing pediatric patients with acute onset of flaccid limb weakness in the late summer and fall,” they wrote. “Ongoing national AFM surveillance will provide an important bridge between research and public health response and will be critical for the development of optimal treatment and prevention recommendations.”  

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