Be vigilant for AFM

The Centers for Disease Control and Prevention (CDC) cautions pediatricians and other pediatric healthcare providers to be on the lookout this summer and early fall for symptoms of acute flaccid myelitis (AFM) in young patients who complain of limb and muscle weakness. The agency reports 11 confirmed cases in 8 states as of June 28, 2019.

This serious but rare paralytic illness was first recognized in the United States in 2014, emerging concurrent with a large outbreak of respiratory illness attributed to enterovirus D-68 (EV-D68). Since 2014, there have been outbreaks of AFM every 2 years. In 2018, 233 confirmed cases of AFM in 41 states were confirmed in children (median age, 5.3 years), the agency reported this week, with the interval from onset of limb weakness until specimens for testing were collected ranging from 2 to 7 days, and reporting to the CDC ranging from 18 to 36 days.

Now the CDC is urging physicians to recognize the symptoms of AFM early and act immediately; collect specimens for testing as soon as possible; get magnetic resonance imaging (MRI) to confirm spinal lesions; alert health departments and the CDC promptly; and refer these patients to specialists for medical treatment and/or immediate hospitalization for medical management and rehabilitation.

There are no specific laboratory tests to identify AFM, nor are there any proven ways to treat or prevent it. Prompt symptom recognition and specimen collection are critical to improving understanding and management of this complex syndrome, says the CDC.