Multistate (USA) - Update: Acute flaccid myelitis, >150 cases

December 13, 2018
State Health Agencies; CDC (US)

A second confirmed case of acute flaccid myelitis (AFM), a condition that causes muscle weakness, was reported to the Nebraska Department of Health and Human Services (DHHS). The child, in the Sarpy/Cass Health Department jurisdiction, was hospitalized and later released. Nebraska’s first confirmed case of AFM was reported in late November also in the Sarpy/Cass health department jurisdiction. 

Another reported case in Douglas County was not confirmed after a thorough review by the Centers for Disease Control and Prevention (CDC). The patient met some, but not all of the criteria for being a confirmed AFM case. Two additional suspected cases are also undergoing further testing at the CDC.

“There is nationwide focus on AFM and state and local health departments are working with federal partners to help find answers,” said Dr. Tom Safranek, State Epidemiologist for DHHS. “Every case reported undergoes a thorough investigation and extensive diagnostic testing which will help pinpoint exactly what’s causing this disease and how it can be prevented.”

DHHS has shared information on recognizing, managing and reporting potential cases of AFM with health care providers and local health departments across Nebraska.

Fast facts about AFM:

  • AFM is a rare but serious condition that affects mostly children and generally causes sudden muscle weakness.
  • Symptoms include sudden weakness in the arms or legs. Some people also experience drooping of the eyelids or face, difficulty moving eyes, slurred speech or difficulty swallowing.
  • If parents see potential symptoms of AFM in their child, they should contact their health care provider promptly.
  • Experts are working to determine the exact cause of AFM.
  • There is no specific treatment for AFM or proven prevention strategy, but washing hands, covering your cough and staying home if you’re sick can help avoid illness.
  • People, especially parents, may be concerned about AFM. The CDC offers helpful resources at https://www.cdc.gov/acute-flaccid-myelitis/index.html.

AFM is not a new condition but the increase in cases nationwide starting in 2014 is new. Since 2014, there have been a total of 484 confirmed cases of AFM in the U.S. 

DHHS started surveillance for AFM in 2014 after cases appeared in Colorado and made it a reportable disease in 2016.

CDC data – Number of confirmed U.S. AFM cases by year of illness onset, 2014-2018*

​Year  ​Number of confirmed cases  Number of states with confirmed cases
​2014 ​120 ​34
​2015 ​22 ​17
​2016 ​149 ​39 (includes DC)
​2017 ​35 ​16
​2018 ​158 ​36


 

*Data as of 12/10/18. Case counts are subject to change.

On the other hand, the Michigan Department of Health and Human Services (MDHHS) has been notified by CDC that Michigan has a confirmed a second case of AFM in 2018. The confirmed case is a child from Oakland County.

The state’s first AFM case was confirmed Dec. 5 and involves a child in Wayne County. Nine suspect cases of AFM in Michigan remain under investigation.

The map below by CDC shows them number of confirmed AFM cases in the U.S. as of December 7, 2018.

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