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What You Need to Know About Acute Flaccid Myelitis (AFM)

Acute Flaccid Myelitis (AFM) is a condition that affects the nervous system. It specifically affects one area of the spinal cord, which causes muscles and reflexes to become weakened. AFM mostly affects children. Symptoms include sudden weakening of arms or legs, along with a loss of muscle tone and reflexes. Additional symptoms can include facial droop, difficulty with eye movements, drooping eyelids, difficulty swallowing or slurred speech. Some patients will recover quickly and completely, while others will continue to have paralysis and need ongoing care.

AFM is not a new condition, and it is still classified as rare, but there is an unexplained rise in the condition over the past four years. The Centers for Disease Control and Prevention (CDC) is investigating reasons for the rise. Over the past four years there have been 404 confirmed cases, 80 of those were confirmed in 2018 across 25 states.

Certain viruses can lead to AFM or similar neurological diseases: poliovirus, enteroviruses, West Nile Virus, and adenoviruses. While an early outbreak coincided with an outbreak of a specific enterovirus, the pathogen related to that enterovirus has not been found in cases after that 2014 outbreak. Because the symptoms are similar to those caused by the poliovirus, many headlines and descriptions refer to it as a "polio-like" disease. It's important to note that none of the 404 cases have tested positive for the poliovirus.

The symptoms of AFM are the same as several other neurological diseases, making diagnosis difficult. An official confirmed diagnosis of AFM requires symptoms of weakened or paralyzed limbs as well as an MRI scan that shows a specific type of damage. A probable diagnosis requires the same symptoms with a cerebrospinal fluid sample showing white blood cell count >5 cells /mm.3 The final case classification is done by the CDC.

AFM is not currently on the 2018 National Notifiable Conditions list, but clinicians are encouraged to be watchful for symptoms that match AFM and report suspected cases to their state health departments. Conduent's Maven System makes it possible for state and local health departments to adapt to changing data collection needs when an outbreak strikes. The flexible, configurable system allows public health departments to add, remove, and change required data elements without custom code. Maven can email appropriate officials when a case of a rare disease such as AFM is reported, and detect and notify health department officials when an outbreak happens.

Reach out to Conduent Public Health Solutions to learn more or view a demonstration of Maven in action.

About the Author

Pamela Knight-Schwartz, MPH is the Director of Public Health Consulting at Conduent Public Health Solutions. She has more than 15 years of experience in public health informatics, working in immunization information systems, disease surveillance systems, and prescription drug monitoring programs in corporate and government environments.

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