Daily Brief: 2017.4.3
Acute flaccid myelitis testing updates
The US Centers for Disease Control and Prevention (CDC) is modifying testing protocols for acute flaccid myelitis (AFM). Given that the CDC have not identified a specific cause, the agency said it will no longer perform clinical testing for enteroviruses or do gene sequencing on specimens collected from suspected AFM cases. Instead, the CDC said it has expanded the search for potential causes of AFM by broadening lab approaches that test for possible infectious and noninfectious causes
(Sources: CIDRAP, CDC)
Acute flaccid myelitis is a condition that affects the nervous system, specifically the spinal cord, and can result from a variety of causes including viral infections. AFM is characterized by a sudden weakness in one or more arms or legs, along with loss of muscle tone and decreased or absent reflexes. Numbness or other physical symptoms are rare, although some patients may have pain in their arms or legs. Children affected by AFM typically experience paralysis on most of their body and need a ventilator to breathe.
Between January 1 to December 31, 2016, a total of 136 people in 37 states across the country were confirmed to have AFM. So far in 2017, CDC has received information for one confirmed case of AFM.
- The CDC urged clinicians to collect specimens from patients with suspected AFM as early as possible in the illness course, ideally on the day of limb weakness onset.
- Pathogen-specific testing should continue at hospital or state public health labs, to include cerebrospinal fluid, sera or whole blood, stool, and respiratory samples. CDC added also that it will now prioritize testing of sterile-site specimens.
- Though non-sterile specimens, including respiratory ones, will not be routinely tested at the CDC, clinicians should still send the CDC stool or fecal specimens to rule out poliovirus.