Vital Signs: Clinical Characteristics of Patients with Confirmed Acute Flaccid Myelitis, United States, 2018.

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  • Additional Information
    • Affiliation:
      Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
      Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
      Division of Global HIV and TB, Center for Global Health, CDC
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      Background: Acute flaccid myelitis (AFM) is a serious neurologic syndrome that affects mostly children and is characterized by the acute onset of limb weakness or paralysis. Since U.S. surveillance for AFM began in 2014, reported cases have peaked biennially. This report describes the clinical characteristics of AFM patients during 2018, the most recent peak year.Methods: Medical records from persons meeting AFM clinical criterion (acute onset of flaccid limb weakness) were submitted to CDC. Patients with confirmed AFM met the clinical criterion and had magnetic resonance imaging indicating spinal cord lesions largely restricted to gray matter and spanning one or more vertebral segments. Symptoms, physical findings, test and imaging results, and hospitalization data were abstracted and described.Results: Among 238 patients with confirmed AFM during 2018, median age was 5.3 years. Among the 238 patients, 205 (86%) had onset during August-November. Most (92%) had prodromal fever, respiratory illness, or both beginning a median of 6 days before weakness onset. In addition to weakness, common symptoms at clinical evaluation were gait difficulty (52%), neck or back pain (47%), fever (35%), and limb pain (34%). Among 211 who were outpatients when weakness began, most (76%) sought medical care within 1 day, and 64% first sought treatment at an emergency department. Overall, 98% of patients were hospitalized, 54% were admitted to an intensive care unit, and 23% required endotracheal intubation and mechanical ventilation.Conclusion: Clinicians should suspect AFM in children with acute flaccid limb weakness, especially during August-November and when accompanied by neck or back pain and a recent history of febrile respiratory illness. Increasing awareness in frontline settings such as emergency departments should aid rapid recognition and hospitalization for AFM.
    • Journal Subset:
      Biomedical; Public Health; USA
    • Instrumentation:
      Clinical Decision Making in Nursing Scale (CDMNS) (Jenkins)
    • ISSN:
      0149-2195
    • MEDLINE Info:
      PMID: NLM32759919 NLM UID: 7802429
    • Publication Date:
      In Process
    • Publication Date:
      20200926
    • DOI:
      10.15585/mmwr.mm6931e3
    • Accession Number:
      145156786
  • Citations
    • ABNT:
      KIDD, S. et al. Vital Signs: Clinical Characteristics of Patients with Confirmed Acute Flaccid Myelitis, United States, 2018. MMWR: Morbidity & Mortality Weekly Report, [s. l.], v. 69, n. 31, p. 1031–1038, 2020. DOI 10.15585/mmwr.mm6931e3. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=145156786. Acesso em: 29 out. 2020.
    • AMA:
      Kidd S, Lopez A, Allan W, et al. Vital Signs: Clinical Characteristics of Patients with Confirmed Acute Flaccid Myelitis, United States, 2018. MMWR: Morbidity & Mortality Weekly Report. 2020;69(31):1031-1038. doi:10.15585/mmwr.mm6931e3
    • APA:
      Kidd, S., Lopez, A., Allan, W., Anyalechi, G., Itoh, M., Yee, E., Oberste, M. S., Routh, J., & Nix, W. A. (2020). Vital Signs: Clinical Characteristics of Patients with Confirmed Acute Flaccid Myelitis, United States, 2018. MMWR: Morbidity & Mortality Weekly Report, 69(31), 1031–1038. https://doi.org/10.15585/mmwr.mm6931e3
    • Chicago/Turabian: Author-Date:
      Kidd, Sarah, Adriana Lopez, W. Allan, Gloria Anyalechi, Megumi Itoh, Eileen Yee, M. Steven Oberste, Janell Routh, and W Allan Nix. 2020. “Vital Signs: Clinical Characteristics of Patients with Confirmed Acute Flaccid Myelitis, United States, 2018.” MMWR: Morbidity & Mortality Weekly Report 69 (31): 1031–38. doi:10.15585/mmwr.mm6931e3.
    • Harvard:
      Kidd, S. et al. (2020) ‘Vital Signs: Clinical Characteristics of Patients with Confirmed Acute Flaccid Myelitis, United States, 2018’, MMWR: Morbidity & Mortality Weekly Report, 69(31), pp. 1031–1038. doi: 10.15585/mmwr.mm6931e3.
    • Harvard: Australian:
      Kidd, S, Lopez, A, Allan, W, Anyalechi, G, Itoh, M, Yee, E, Oberste, MS, Routh, J & Nix, WA 2020, ‘Vital Signs: Clinical Characteristics of Patients with Confirmed Acute Flaccid Myelitis, United States, 2018’, MMWR: Morbidity & Mortality Weekly Report, vol. 69, no. 31, pp. 1031–1038, viewed 29 October 2020, .
    • MLA:
      Kidd, Sarah, et al. “Vital Signs: Clinical Characteristics of Patients with Confirmed Acute Flaccid Myelitis, United States, 2018.” MMWR: Morbidity & Mortality Weekly Report, vol. 69, no. 31, Aug. 2020, pp. 1031–1038. EBSCOhost, doi:10.15585/mmwr.mm6931e3.
    • Chicago/Turabian: Humanities:
      Kidd, Sarah, Adriana Lopez, W. Allan, Gloria Anyalechi, Megumi Itoh, Eileen Yee, M. Steven Oberste, Janell Routh, and W Allan Nix. “Vital Signs: Clinical Characteristics of Patients with Confirmed Acute Flaccid Myelitis, United States, 2018.” MMWR: Morbidity & Mortality Weekly Report 69, no. 31 (August 7, 2020): 1031–38. doi:10.15585/mmwr.mm6931e3.
    • Vancouver/ICMJE:
      Kidd S, Lopez A, Allan W, Anyalechi G, Itoh M, Yee E, et al. Vital Signs: Clinical Characteristics of Patients with Confirmed Acute Flaccid Myelitis, United States, 2018. MMWR: Morbidity & Mortality Weekly Report [Internet]. 2020 Aug 7 [cited 2020 Oct 29];69(31):1031–8. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=145156786