CDC creates AFM task force as confirmed cases rise to 106

The Centers for Disease Control and Prevention (CDC) announced yesterday the creation of the Acute Flaccid Myelitis (AFM) Task Force, which will search for the cause of the mysterious polio-like condition.

"I want to reaffirm to parents, patients, and our Nation CDC’s commitment to this serious medical condition," said CDC Director Robert Redfield, MD, in a press release.

"This Task Force will ensure that the full capacity of the scientific community is engaged and working together to provide important answers and solutions to actively detect, more effectively treat, and ultimately prevent AFM and its consequences."

The task force will comprise experts from the scientific, medical, and public health disciplines and will convene under the CDC's Office of Infectious Diseases' Board of Scientific Counselors (BSC). The group is expected to make its first recommendations during the BSC's public meeting on Dec 6 in Atlanta.

2018 totals mirror 2014, 2016

The CDC also updated the confirmed case count of the ongoing AFM outbreak in 29 states, bringing this year's total to 106. Fourteen new cases have been added in recent weeks, and all but 5 of the 106 patients are under the age of 5.

"These 106 confirmed cases are among the total of 273 reports that CDC received of patients under investigation (PUIs). CDC recently received increased reports for PUIs with onset of symptoms in August, September, and October," the CDC said in its update. The bulk of confirmed cases this year had an onset of symptoms in September, according to a CDC graph.

Last year, only 33 confirmed cases of AFM were recorded in 16 states. In 2016, 149 people were confirmed to have AFM in 39 states. Again, the number was lower in 2015, at 22. In 2014, the first year the CDC began tracking AFM, 120 people in 34 states had confirmed cases.

Trends offer few clues

More than 90% of AFM patients report a mild respiratory virus or fever in the weeks preceding their symptom onset. The patients have not tested positive for any polioviruses. AFM causes limb paralysis and weakness by affecting the gray matter surrounding the spinal cord.

Only 4 out of 414 confirmed AFM cases since 2014 have had a known pathogen detected in spinal fluid, and they have included coxsackievirus A16, enterovirus (EV)-A71, and EV-D68.

Last week the CDC published data on 80 confirmed cases in 2018, which showed that 54% have tested positive for EV or rhinovirus at the time of AFM diagnosis.

Though AFM has been connected to EV, the vast majority of children exposed to EVs will not develop AFM. The CDC estimates that less than one to two in a million children in the United States will get AFM every year.

See also:

Nov 19 CDC task force press release

Nov 20 CDC AFM update

Nov 13 CIDRAP News story "AFM count tops 250 as CDC struggles to find cause"

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