Acute Flaccid Myelitis (AFM) Information for Health Care Providers

Reporting AFM

Florida participates in enhanced AFM surveillance through the Centers for Disease Control and Prevention (CDC) to provide a better understanding of the spectrum of AFM illness, including all possible causes, risk factors and outcomes.

The Florida Department of Health asks clinicians to provide information for patients who meet the clinical criteria for AFM (sudden onset of flaccid limb weakness) to their local health department regardless of any laboratory results or Magnetic Resonance Imaging (MRI) findings.

Requested Information and Documents

Information should be sent to the local or state public health department regardless of any laboratory and MRI results.

1. Order a spinal MRI and collect the following specimens for potential public health testing as soon as possible:
   • Cerebrospinal fluid (CSF)
   • Serum (collected at same time or within 24 hours of CSF if possible)
   • Two stool samples (collected at least 24 hours apart)
   • Respiratory–nasopharyngeal or oropharyngeal swab
     
     
     
     
2. Contact the local health department and work with them to:
   • Complete the AFM Patient Summary
   • Send MRI reports and images*
   • Send neurology consult notes
   • Coordinate specimen shipment

*Spinal cord lesions may not be present on initial MRI; a negative or normal MRI performed within the first 72 hours after onset of limb weakness does not rule out AFM.

Please also report:

• Any person whose death certificate lists acute flaccid myelitis as a cause of death or a condition contributing to death.
  
  
• Autopsy findings that include histopathologic evidence of inflammation largely involving the anterior horn of the spinal cord spanning ≥1 vertebral segment.

The Council of State and Territorial Epidemiologists (CSTE) AFM Case Definition will be used to assign a case classification after review by a team of neurologists at CDC. This patient classification will be given to the health department which will relay this information to the clinician. The case classification should not be used to decide whether to report a patient.

Long-Term Follow Up

Patients with confirmed or probable AFM will be contacted by the health department at 2 months after the onset of limb weakness to collect information on outcomes after their AFM illness.

Additional Resources for Providers

AFM Job Aid for Clinicians

Provider Guidance

American Academy of Pediatrics (AAP) AFM Micro-Learning Sessions

Centers for Disease Control and Prevention (CDC) Acute Flaccid Myelitis (AFM) Web Page for Clinicians

CDC AFM Patient Summary Form

CDC Clinical Guidance for the Acute Medical Treatment of AFM   

CDC Resources for Clinicians

Council of State and Territorial Epidemiologists (CSTE) Case Definition

Siegel Rare Neuroimmune Association (SRNA) AFM Physician Consult and Support Portal Available 24/7