Acute Flaccid August 2020 Provider Guidance

Acute Flaccid Myelitis (AFM) is a rare syndrome characterized by rapid onset of flaccid weakness in one or more limbs with abnormalities of the or brain on magnetic resonance imaging (MRI). Timing is Key for AFM

Recognize AFM Collect specimens & Report to the department Diagnosis & medical get a MRI management Recognizing AFM Collect specimens & get a MRI • AFM tends occur in late summer or early fall • Specimens should be collected as early as possible in the course • Respiratory symptoms or consistent with a viral infec- of illness, preferably on the day of limb weakness onset tion occurs less than a week before onset of limb weakness • Specimens need to be sent to a State Public Health Laboratory, • Hospitalize patient immediately upon suspicion of AFM contact your county health department (CHD) to coordinate • Don’t wait for CDC’s case classification to diagnosis or • Order an MRI of the entire spine and brain with and without treat contrast 3 Tesla scanners are preferred and axial/sagittal images are the most helpful Symptoms

• Arm or leg weakness • Loss of muscle tone • Difficulty moving the eyes • Loss of reflexes • Difficulty with swallowing • Facial droop or weakness • Pain in arms, legs, neck or • Slurred speech Additional information concerning specimen collection can be found in the back Job Aid for Clinicians Report to health department Diagnosis & medical management Please contact your CHD to report a suspected case of AFM at There are no proven ways to treat or prevent AFM FloridaHealth.gov/CHDEpiContact Providers should expedite and infectious disease consults to discuss If the CHD cannot be reached, contact the state health department management and treatment at 850-245-4401 Long-term follow-up Items that need to be submitted The state health department is conducting long-term follow-ups on cases to • Admission and discharge notes better understand AFM outcomes. It consists of a 9 question survey and medical • Neurology and infectious disease consult notes records. Data will be shared with the Centers for Disease Control and Prevention. • MRI report Follow-ups will occur at 60 days, 6 months, and 1 year after limb weakness onset. • MRI images • Vaccination history The AFM Physician Consult and Support Portal is available to help with patient diagnosis • Laboratory test results and medical management contact them at • Patient summary form wearesrna.org/living-with-myelitis/resources/afm-physician-support-portal

To learn more about AFM surveillance, visit cdc.gov/acute-flaccid-myelitis For additional questions, please contact your local county health department