Volume 26, Number 2—February 2020
CME ACTIVITY - Research
Characteristics of Patients with Acute Flaccid Myelitis, United States, 2015–2018
Nilay McLaren, Adriana Lopez, Sarah Kidd, John X. Zhang, W. Allan Nix, Ruth Link-Gelles, Adria Lee, and Janell A. Routh
Table 1
Descriptive characteristics of confirmed AFM cases in patients <22 years of age from peak years versus nonpeak years, United States, January 2015–December 2018*
| Characteristic | Peak years, n = 366† | Nonpeak years, n = 50‡ | p value |
|---|---|---|---|
| Age, y, median (range) [IQR] |
5.2 (0.4–21.9) [3.2–8.0] |
8.3 (0.3–20.2) [3.9–11.9] |
0.02 |
| Sex | |||
| M | 217/366 (59) | 32/50 (64) | 0.54 |
| F |
149/366 (41) |
18/50 (36) |
0.54 |
| Lumbar puncture | 343/363 (94) | 48/49 (98) | 0.84 |
| Pleocytosis§ | 283/328 (86) | 28/47 (60) | <0.001 |
| CSF, cells/mm3, median (range) [IQR] | 75 (0–3,261) [24–150] | 32 (0–1,081) [3–168] | 0.07 |
| Upper extremity involvement only | 121/366 (33) | 8/50 (16) | 0.01 |
| Lower extremity involvement only | 49/366 (13) | 16/50 (32) | <0.001 |
| Paralysis of all 4 limbs | 101/366 (28) | 24/50 (48) | 0.005 |
| Severe AFM¶ | 9/366 (2) | 9/50 (18) | <0.001 |
| Cranial nerve lesion |
96/366 (26) |
10/50 (20) |
0.39 |
| Illness within previous 4 weeks | |||
| Any fever | 258/358 (72) | 27/49 (55) | 0.02 |
| Any respiratory illness | 282/360 (78) | 21/49 (43) | <0.001 |
| Any gastrointestinal illness | 111/344 (32) | 12/34 (35) | 0.24 |
| Any respiratory illness or fever |
328/366 (90) |
31/50 (62) |
<0.001 |
| Enterovirus/rhinovirus RNA positive | 98/258 (38) | 5/31 (16) | 0.02 |
| Enterovirus D68 | 53/98 (54) | 0/5 | 0.02 |
| Enterovirus A71 | 13/98 (13) | 1/5 (20) | 0.59 |
*Values are no./total (%), except where indicated otherwise. AFM, acute flaccid myelitis; CSF, cerebrospinal fluid; IQR, interquartile range.
†2016 and 2018.
‡2015 and 2017.
§Defined as leukocyte count >5 cells/mm3.
¶Defined as AFM cases of respiratory distress that required mechanical ventilation, cranial nerve involvement, and paralysis of all 4 limbs.
Page created: January 15, 2020
Page updated: January 15, 2020
Page reviewed: January 15, 2020
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