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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. RouthComments to Author 
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Main Article

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.

Main Article

Page created: January 15, 2020
Page updated: January 15, 2020
Page reviewed: January 15, 2020
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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