CDC Updates Specimen Collection, Shipping, and Testing Guidance for Suspected Acute Flaccid Myelitis (AFM) Cases
The US Centers for Disease Control and Prevention (CDC) continues to receive information about cases of Acute Flaccid Myelitis (AFM):
- In 2017, the CDC has received information for one confirmed case of AFM.
- From January 1, 2016 through December 31, 2016, the CDC received information for 136 persons from 37 states who met the Council of State and Territorial Epidemiologists (CSTE) case definition for AFM
Despite extensive pathogen-specific testing of many specimens since 2014, CDC and others have not identified an etiology for the AFM cases. Therefore, CDC will no longer perform clinical diagnostics for enteroviruses or metagenomic sequencing on specimens collected from suspect cases of AFM. Instead, CDC has expanded the search for potential causes of acute flaccid myelitis (AFM) by broadening laboratory approaches that test for potential infectious and noninfectious causes, including possibly immune-mediated mechanisms.
At this time the CDC is informing health care providers of updated laboratory guidance. Changes to collection, storage and shipping guidance for suspected AFM specimens can be found on the CDC’s website, a link is also provided below. Additionally, the CDC has a printable job aid that details how clinicians should send information about suspected AFM cases to the health department
Clinicians should be aware of the follow from the CDC’s Clinical Action report:
- Pathogen-specific testing should continue at hospital or state public health laboratories and may include cerebrospinal fluid, sera or whole blood, stool, and respiratory specimens. CDC will prioritize testing of sterile site specimens (i.e., cerebrospinal fluid, blood) using these new protocols to optimize yield of an etiologic agent or possible mechanism for AFM. Non-sterile site specimens, such as respiratory samples, will not be routinely tested at CDC. Stool or fecal specimens should be sent to CDC to rule out the presence of poliovirus. Specimens that are positive for enteroviruses/rhinoviruses at external laboratories may be sent to CDC for typing.
- The new testing performed at CDC uses assays that are not CLIA-approved and are not intended for clinical diagnosis; therefore, CDC will not be able to provide specific test results for individual samples. CDC will rapidly disseminate results that indicate a possible cause of AFM to state and local health departments.
Follow the links below for additional information and resources from the CDC.
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