Abstract
Starting in 2014, biennial clusters of acute flaccid myelitis (AFM), frequently described as "polio-like" illness, have been reported across the United States and elsewhere, often linked to enteroviruses. To assess AFM trends in Canada, we reviewed the Canadian Acute Flaccid Paralysis Surveillance System (CAFPSS) for cases reported during the 2018 and 2019 calendar years that meet the Centers for Disease Control and Prevention case definitions for AFM. A total of 10 cases (8 in 2018 and 2 in 2019) met the confirmed AFM case definition and 30 (26 in 2018 and 4 in 2019) met the probable AFM case definition. Sixty percent of confirmed and probable cases were younger than five years old, and all cases had symptom onset between the months of July and October. Enteroviruses were detected in 50% of confirmed cases. At the time of writing this report, 2020 AFM data were not yet available; it is unknown if a spike in AFM cases will be seen in 2020.
Highlights
IntroductionSpikes in acute flaccid myelitis (AFM), an emerging form of acute flaccid paralysis (AFP) related to viral infections and frequently described as “polio-like” illness, have been reported in the United States and elsewhere, in a seemingly biennial pattern in the summer and fall, in 2014, 2016 and 2018 [1,2,3,4,5]
Spikes in acute flaccid myelitis (AFM), an emerging form of acute flaccid paralysis (AFP) related to viral infections and frequently described as “polio-like” illness, have been reported in the United States and elsewhere, in a seemingly biennial pattern in the summer and fall, in 2014, 2016 and 2018 [1,2,3,4,5].This study describes the preliminary analysis of AFM in Canada for the years 2018 and 2019, using data from the Canadian Acute Flaccid Paralysis Surveillance System (CAFPSS)
CAFPSS did, allow for the use of an existing surveillance tool to monitor trends during periods when spikes in AFM activity have been reported elsewhere and to identify AFM activity related in part to nonpolio enterovirus with a similar pattern in seasonality to reports coming out of the United States
Summary
Spikes in acute flaccid myelitis (AFM), an emerging form of acute flaccid paralysis (AFP) related to viral infections and frequently described as “polio-like” illness, have been reported in the United States and elsewhere, in a seemingly biennial pattern in the summer and fall, in 2014, 2016 and 2018 [1,2,3,4,5]. AFP is defined as a sudden onset of paralysis with reduced muscle tone in one or more limbs This syndrome is caused by a range of etiologies, such as Guillain–Barré syndrome, transverse myelitis or neuropathies. The Centers for Disease Control and Prevention (CDC) has reported extensively on recent trends of AFM, in the United States [3,11]. This emerging trend has led to concerns about the potential effect of AFM on Canadians. The seriousness of the condition as well as the lack of clear knowledge about the etiology of the disease underscore the need to better understand the epidemiology of AFM to further identify prevention and patient management measures [3]
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