Cases of Acute Flaccid Myelitis in Minnesota and other states

For an insight into the CDC’s thinking, consider this 2014 article from the Lancet:

https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(14)70132-2/fulltext

“Maybe we should know more about it”

Does Mark Pallansch know that poliovirus does not show up in the CSF, except in the most severe 1% of cases? This is why, in the 1950’s, polio was diagnosed purely based on visible signs and symptoms. It was well appreciated at the time that poliovirus simply does not show up in either the blood or CSF after the first symptoms have become apparent.

 

Update from the CDC:
https://www.cdc.gov/mmwr/volumes/68/wr/mm6812a1.htm?s_cid=mm6812a1_w

Good to hear the CDC is trying active, prospective, surveillance.
Active, prospective, surveillance is the only real surveillance.

CDC’s passive surveillance approach is extremely limited in its capacity to identify infectious outbreaks.
I wonder how many outbreaks have been missed over the years due to the CDC’s “sit back and wait for someone to say something” approach.

...And when did they switch from calling it “Acute Flaccid Paralysis (AFP)” to calling it “Acute Flaccid Myelitis (AFM)”?

 

A bit of Google Scholar sleuthing suggests it was the CDC who started using the term AFM in 2014.

 

And now NIAID has weighed in, with a somewhat more urgent outlook than the CDC’s:
https://mbio.asm.org/content/10/2/e00521-19

Ten years ago people warned that Enterovirus 71 would be the “poliovirus of the 21st century”:
https://www.tandfonline.com/doi/pdf/10.1080/10158782.2009.11441350
https://dabamirror.sci-hub.tw/4635/2ca3893261125263cb72e32d848d0c11/modlin2007.pdf

Now they’re saying Enterovirus D68 might claim that title:
https://twin.sci-hub.tw/6383/99012e8beec3c1fc6b4125ac3aa4f916/wiznitzer2017.pdf
(co-authored by Avi Nath, of the NIH Post-infectious ME study)

 

According to this story, Enterovirus-D68 has been confirmed in one patient, but...

http://www.startribune.com/virus-identified-as-a-cause-of-paralyzing-condition-in-minnesota-children-acute-flaccid-myelitis/508757812/

 

The CDC has now conceded that Enterovirus D68 can cause Acute Flaccid Paralysis. Although the concession of causality is within the context of a single patient, there may be wider implications.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6815a4.htm?s_cid=mm6815a4_w

 

It has been discussed in the literature for quite a while, so I'm not totally surprised.