AFM Health Advisory - Oct. 15, 2018

Health Advisory
Health Advisory
October 17, 2018

Acute Flaccid Myelitis (AFM)
October 15, 2018

As of October 16, 2018, ten confirmed cases of Acute Flaccid Myelitis (AFM) have been reported to the Texas Department of State Health Services (DSHS) for 2018. Healthcare providers are encouraged to continue vigilance for cases of AFM. Providers wanting to report shall send all information about patients that meet the clinical criterion for AFM (sudden onset of flaccid limb weakness) to their local health department. Information shall be sent on patients who meet the clinical criterion regardless of any laboratory results or magnetic resonance imaging (MRI) findings. Note that there is no age restriction for reporting suspected cases. The case definition includes people of all ages to include information in both children and adults. For more information about the case definition for AFM, please see

Background: AFM has been under investigation by health departments and the Centers for Disease Control and Prevention (CDC) for the past four years. AFM is an illness characterized by acute onset of flaccid limb weakness and MRI findings of lesions in the gray matter of the spinal cord. AFM may start with a prodromal respiratory or gastrointestinal illness about one week before limb weakness onset. Pain in the neck or back may also precede weakness. Cranial nerve findings such as slurred speech, difficulty swallowing, and eyelid or facial droop may occur. On exam, the weak limb(s) displays poor tone and diminished reflexes. Cerebrospinal fluid often shows a lymphocytic pleocytosis, with or without elevated protein. MRI findings in AFM cases include lesions in the gray matter of the spinal cord.

For information about how to report a suspected AFM patient, please see the AFM Clinician Job Aid. For additional information and guidance on AFM, please visit the Centers for Disease Control & Prevention website at: For questions or to notify us of any patients who you are evaluating for acute onset of flaccid limb weakness, please contact either your local health department or DSHS at (512) 776-7676.