4.7 Article

Using the Acute Flaccid Paralysis Surveillance System to Identify Cases of Acute Flaccid Myelitis, Australia, 2000-2018

Journal

EMERGING INFECTIOUS DISEASES
Volume 28, Issue 1, Pages 20-28

Publisher

CENTERS DISEASE CONTROL & PREVENTION
DOI: 10.3201/eid2801.211690

Keywords

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Funding

  1. Australian Government Department of Health
  2. University of Sydney
  3. Sydney Children's Hospital Network
  4. Royal Australasian College of Physicians
  5. Victorian Government Department of Health and Human Services
  6. World Health Organization
  7. Medical Research Future Fund Next Generation Fellowship [1135959]
  8. National Health and Medical Research Council Early Career Fellowship [1145817]
  9. National Health and Medical Research Council of Australia [1145817] Funding Source: NHMRC

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Since 2012, both the United States and Australia have reported cases of acute flaccid myelitis (AFM) in children. Australia's AFP surveillance system is well-placed to identify future AFM cases, with a low incidence rate.
Since 2012, the United States has reported a distinct syndrome of acute flaccid paralysis (AFP) with anterior myelitis, predominantly in children. This polio-like syndrome was termed acute flaccid myelitis (AFM). Australia routinely conducts AFP surveillance to exclude poliomyelitis. We reviewed 915 AFP cases in Australia for children <15 years of age during 2000-2018 and reclassified a subset to AFM by using the US Council of State and Territorial Epidemiologists case definition. We confirmed 37 AFM cases by using magnetic resonance imaging findings and 4 probable AFM cases on the basis of cerebrospinal fluid pleocytosis. Nonpolio enteroviruses were detected in 33% of AFM cases from which stool samples were tested. Average annual AFM incidence was 0.07 cases/100,000 person-years in children <15 years of age. AFM occurred sporadically in Australia before 2010 but regularly since then, indicating sustained, albeit rare, clinical manifestation in children. The AFP surveillance system in Australia is well-positioned to identify future AFM cases.

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