Journal
EMERGING INFECTIOUS DISEASES
Volume 28, Issue 1, Pages 20-28Publisher
CENTERS DISEASE CONTROL & PREVENTION
DOI: 10.3201/eid2801.211690
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Funding
- Australian Government Department of Health
- University of Sydney
- Sydney Children's Hospital Network
- Royal Australasian College of Physicians
- Victorian Government Department of Health and Human Services
- World Health Organization
- Medical Research Future Fund Next Generation Fellowship [1135959]
- National Health and Medical Research Council Early Career Fellowship [1145817]
- 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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