Key result
Acute flaccid myelitis cases during peak years had significantly higher rates of enterovirus or rhinovirus RNA positivity (38% vs 16%) and pleocytosis (86% vs 60%) compared to nonpeak years.
Why the study?
Observed peaks of AFM have occurred biennially since 2014 in the United States, and the study aimed to determine if AFM etiology differed between peak and nonpeak years.
Do the clinical and laboratory characteristics of acute flaccid myelitis differ between peak and nonpeak years?
Observational (n=416)
Yes
Do the clinical and laboratory characteristics of acute flaccid myelitis differ between peak and nonpeak years?
Absolute Event Rate: 38% vs 16%
p-value: p=0.02
Acute flaccid myelitis etiology and clinical presentation differ significantly between peak and nonpeak years, with enterovirus D68 associated with AFM only in peak years.
Observed peaks of acute flaccid myelitis (AFM) cases have occurred biennially since 2014 in the United States. We aimed to determine if AFM etiology differed between peak and nonpeak years, considering that clinical features of AFM differ by virus etiology. We compared clinical and laboratory characteristics of AFM cases that occurred during peak (2016 and 2018, n = 366) and nonpeak (2015 and 2017, n = 50) years. AFM patients in peak years were younger (5.2 years) than those in nonpeak years (8.3 years). A higher percentage of patients in peak years than nonpeak years had pleocytosis (86% vs. 60%), upper extremity involvement (33% vs. 16%), and an illness preceding limb weakness (90% vs. 62%) and were positive for enterovirus or rhinovirus RNA (38% vs. 16%). Enterovirus D68 infection was associated with AFM only in peak years. Our findings suggest AFM etiology differs between peak and nonpeak years.
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McLaren et al. (2020) conducted an observational in Acute Flaccid Myelitis (n=416). Peak incidence years (2016 and 2018) vs. Nonpeak incidence years (2015 and 2017) was evaluated on Enterovirus or rhinovirus RNA positivity (p=0.02). Acute flaccid myelitis cases during peak years had significantly higher rates of enterovirus or rhinovirus RNA positivity (38% vs 16%) and pleocytosis (86% vs 60%) compared to nonpeak years.
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