Why the study?
Since 2012, a distinct syndrome of acute flaccid paralysis with anterior myelitis (AFM) has been reported in children, prompting the use of Australia's routine AFP surveillance system to identify AFM cases.
Retrospective review of Australia's AFP surveillance system identified 41 cases of AFM from 2000-2018, demonstrating sustained but rare occurrence with an average annual incidence of 0.07 cases/100,000 person-years in children <15 years.
AFM incidence remains low yet sustained in Australian children; hypothesis-generating for surveillance and etiology.
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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Walker et al. (2022) studied this question.
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