Clinicians
Clinicians should continue to be vigilant and send all information about patients that meet the clinical criteria (sudden onset of flaccid limb weakness) for AFM to their state or local health department. Since AFM is a relatively new condition, we need information on all patients to help us better understand the spectrum of AFM illness, all possible causes, risk factors, and outcomes for this condition. Clinicians should send information on patients who meet the clinical criteria regardless of any laboratory results or MRI findings.
Clinicians should work with their state or local health department to complete the patient summary form provided below as soon as possible after patient identification so that they can be monitored in real time. Information should be sent regardless of any laboratory and MRI results.
The health department will request additional information contained in medical records, such as admission and discharge notes, neurology and infectious disease consult notes, MRI report, MRI images, vaccination history, and laboratory test results, in order to assist with case classification and identification of potential etiologies. If clinicians have additional questions, they can contact the CDC Emergency Operations Center at 770-488-7100.
Health Departments
As part of the case classification process using a panel of neurology experts, patient summary forms, and additional case information for each patient under investigation (PUI) for AFM should also be sent to CDC using a secure CDC FTP site. Local and/or state health departments can contact CDC by email at AFMinfo@cdc.gov or via secure fax at 404-471-8442 for further information on sending forms. Health departments should send information for PUIs, regardless of any laboratory or MRI results.
Patient Summary Form
- Acute Flaccid Myelitis: Patient Summary Form Word[v 5.1, 2 pages] UPDATED OCT 2018
- Acute Flaccid Myelitis: Patient Summary Form PDF[v 5.1, 2 pages] UPDATED OCT 2018
- Instructions for completing the AFM Patient Summary Form[3 pages] UPDATED OCT 2018
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