For Clinicians

Clinicians should be vigilant for and report to their state or local health department all patients with sudden onset of neurologic illness associated with limb weakness that meet CDC’s case definition below. This illness is now being referred to as acute flaccid myelitis.

Case Definition

To be considered a case, a patient must meet ALL four of these criteria:

1. Patient ?21 years of age,
2. Acute onset of focal limb weakness,
3. On or after August 1, 2014, AND
4. An MRI showing a spinal cord lesion largely restricted to gray matter.

For a summary of statistics among cases confirmed through November 13, 2014, read CDC’s MMWR Acute Flaccid Myelitis Among Persons Aged ?21 Years — United States, August 1–November 13, 2014.

Specimen Collection Instructions

Clinicians should follow these Specimen Collection Instructions for collecting specimens from patients that meet CDC’s case definition above. Available clinical specimens should be submitted to the state or local health department, and shipped from the health department to CDC as soon as possible after case identification, so that CDC can test and monitor these cases in as real time as possible.

Patient Summary Form

Clinicians should report to their state or local health department all patients who meet CDC’s case definition using the following Patient Summary Form. The form should be completed by, or in conjunction with, a clinician who provided care to the patient during the neurologic illness, and submitted to the state or local health department as soon as possible after case identification, so that CDC can monitor these cases in as real time as possible. A form that is largely complete but has some information pending (e.g., hospital or health department laboratory results) or under investigation (e.g., polio vaccination history) should still be submitted as soon as possible, and the pending results can then be provided to CDC when they become available.

Interim Considerations for Clinical Management of Patients

Information to help clinicians and public health officials manage care of children with acute flaccid myelitis that meet CDC’s case definition above.

Please note: these considerations are intended to apply to "acute flaccid myelitis," as defined in the document, and are not intended to be generalized to all forms or etiologies of childhood acute flaccid paralysis, such as Guillain-Barré syndrome, transverse myelitis, or other immune-mediated etiologies. If an alternative diagnosis for the acute paralysis is under consideration, all efforts should be made to explore the alternative diagnosis, and if found, appropriate intervention should be rendered.

RELEASED November 7, 2014

• Acute Flaccid Myelitis: Interim Considerations for Clinical Management [PDF 11 pages]

Top of Page