CDC Updates Specimen
Collection, Shipping, and Testing Guidance for Suspected Acute Flaccid Myelitis
Flaccid Myelitis in the United States
continues to receive information about cases of AFM. So far in 2017, CDC has
received information for one confirmed case of AFM. From January 1, 2016
through December 31, 2016, CDC received information for 136 persons from 37
states who met the Council of State and Territorial Epidemiologists
definition for confirmed AFM. Despite extensive pathogen-specific testing of many specimens
since 2014, CDC and others have not identified an etiology for the AFM cases.
Therefore, CDC will no longer perform clinical diagnostics for enteroviruses or
metagenomic sequencing on specimens collected from suspect cases of AFM.
Instead, CDC has expanded the search for potential causes of acute flaccid
myelitis (AFM) by broadening laboratory approaches that test for potential
infectious and noninfectious causes, including possibly immune-mediated mechanisms.
continues to intensify its efforts to understand the cause and risk factors of
AFM and has changed its collection, storage, and shipping guidance for
specimens from AFM cases. Changes can be found on CDC's website.
please see the printable
job aid PDF on CDC's website.
testing should continue at hospital or state public health laboratories and may
include cerebrospinal fluid, sera or whole blood, stool, and respiratory
specimens. CDC will prioritize testing of sterile site specimens (i.e.,
cerebrospinal fluid, blood) using these new protocols to optimize yield of an
etiologic agent or possible mechanism for AFM. Non-sterile site specimens, such
as respiratory samples, will not be routinely tested at CDC. Stool or fecal
specimens should be sent to CDC to rule out the presence of poliovirus.
Specimens that are positive for enteroviruses/rhinoviruses at external
laboratories may be sent to CDC for typing.
testing performed at CDC uses assays that are not CLIA-approved and are not
intended for clinical diagnosis; therefore, CDC will not be able to provide
specific test results for individual samples. CDC will rapidly disseminate
results that indicate a possible cause of AFM to state and local health
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