Welcome to the State of California 
 

Acute Flaccid Myelitis (AFM) Surveillance

The California Department of Public Health (CDPH) is reporting a statewide increase in acute flaccid myelitis (AFM) since August 2016. Please report AFM cases to CDPH and submit clinical specimens for laboratory testing.

An overview of the current situation can be found here.

CDPH and the Centers for Disease Control (CDC) conduct enhanced viral testing and surveillance for patients with acute flaccid myelitis.

For detailed information on AFM surveillance please review our AFM Quicksheet.

We are seeking information and specimens on patients meeting the following definition:

Confirmed Case:

1.     Acute onset of focal limb weakness, AND:

2.     A magnetic resonance image (MRI) showing spinal cord lesion largely restricted to gray matter and spanning one or more spinal segments

Probable Case:

1.     Acute onset of focal limb weakness, AND:

2.     Cerebrospinal fluid (CSF) with pleocytosis (white blood cell count >5 cells/mm3, may adjust for presence of red blood cells by subtracting 1 white blood cell for every 500 red blood cells present).

If you are aware of a patient that meets the confirmed or probable case definitions above please complete the following steps:

  1. Submit the AFM Patient Case Summary Form  AND medical records listed on the form to the patient's local health jurisdiction (LHJ). 
  2. Contact the patient's local health jurisdiction to obtain approval for specimen testing. 
  3. After approval has been received, submit a full set of specimens (listed below) with a completed General  Purpose Specimen Submittal Form to: 

ATTN: Specimen Receiving

Viral and Rickettsial Disease Laboratory

850 Marina Bay Parkway

Richmond, CA 94804

         To optimize laboratory testing, we are requesting the following sample types, collected as close to onset date as possible:

·         Nasopharyngeal and oropharyngeal swabs (in viral transport media), or nasopharyngeal wash or aspirate (in sterile collection tube)

·         CSF (2-3cc, if available, in sterile collection tube)

·         Acute and convalescent phase serum, collected prior to treatment with IVIG (2-3cc in red or tiger-top tube)

·         Two stool specimens (quarter-sized amount in sterile wide-mouth container) collected 24 hours apart

                Samples can be sent on dry ice or cold packs for delivery Monday through Friday.

                For questions about specimen shipping please contact the Viral and Rickettsial Disease Laboratory (VRDL) at (510) 307-8585. 

       4.  Send the following samples to CDC as soon as possible after they are collected:

                  ·         CSF (2cc unspun in sterile collection tube)

                  ·       Whole blood (3-5cc unspun in lavender or green top tube with anti-coagulant; EDTA or heparin)                   

Samples should be stored refrigerated and shipped to CDC directly from the hospital overnight on cold packs within 24-48 hours of specimen collection to arrive at CDC on Tuesdays through Fridays, and should not be routed through VRDL or the LHJ public health laboratory. 

                 Please contact Shrimati Datta (shrimati.datta@cdph.ca.gov; 510-620-3747) for the appropriate CDC specimen submittal form and shipping address. 

 

For questions about AFM surveillance contact Shrimati Datta (Shrimati.Datta@cdph.ca.gov; (510) 620-3747) or Kristen Wendorf (Kristen.Wendorf@cdph.ca.gov; (510) 620-3735). 


Resources
 
 
Last modified on: 3/29/2017 3:05 PM