Primary goal:
A comprehensive update about Acute Flaccid Myelitis (AFM) focused on education and clinical preparedness in the setting of emerging and re-emerging viral disorders.
Target Audience:
This program was designed for health care providers including pediatricians, neurologists, infectious disease, rehabilitation, emergency and intensivist specialists, nursing professionals, rehabilitation personnel, researchers, families, and advocates involved in the diagnosis, care, and management of patients with AFM.
Logistics:
Three live virtual mini-symposia webinars focused on the most relevant aspects of AFM, from clinical diagnosis, critical care management, state-of-the-art research on virology, immunology, vaccines and pathogenesis, to rehabilitation and long-term management.
Links to each Symposium Lecture:
Virtual mini-symposium 1: August 18th, 2022 – AFM Diagnosis and Acute Management
Click here for the full playlist of AFM Mini Symposium 1 lectures
- Dr. Catherine E. Otten, Seattle Children’s Hospital | University of Washington, presents “Clinical Presentation and Manifestations – when to consider AFM”
- Dr. Molly Wilson-Murphy, Boston Children’s Hospital | Harvard Medical School, presents “Initial Evaluation for AFM”
- Dr. Becky Riggs, Oregon Health Science University School of Medicine, presents “ICU/symptomatic management of AFM”
- Adriana Lopez, MHS, Centers for Disease Control and Prevention, presents “Specimen collection and reporting for suspected AFM cases”
- Dr. Steve F. Kralik, Texas Children’s Hospital | Baylor College of Medicine, presents “Neuroradiological manifestations of AFM”
- Dr. Sarah Hopkins, Children’s Hospital of Philadelphia, presents “Initial counseling for caregivers at the time of diagnosis of AFM”
Virtual mini-symposium 2: August 25th, 2022 – AFM Research Updates
Click here for the full playlist of AFM Mini Symposium 2 lectures
- Dr. Emma Hodcroft, University of Bern, presents “Viral evolution and epidemiology of EV-D68”
- Dr. Megan Culler Freeman, University of Pittsburgh, presents “Innate immune responses to EV-D68 in airways and gut”
- Dr. William Jackson, University of Maryland School of Medicine, presents “Mechanisms of paralysis in AFM, a new understanding”
- Dr. Matthew Vogt, University of North Carolina at Chapel Hill, presents “Monoclonal antibodies in the treatment of EV-D68 infection and AFM”
- Dr. Bernardo Mainou, Centers for Disease Control and Prevention, presents “New approaches for immunological and viral diagnosis of enteroviruses”
- Dr. Peter Krug, National Institutes of Health, presents “Evaluating virus-like particle vaccines for EV-D68”
Virtual mini-symposium 3: September 8th, 2022 – Management of long-term consequences of AFM
Click here for the full playlist of AFM Mini Symposium 3 lectures
- Dr. Travis Edmiston, Kennedy Krieger Institute | Johns Hopkins University School of Medicine, presents “Acute rehabilitation: ICU and transition to inpatient acute rehabilitation”
- Janet Dean, MS, RN, CRRN, CRNP, Kennedy Krieger Institute | Johns Hopkins University School of Medicine, presents “The first year: Inpatient rehabilitation and transition to home and outpatient”
- Dr. Michelle Melicosta, MPH, FAAP, Kennedy Krieger Institute | Johns Hopkins University School of Medicine, presents “Respiratory and ventilatory rehabilitation”
- Dr. Rajashree Srinivasan, Children’s House at Children’s Health, presents “Long-term rehabilitation: Long-term outcomes and management of secondary consequences”
- Dr. Paul Sponsellar, Johns Hopkins University School of Medicine, presents “Orthopedic complications and management in spinal cord disorders and AFM”
- Adriana Lopez, MHS, Centers for Disease Control and Prevention, presents “Enteroviruses and AFM 2022 update”
1st AFM Virtual Symposia Series
The Acute Flaccid Myelitis Working Group, Johns Hopkins Medicine, and Kennedy Krieger Institute organized the first virtual symposium, Acute Flaccid Myelitis: What we have learned in order to be prepared.
The first three parts of the symposium have covered a breadth of topics on AFM diagnosis and acute management, critical care management, and understanding pathogenesis, viruses, and immunity. We summarize and highlight some of the key lessons we have learned from leaders in the community who have dedicated their careers to understanding AFM and helping families and children. Over 300 people registered for this symposium. All sessions were recorded and are available here.
Clinical Series
Article | Authors | Author Information | Location | Year published |
---|---|---|---|---|
Clinical characteristics of enterovirus A71 neurological disease during an outbreak in children in Colorado, USA, in 2018: an observational cohort study | Messacar K, Spence-Davizon E, Osborne C, et al. | Children’s Hospital Colorado | Aurora, CO | 2020 |
Acute Flaccid Myelitis: A Single Pediatric Center Experience From 2014 to 2019 | Patel R, Gombolay G, et al | Division of Pediatric Neurology, Emory University School of Medicine, | GA, USA | 2020 |
Vital Signs: Clinical Characteristics of Patients with Confirmed Acute Flaccid Myelitis, United States, 2018 | Kidd S, Lopez A et al | Division of Viral Diseases, Centers for Disease Control and Prevention | USA | 2020 |
Acute Flaccid Myelitis With Neuroradiological Finding of Brachial Plexus Swelling | Chong PF, et al | “Department of Pediatric Neurology, Fukuoka Children’s Hospital, Fukuoka, Japan” | Japan | 2020 |
Unmet needs in the evaluation, treatment, and recovery for 167 children affected by acute flaccid myelitis reported by parents through social media. | Bove R, Rowles W, Carleton M, et al. | Department of Neurology, University of California, San Francisco, San Francisco, California. | US | 2020 |
Characteristics of Upper Extremity Recovery in Acute Flaccid Myelitis: A Case Series. | Emmanuelle Tiongson, Leigh Ramos-Platt, Mitchel Seruya | Children’s Hospital Los Angeles, Los Angeles, CA, USA. | CA, USA | 2020 |
Continued biennial circulation of enterovirus D68 in Colorado | Messacar K, Dominguez SR | Departments of Pediatrics & Infectious Diseases, Children’s Hospital Colorado | Aurora, CO | 2019 |
Comparative quantitative clinical, neuroimaging, and functional profiles in children with acute flaccid myelitis at acute and convalescent stages of disease. | Gordon-Lipkin E, Pardo-Villamizar C | Department of Neurology, Johns Hopkins University School of Medicine & Kennedy Krieger Institute | Baltimore, MD | 2019 |
Acute flaccid myelitis: rehabilitation challenges and outcomes in a pediatric cohort. | Melicosta ME, Dean J, Hagen K, et al. | Kennedy Krieger Institute, Baltimore, MD, USA. | Baltimore, MD | 2019 |
Early results of nerve transfers for restoring function in severe cases of acute flaccid myelitis. | Pino PA, Intravia J, Kozin SH, Zlotolow DA | Department of Orthopedic Surgery, Shriners Hospital for Children-Philadelphia | Philadelphia, PA | 2019 |
Clinical Subpopulations in a Sample of North American Children Diagnosed With Acute Flaccid Myelitis, 2012-2016. | Elrick MJ, Gordon-Lipkin E, Crawford TO, Pardo-Villamizar(1), Van Haren K (2), Messacar K (3), Duggal P, Milstone AM (4), Benson L (5) | (1) Department of Neurology, Johns Hopkins University School of Medicine, (2) Department of Neurology, Stanford University, (3) Department of Pediatrics, Children’s Hospital Colorado, (4) Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, (5) Department of Neurology, Boston Children’s Hospital | US | 2018 |
Outcomes of Colorado children with acute flaccid myelitis at 1 year. | Martin JA, Messacar K | Departments of Pediatrics & Infectious Diseases, Children’s Hospital Colorado/University of Colorado School of Medicine | Aurora, CO | 2017 |
Surveillance for enterovirus D68 in colorado children reveals continued circulation. | Messacar K, Robinson CC, Pretty K, Yuan J, Dominguez SR. | Children’s Hospital Colorado/University of Colorado School of Medicine | Aurora, CO | 2017 |
Enterovirus D68 Infection in Children with Acute Flaccid Myelitis, Colorado, USA, 2014. | Aliabadi N, Dominguez SR, Messacar K | Departments of Pediatrics & Infectious Diseases, Children’s Hospital Colorado/University of Colorado School of Medicine | Aurora, CO | 2016 |
Acute flaccid myelitis: A clinical review of US cases 2012-2015. | Messacar K, Schreiner TL, Dominguez SR (1) Van Haren K (2), Glaser CA (3) | Departments of Pediatrics & Infectious Diseases, Children’s Hospital Colorado/University of Colorado School of Medicine // (2)Department of Neurology, Stanford University School of Medicine //(3) Kaiser Permanente Medical Center, UCSF | US | 2016 |
Resource burden during the 2014 enterovirus D68 respiratory disease outbreak at children’s Hospital Colorado: an unexpected strain | Messacar K, Dominguez SR | Departments of Pediatrics & Infectious Diseases, Children’s Hospital Colorado | Aurora, CO | 2016 |
Acute flaccid myelitis of unknown etiology in California, 2012-2015. | Van Haren K, Charles Chiu | Department of Neurology, Stanford University School of Medicine, Stanford, California. Departments of Laboratory Medicine and Medicine, Division of Infectious Diseases, University of California, San Francisco | US | 2015 |
A cluster of acute flaccid paralysis and cranial nerve dysfunction temporally associated with an outbreak of enterovirus D68 in children in Colorado, USA. | Messacar K, Schreiner TL, Dominguez SR, Azbug MJ | Children’s Hospital Colorado | Aurora, CO | 2015 |
MRI findings in children with acute flaccid paralysis and cranial nerve dysfunction occurring during the 2014 enterovirus D68 outbreak. | Maloney JA, Mirsky DM, Messacar K, Dominguez SR, Schreiner T, Stence NV | Children’s Hospital Colorado | Aurora, CO | 2015 |
Reviews, opinions, and definitions
Article | Authors | Author Information | Location | Year published |
---|---|---|---|---|
Acute Flaccid Myelitis: A Clinical Review | Olwen C Murphy , Carlos A Pardo | Johns Hopkins Myelitis and Myelopathy Center | Baltimore, MD, US | 2020 |
” Update on acute flaccid myelitis: recognition, reporting, aetiology and outcomes” | Duriel Hardy , Sarah Hopkins | Division of Neurology, Children’s Hospital of Philadelphia | PA, USA | 2020 |
Acute Flaccid Myelitis: A Call for Vigilance and an Update on Management | Sarah E Hopkins, Jay Desai , Leslie Benson | Division of Neurology, Children’s Hospital of Philadelphia, Division of Neurology, Children’s Hospital of Los Angeles & Department of Neurology, Boston Children’s Hospital | US | 2020 |
Recommendations for Therapy following Nerve Transfer for Children with Acute Flaccid Myelitis | Mitchel Seruya et al | Children’s Hospital Los Angeles, Los Angeles, CA, USA | Los Angeles, CA | 2020 |
Enterovirus D68-Associated Acute Flaccid Myelitis: Rising to the Clinical and Research Challenges | Messacar K | Pediatric Infectious Disease Section, Children’s Hospital Colorado, University of Colorado | Aurora, CO | 2019 |
Understanding Enterovirus D68-Induced Neurologic Disease: A Basic Science Review | Hixon A (…) Messacar K, Tyler K | Children’s Hospital Colorado, University of Colorado School of Medicine | Aurora, CO | 2019 |
Acute flaccid myelitis and enterovirus D68: lessons from the past and present | Jelte Helfferich , Marjolein Knoester et al | Department of Neurology, University Medical Center Groningen | Groningen, The Netherlands | 2019 |
Enterovirus D68 and acute flaccid myelitis-evaluating the evidence for causality. | Messacar K, Abzug MJ, Dominguez SR | Department of Pediatrics and Neurology, University of Colorado,Children’s Hospital Colorado | Aurora, CO | 2018 |
Acute Flaccid Myelitis-Keys to Diagnosis, Questions About Treatment, and Future Directions | Hopkins SE (1), Elrick MJ(2), Messacar K(3). | (1)Division of Neurology, Children’s Hospital of Philadelphia, (2) Department of Neurology, Johns Hopkins School of Medicine (3) Department of Pediatrics, Children’s Hospital Colorado | US | 2018 |
Acute Flaccid Paralysis and Enteroviral Infections. | Bitnun A, Yeh EA | The Hospital for Sick Children Department of Pediatrics, Division of Neurology and Division of Infectious diseases | Toronto, Canada | 2018 |
Acute flaccid myelitis | Gill PJ, Bitnun A, Yeh EA | The Hospital for Sick Children Department of Pediatrics, Division of Neurology and Division of Infectious diseases | Toronto, Canada | 2018 |
Acute Flaccid Myelitis: Etiologic Challenges, Diagnostic and Management Considerations | Hopkins, SE | Division of Neurology, Children’s Hospital of Philadelphia | Philadelphia, PA | 2017 |
The Emergence of Enterovirus-D68 | Messacar K, Abzug MJ, Dominguez SR. | Children’s Hospital Colorado, University of Colorado | Aurora, CO | 2016 |
The Changing Epidemiology of Acute Flaccid Paralysis Warrants a Paradigm Shift in Surveillance | Messacar K, Abzug MJ, Dominguez SR. | Children’s Hospital Colorado, University of Colorado | Aurora, CO | 2016 |
Virology and Immunology
Article | Authors | Author Information | Location | Year published |
---|---|---|---|---|
Epidemiology and Sequence-Based Evolutionary Analysis of Circulating Non-Polio Enteroviruses | David M Brown, Yun Zhang, Richard H Scheuermann | La Jolla Institute for Immunology | La Jolla, CA | 2020 |
Epidemiological dynamics of enterovirus D68 in the US: implications for acute flaccid myelitis | Sang Woo Park et al | Department of Ecology and Evolutionary Biology, Princeton University | NJ, USA | 2020 |
Human antibodies neutralize enterovirus D68 and protect against infection and paralytic disease | Vogt MR, Fu J, Kose N, et al. | Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center | Nashville, TN | 2020 |
Cytokine biomarkers associated with clinical cases of acute flaccid myelitis | Weldon, W (…) Oberste, M | Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta GA | US | 2020 |
Neurotropism of enterovirus D68 isolates is independent of sialic acid and is not a recently acquired phenotype. | Rosenfeld AB, Warren AL, Racaniello VR. | Department of Microbiology, Columbia University College of Physicians and Surgeons | New York, NY | 2019 |
Antibodies to enteroviruses in cerebrospinal fluid of patients with acute flaccid myelitis. | Mishra N, Ng TFF, Marine RL, et al. | Center for Infection and Immunity, Mailman School of Public Health, Columbia University | US | 2019 |
Contemporary Circulating Enterovirus D68 Strains Infect and Undergo Retrograde Axonal Transport in Spinal Motor Neurons Independent of Sialic Acid | Hixon A, Clarke P, Tyler K | University of Colorado, Aurora | Aurora, CO | 2019 |
Current Understanding of Humoral Immunity to Enterovirus D68. | Vogt MR, Crowe JE Jr | Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center | Nashville, TN | 2018 |
Contemporary Circulating Enterovirus D68 Strains Have Acquired the Capacity for Viral Entry and Replication in Human Neuronal Cells. | Brown DM (…), Tyler K, Scheuermann R | Department of Neurology, University of Colorado School of Medicine & J. Craig Venter Institute | US | 2018 |
Enteroviruses Remodel Autophagic Trafficking through Regulation of Host SNARE Proteins to Promote Virus Replication and Cell Exit. | Corona AK Saulsbery HM, Jackson WT | Department of Microbiology and Immunology, University of Maryland School of Medicine | Baltimore, MD | 2018 |
Enterovirus D68 infection induces IL-17-dependent neutrophilic airway inflammation and hyperresponsiveness. | Rajput C et al Jackson WT | Department of Microbiology and Immunology, University of Maryland School of Medicine | Baltimore, MD | 2018 |
Safety, tolerability, and efficacy of fluoxetine as an antiviral for acute flaccid myelitis. | Messacar K | Children’s Hospital Colorado, University of Colorado | Aurora, CO | 2018 |
Evaluating Treatment Efficacy in a Mouse Model of Enterovirus D68-Associated Paralytic Myelitis. | Hixon AM, Clarke P, Tyler K | Department of Immunology and Microbiology, University of Colorado School of Medicine | Aurora, CO | 2017 |
A mouse model of paralytic myelitis caused by enterovirus D68. | Hixon AM, Tyler KL | Departments of Immunology and Microbiology, and Medicine, University of Colorado School of Medicine | Aurora, CO | 2017 |
Genetic changes found in a distinct clade of Enterovirus D68 associated with paralysis during the 2014 outbreak. | Zhang Y, Scheuermann RH. | J. Craig Venter Institute | La Jolla, California | 2016 |
AFM in the world
Title | Topic | Presenters | Institution | Year |
---|---|---|---|---|
Enterovirus D68 and Acute Flaccid Myelitis, 2020 | Clinical/infections | Sarah Kidd | CDC | 2020 |
Acute Flaccid Myelitis and Nerve Transfer Surgery – PediaCast CME 059 | Surgical/nerve transplants | Amy Moore and colleagues | PediaCast CME | 2020 |
Acute Flaccid Myelitis: Answering Questions Through National Collaboration | Clinical/epidemiology | Janell Routh | CDC | 2020 |
What Parents Should Know About AFM | Family perpective | B. Mcelroy and Elizabenth Cordon | DFW Child | 2020 |
Enterovirus as cause of AFM; AEDs and cognition | Immunology/diagnosis | Michael Wilson | UCSF | 2019 |
Diagnosing and Treating Acute Flaccid Myelitis Podcast | Diagnosis/treatment | Sarah Hopkins | CHOP | 2019 |
Enteroviruses and Acute Flaccid Myelitis | Clinical/infections | Erin Graf | CDC/CHOP | 2019 |
Rachel Scott | Family perspective | Rachel Scott | Wheel stories | 2019 |
Your EV-D68th nervous breakdown | Immunology/diagnosis | V. Racaniello and others | This Week in virology (TWIV) | 2019 |
Karolinska viral | Virology | V. Racaniello and others | This Week in virology (TWIV) | 2019 |
What’s Behind a Spike of AFM Cases in the US? | Clinical/epidemiology | Olwen Murphy | BBC | 2018 |
All About Acute Flaccid Myelitis with John Williams, MD | Clinical/infections | John Williams | UPMC | 2018 |
A podcast on acute flaccid myelitis | Clinical/Diagnosis | Brad Sobolewski | Pediatric Emergency Podcast/Cincinnatti CH | 2018 |
2018 Podcast on Acute Flaccid Myelitis | Clinical overview | Ben Greenberg and Carlos Pardo | SRNA | 2018 |
Acute flaccid myelitis: what clinicians know and don’t know about the polio-like syndrome | Clinical overview | Peter Gill | Sick Children Hospital | 2018 |
Acute Flaccid Myelitis: What Physicians Should Know | Clinical overview | Matt Elrick | Pediatric Consultant/Hopkins | 2018 |
Acute flaccid myelitis | Clinical overview | Sarah Hopkins & Ana Cristancho | Brain waves/CHOP | 2016 |
Understanding AFM | Clinical overview | Ben Greenberg | SRNA | 2016 |
Why is this outbreak different from all other outbreaks? | Virology | V. Racaniello and others | This Week in virology (TWIV) | 2015 |
Acknowledgements
The AFM working group is grateful for the support provided by the Siegel Rare Neuroimmune Association (SRNA), the AFM Association, and the Bart McLean Fund for Neuroimmunology Research.