Acute Flaccid Myelitis Cases Remain Low Despite Increases in EV-D68 Respiratory Illnesses

Confirmed cases of acute flaccid myelitis (AFM) in the United States remained low from 2020 through 2025, even with increases in enterovirus D68 (EV-D68)–associated respiratory illnesses in several years. The CDC emphasizes the importance of continued surveillance for AFM, a rare but serious neurologic condition primarily affecting children, to support timely detection and strengthen U.S. polio preparedness. Clinicians are advised to remain alert for suspected cases and report them to health departments.

Context

AFM is a rare but severe condition that affects the spinal cord and can lead to paralysis, primarily impacting children. The Centers for Disease Control and Prevention (CDC) has noted that while EV-D68 respiratory illnesses have increased, AFM cases have not followed the same trend. This discrepancy highlights the need for ongoing vigilance and research into the relationship between these illnesses.

Why it matters

The low number of acute flaccid myelitis (AFM) cases is significant as it indicates effective monitoring and response to a serious neurological condition, particularly in children. Continued awareness and surveillance are crucial for early detection and management. This is especially important in the context of rising respiratory illnesses linked to enterovirus D68 (EV-D68).

Implications

The sustained low incidence of AFM suggests that current public health measures are effective, which may reassure parents and caregivers. However, the potential for sudden increases in cases remains, necessitating continued preparedness. Children, particularly those with respiratory illnesses, may be most affected, highlighting the importance of awareness among healthcare providers.

What to watch

Health authorities will continue to monitor AFM cases closely, especially during peak seasons for respiratory illnesses. Clinicians are encouraged to report any suspected AFM cases to health departments to ensure prompt investigation. Future updates from the CDC may provide insights into trends or changes in AFM incidence as surveillance efforts progress.