1. School Nurse Meeting December 10, 2018
Stephanie Snitily, RN BSN
Communicable Disease Program Coordinator
Chelan-Douglas Health District

2. Influenza Update

3. Influenza Update

4. AFM Update WA State AFM 2015: 0 2016: 10 2017: 3

5. What CDC has learned since 2014
Most of the patients with AFM (more than 90%) had a mild respiratory illness or fever consistent with a viral infection before they developed AFM.
Viral infections such as from enteroviruses are common, especially in children, and most people recover. We don’t know why a small number of people develop AFM, while most others recover. We are continuing to investigate this.
These AFM cases are not caused by poliovirus; all the stool specimens from AFM patients that we received tested negative for poliovirus.
We detected coxsackievirus A16, EV-A71, and EV-D68 in the spinal fluid of four of 458 confirmed cases of AFM since 2014, which points to the cause of their AFM. For all other patients, no pathogen (germ) has been detected in their spinal fluid to confirm a cause.
Most patients had onset of AFM between August and October, with increases in AFM cases every two years since At this same time of year, many viruses commonly circulate, including enteroviruses, and will be temporally associated with AFM.
Most AFM cases are children (over 90%) and have occurred in 46 states and DC.

6. In 2017, CDC received information for 35 confirmed cases of AFM
In 2017, CDC received information for 35 confirmed cases of AFM. (Note: The cases occurred in 16 states across the U.S.)
In 2016, 149 people were confirmed to have AFM. (Note: The cases occurred in 39 states across the U.S. and DC)
In 2015, 22 people were confirmed to have AFM. (Note: The cases occurred in 17 states across the U.S.)
From August to December 2014, 120 people were confirmed to have AFM. (Note: The cases occurred in 34 states across the U.S.)
The case counts represent only those cases for which information has been sent to and confirmed by CDC.

7. Questions?
Happy Holidays!