Acute flaccid myelitis in Europe between 2016 and 2023: indicating the need for better registration

BackgroundAcute flaccid myelitis (AFM) is a rare polio-like condition affecting mainly children and characterised by severe, often persistent, weakness. It is one of several causes of acute flaccid paralysis (AFP), which manifests as acute onset of limb weakness and reduced muscle tone. Some non-polio enteroviruses (EV), such as EV-D68 may cause AFM. Little is known about AFM incidence in Europe.AimWe aimed to better understand AFM incidence, aetiology and current surveillance policies in Europe.MethodsIn 28 countries, members of the European non-polio enterovirus network (ENPEN) and a newly established AFM network of clinicians under ENPEN received a survey asking them how AFM surveillance was performed in their countries in 2016-2023 and the numbers of AFM cases including those diagnosed with EV-D68 infection during this period.ResultsSurveillance information was obtained for 16 countries. In eight countries, AFP surveillance initiated for poliomyelitis eradication was still ongoing, while non-polio AFM cases were only systematically reported in Norway. The survey revealed 130 AFM cases for 14 countries, with 48 (37%) EV-D68-laboratory-confirmed. Among the AFM cases, 70% (n = 91) occurred in 2016, 2018 and 2022, when EV-D68 circulation increased.ConclusionsThis report provides some indication of AFM case numbers in Europe since 2016. However, as 15 of 16 countries with AFM monitoring information lacked structural AFM surveillance, numbers should be interpreted with caution. Knowing AFM incidence matters to determine its impact and detect future outbreaks. Thus, the newly established clinical network will develop a European AFM repository.

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Publication Details

Journal
Eurosurveillance
Published
2025-05-29
DOI
https://doi.org/10.2807/1560-7917.es.2025.30.21.2400579
Citations
1
Primary Topic
Viral Infections and Immunology Research
Type
article
Field-Weighted Citation Impact
1.39
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article

Acute flaccid myelitis in Europe between 2016 and 2023: indicating the need for better registration

Marine Rodesch, Jay Shetty, Dilşad Türkdoğan, Raquel Neves et al.
1 citations
Eurosurveillance
Viral Infections and Immunology Research
1.39
article

Acute flaccid myelitis in Europe between 2016 and 2023: indicating the need for better registration

Marine Rodesch, Jay Shetty, Dilşad Türkdoğan, Raquel Neves, Ronny Wickström, Kimberley Benschop, Mélodie Aubart, Sofie Midgley, Jaco J. Verweij, Cristina Calvo, Richard Molenkamp, Steinar Solberg, Gülten Öztürk, Noemí López, María Cabrerizo, Ana Felipe‐Rucián, Jelte Helfferich, Heli Harvala, Paula Palminha, Stefania Maria Bova, Cristina Andrés, Tytti Vuorinen, Thea Kølsen Fischer, Birgit Prochazka, Sandy Siegert, Olcay Ünver, Ralitsa Iordanova, Carlos Ribeiro, Andrés Antón, Karin von Eije, Helle Cecilie Viekilde Pfeiffer, Joakim Øverbø, Artur Sulik, Per Kristian Knudsen, Marianne Kragh Thomsen, Jorgina Vila, Isabelle Schuffenecker, Audrey Mirand, Stollar Fabiola, Freek van Loenen, Lubomira Nikolaeva Glomb, Ekkehardt Alpeter
article en
1 citations

Abstract

BackgroundAcute flaccid myelitis (AFM) is a rare polio-like condition affecting mainly children and characterised by severe, often persistent, weakness. It is one of several causes of acute flaccid paralysis (AFP), which manifests as acute onset of limb weakness and reduced muscle tone. Some non-polio enteroviruses (EV), such as EV-D68 may cause AFM. Little is known about AFM incidence in Europe.AimWe aimed to better understand AFM incidence, aetiology and current surveillance policies in Europe.MethodsIn 28 countries, members of the European non-polio enterovirus network (ENPEN) and a newly established AFM network of clinicians under ENPEN received a survey asking them how AFM surveillance was performed in their countries in 2016-2023 and the numbers of AFM cases including those diagnosed with EV-D68 infection during this period.ResultsSurveillance information was obtained for 16 countries. In eight countries, AFP surveillance initiated for poliomyelitis eradication was still ongoing, while non-polio AFM cases were only systematically reported in Norway. The survey revealed 130 AFM cases for 14 countries, with 48 (37%) EV-D68-laboratory-confirmed. Among the AFM cases, 70% (n = 91) occurred in 2016, 2018 and 2022, when EV-D68 circulation increased.ConclusionsThis report provides some indication of AFM case numbers in Europe since 2016. However, as 15 of 16 countries with AFM monitoring information lacked structural AFM surveillance, numbers should be interpreted with caution. Knowing AFM incidence matters to determine its impact and detect future outbreaks. Thus, the newly established clinical network will develop a European AFM repository.

EurosurveillanceVol. 30(21)
Université Claude Bernard Lyon 1 (FR), University of Copenhagen (DK), National Health Service (GB), Oslo University Hospital (NO), Hôpital Necker-Enfants Malades (FR), NHS Blood and Transplant (GB), Norwegian Institute of Public Health (NO), University Medical Center Groningen (NL), Karolinska University Hospital (SE), Medical University of Białystok (PL), University of Turku (FI), University of Groningen (NL), Université Paris Cité (FR), Royal Hospital for Children (GB), Medical University Plovdiv (BG), Instituto de Salud Carlos III (ES), Federal Department of Home Affairs (CH), Erasmus MC (NL), Turku University Hospital (FI), Erasmus Hospital (BE), Aarhus University Hospital (DK), Copenhagen University Hospital (DK), Karolinska Institutet (SE), Zealand University Hospital (DK), Swiss Paediatric Oncology Group (CH), Assistance Publique – Hôpitaux de Paris (FR), Vall d'Hebron Institut de Recerca (ES), Hospital La Paz Institute for Health Research (ES), National Institute for Public Health and the Environment (NL), Centro Nacional de Epidemiología (ES), University Hospital of Geneva (CH), Federal Office of Public Health (CH), Centro de Investigación Biomédica en Red (ES), Vall d'Hebron Hospital Universitari (ES), Centre Hospitalier Universitaire de Clermont-Ferrand (FR), Ospedale dei Bambini Vittore Buzzi (IT), National Institute of Health Dr. Ricardo Jorge (PT), Elisabeth-TweeSteden Ziekenhuis (NL), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (ES), Institut des Maladies Génétiques Imagine (FR), National Center of Infectious and Parasitic Diseases (BG), University College London (GB), Universidad Autónoma de Madrid (ES), Marmara University (TR), Medical University of Vienna (AT)
Partnerships for the goals
Openalex Percentile: Top 19%
Viral Infections and Immunology Research
1.39
DOIOpen Access PDFOpenAlex
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