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

2025-05-29Artigo científico Acesso aberto
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dc.contributor.authorHelfferich, Jelte
dc.contributor.authorCalvo, Cristina
dc.contributor.authorAlpeter, Ekkehardt
dc.contributor.authorAndrés, Cristina
dc.contributor.authorAntón, Andrés
dc.contributor.authorAubart, Melodie
dc.contributor.authorBova, Stefania Maria
dc.contributor.authorCabrerizo, Maria
dc.contributor.authorvon Eije, Karin
dc.contributor.authorFabiola, Stollar
dc.contributor.authorFelipe, Ana
dc.contributor.authorIordanova, Ralitsa
dc.contributor.authorThomsen, Marianne Kragh
dc.contributor.authorKnudsen, Per Kristian
dc.contributor.authorvan Loenen, Freek
dc.contributor.authorLopez, Noemi
dc.contributor.authorMirand, Audrey
dc.contributor.authorMolenkamp, Richard
dc.contributor.authorMidgley, Sofie
dc.contributor.authorNeves, Raquel
dc.contributor.authorGlomb, Lubomira Nikolaeva
dc.contributor.authorØverbø, Joakim
dc.contributor.authorÖztürk, Gülten
dc.contributor.authorPalminha, Paula
dc.contributor.authorViekilde Pfeiffer, Helle Cecilie
dc.contributor.authorProchazka, Birgit
dc.contributor.authorRibeiro, Carlos
dc.contributor.authorRodesch, Martine
dc.contributor.authorSchuffenecker, Isabelle
dc.contributor.authorShetty, Jay
dc.contributor.authorSiegert, Sandy
dc.contributor.authorSolberg, Silje Lae
dc.contributor.authorSulik, Artur
dc.contributor.authorTürkdoğan, Dilşad
dc.contributor.authorÜnver, Olcay
dc.contributor.authorVerweij, Jaco
dc.contributor.authorVila, Jorgina
dc.contributor.authorVuorinen, Tytti
dc.contributor.authorWickström, Ronny
dc.contributor.authorFischer, Thea K.
dc.contributor.authorHarvala, Heli
dc.contributor.authorBenschop, Kimberley S.M.
dc.date.accessioned2026-02-20T11:31:03Z
dc.date.available2026-02-20T11:31:03Z
dc.date.issued2025-05-29
dc.description.abstractBackground: Acute 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.eng
dc.description.abstractKey public health message: - What did you want to address in this study? Acute flaccid myelitis (AFM) is a rare but serious condition involving progressive and often severe limb weakness. Several viruses can cause AFM, and AFM cases have been observed to occur when enterovirus D68 (EV-D68) circulates. Little is known about AFM incidence in Europe, so we wanted to shed light on AFM surveillance policies in different countries there, and on AFM case numbers recorded between 2016 and 2023, as well as their aetiology. - What have we learnt from this study? A survey of members of the European non-polio enterovirus network (ENPEN), which includes a newly established clinical network was conducted in 28 countries. Through the survey we obtained surveillance information from 16 countries. Among these, only Norway had a valid structured surveillance for AFM. The survey revealed 130 AFM cases for 14 countries, with 91 cases (70%) in years 2016, 2018 and 2022, when EV-D68 circulation increased. - What are the implications of your findings for public health? Due to the lack of structured surveillance, the numbers of AFM cases reported through our study should be interpreted with caution. Improved knowledge of the incidence of AFM in European countries is crucial to determine its impact on people’s health, as well as to detect future AFM outbreaks. To this end, the newly established clinical network under ENPEN will develop a European AFM repository, aiming to involve of as many countries as possible.eng
dc.identifier.citationEuro Surveill. 2025 May;30(21):2400579. doi: 10.2807/1560-7917.ES.2025.30.21.2400579
dc.identifier.doi10.2807/1560-7917.ES.2025.30.21.2400579
dc.identifier.issn1560-7917
dc.identifier.pmid40444374
dc.identifier.urihttp://hdl.handle.net/10400.18/10958
dc.language.isoen
dc.peerreviewedyes
dc.publisherEuropean Centre for Disease Prevention and Control
dc.relation.hasversionhttps://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2025.30.21.2400579
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectAcute Flaccid Myelitis
dc.subjectAcute Flaccid Paralysis
dc.subjectChildren
dc.subjectEnterovirus A71
dc.subjectEnterovirus D68
dc.subjectSurveillance
dc.subjectCentral Nervous System Viral Diseases
dc.subjectNeuromuscular Diseases
dc.subjectEurope
dc.subjectAgentes Microbianos e Ambiente
dc.subjectPolíticas de Saúde
dc.titleAcute flaccid myelitis in Europe between 2016 and 2023: indicating the need for better registrationpor
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue21
oaire.citation.startPage2400579
oaire.citation.titleEurosurveillance: Europe's journal on infectious disease surveillance, epidemiology, prevention and control
oaire.citation.volume30
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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