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Report on the 2018 Acute Flaccid Myelitis Outbreaks in the USA

An increase in the number of Acute Flaccid Myelitis (AFM) cases reported in the USA was detected in August 2018. The CDC has confirmed 186 cases of AFM in 2018 making this the largest outbreak of AFM reported in the USA. The cause however remains unknown. In this watching brief we review key features of the current outbreak in context, describe what is known about AFM, and consider probable causes. A two-year epidemic cycle of AFM appears to be emerging, and most current evidence implicates both EV-A71 and EV-D68 as the probable cause of the current outbreak yet key questions remain.