Letter of Invitation - MN

May 29, 2019
Mark Pallansch, PhD
Director, Division of Viral Diseases
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention
Atlanta, GA
Dear Dr. Pallansch:
In fall 2018, Minnesota experienced an increase in the number of cases of acute flaccid myelitis
(AFM). To date, there have been 11 confirmed AFM cases in Minnesota with onset during 2018
compared with four during 2014-2017. No common exposures have been identified among the
cases and the risk factors for developing this disease are not well understood. We are more
broadly investigating these 2018 cases in an effort to better understand common exposures
among AFM patients. In addition, we are investigating anecdotal information suggesting that
diagnosis might have been delayed in some cases, perhaps due to a lack of awareness about
AFM by healthcare providers.
We are writing to formally request assistance from the Centers for Disease Control and
Prevention (CDC) with this investigation. Specifically, assistance is needed to administer a
comprehensive hypothesis-generating questionnaire to AFM patients with the objectives of
identifying common exposures and describing the healthcare seeking behaviors of AFM
patients and their families prior to the AFM diagnosis. The results from this investigation will
be used to help develop prevention and control measures and identify gaps in clinician
awareness that can be targeted through public health messaging. This activity will remain under
the direction and supervision of Minnesota Department of Health. The Department will retain
ownership of all data collected.
Thank you for consideration of this request. The Minnesota Department of Health appreciates
the support and assistance of the CDC to help protect the public health of the citizens of
Minnesota.
Sincerely,

Ruth Lynfield, MD
State Epidemiologist and Medical Director
Minnesota Department of Health
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