This article is more than 5 years old. Information may no longer be current.
1 in 5 kids with flu had neurological symptoms during 2016-2017 season
Click Here to Manage Email Alerts
Neurologic manifestations of influenza, including seizures and encephalopathy, occurred in nearly 20% of children presenting to a Colorado hospital during the 2016-2016 season, according to research published in the Journal of the Pediatric Infectious Diseases Society. Most of these children were infected with influenza A(H3N2), and they were 10 times more likely to require hospitalization, researchers wrote.
Suchitra Rao, MD, assistant professor in the divisions of infectious diseases, hospital medicine and epidemiology at the University of Colorado School of Medicine and Children’s Hospital Colorado, and colleagues wrote that they observed an increase in neurologic manifestations of influenza during the 2016-2017 season at their institution.
“Influenza viruses cause a variety of neurologic manifestations in children, including simple and complex febrile seizures, exacerbations of underlying seizure disorders, encephalopathy and encephalitis,” the researchers wrote. “The type and frequency of influenza-associated neurologic diseases in children are influenced by circulating strains, predisposing host factors and uptake and efficiency of influenza vaccinations.”
Rao and colleagues conducted a retrospective cohort study with nested matched case-control of children with neurological manifestations of influenza (NMI) who presented to Children’s Hospital Colorado between Dec. 27, 2016, and April 12, 2017. The primary outcome of the study was the presence of NMI, defined as seizures, altered mental status for more than 24 hours as the primary complaint, or encephalopathy, encephalitis, meningitis or seizures among the discharge diagnoses.
Influenza was identified in 182 children during the study period. NMI occurred in 18% of influenza patients. Of these patients, 85% were infected with H3N2. Most had seizures only (n = 18). The remaining children had encephalopathy only (n = 5) or both seizures and encephalopathy (n = 10).
Children with NMI accounted for 43% of all influenza-related hospital admissions, and over half (54%) of these patients needed ICU care.
The researchers wrote that 30% of children with neurologic manifestations had an underlying neurologic condition. However, these children did not have more severe symptoms or greater morbidity compared with children without neurologic conditions.
"Our findings suggest that influenza testing among febrile children with altered mental status or seizures should be considered and highlight the importance of influenza vaccination among children with an underlying neurologic disorder,” Rao and colleagues wrote. – by Katherine Bortz
Disclosures: Rao reports receiving grant support from GlaxoSmithKline. Please see the study for all other authors’ relevant financial disclosures.
Perspective
Back to Top
Janet A. Englund, MD
Rao and colleagues describe the neurologic manifestations of influenza in children presenting for care at Children’s Hospital Colorado during the 2016-2017 influenza season. Using a retrospective cohort study design in children with PCR-confirmed influenza, the authors demonstrated that 18% of 182 influenza-positive children had neurologic complications, with high rates of nonvaccination or partial vaccination.
Over half the children with neurologic complications required ICU admission, indicating that these complications, including seizures and encephalopathy, were clinically significant. This study demonstrates the relative high risk for neurological complications in children with influenza A(H3N2), and it reinforces the importance of the prevention of influenza with vaccination. The authors also point out the need to evaluate febrile children presenting with altered mental status or seizures for influenza infection.
Click Here to Manage Email Alerts