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Neurologic complications of influenza A(H1N1)pdm09: surveillance in 6 pediatric hospitals.

Abstract：

OBJECTIVE:We sought to determine the range and extent of neurologic complications due to pandemic influenza A (H1N1) 2009 infection (pH1N1'09) in children hospitalized with influenza. METHODS:Active hospital-based surveillance in 6 Australian tertiary pediatric referral centers between June 1 and September 30, 2009, for children aged <15 years with laboratory-confirmed pH1N1'09. RESULTS:A total of 506 children with pH1N1'09 were hospitalized, of whom 49 (9.7%) had neurologic complications; median age 4.8 years (range 0.5-12.6 years) compared with 3.7 years (0.01-14.9 years) in those without complications. Approximately one-half (55.1%) of the children with neurologic complications had preexisting medical conditions, and 42.8% had preexisting neurologic conditions. On presentation, only 36.7% had the triad of cough, fever, and coryza/runny nose, whereas 38.7% had only 1 or no respiratory symptoms. Seizure was the most common neurologic complication (7.5%). Others included encephalitis/encephalopathy (1.4%), confusion/disorientation (1.0%), loss of consciousness (1.0%), and paralysis/Guillain-Barré syndrome (0.4%). A total of 30.6% needed intensive care unit (ICU) admission, 24.5% required mechanical ventilation, and 2 (4.1%) died. The mean length of stay in hospital was 6.5 days (median 3 days) and mean ICU stay was 4.4 days (median 1.5 days). CONCLUSIONS:Neurologic complications are relatively common among children admitted with influenza, and can be life-threatening. The lack of specific treatment for influenza-related neurologic complications underlines the importance of early diagnosis, use of antivirals, and universal influenza vaccination in children. Clinicians should consider influenza in children with neurologic symptoms even with a paucity of respiratory symptoms.

journal_name

Neurology

journal_title

Neurology

authors

Khandaker G,Zurynski Y,Buttery J,Marshall H,Richmond PC,Dale RC,Royle J,Gold M,Snelling T,Whitehead B,Jones C,Heron L,McCaskill M,Macartney K,Elliott EJ,Booy R

doi

10.1212/WNL.0b013e31826d5ea7

subject

Has Abstract

pub_date

2012-10-02 00:00:00

pages

1474-81

issue

eissn

0028-3878

issn

1526-632X

pii

WNL.0b013e31826d5ea7

journal_volume

pub_type

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Neurologic complications of influenza A(H1N1)pdm09: surveillance in 6 pediatric hospitals.