tetano
Editor, Senior Moderator
Clin Infect Dis. 2012 May 9. [Epub ahead of print]
A Population-Based Study of Neurologic Manifestations of Severe Influenza A(H1N1)pdm09 in California.
Glaser C, Winter K, Dubray K, Harriman K, Uyeki TM, Sejvar J, Gilliam S, Louie J.
Source
Communicable Disease and Emergency Response Branch, Division of Communicable Disease Control, California Department of Public Health, Richmond, CA, USA.
Abstract
BackgroundReported influenza-associated neurologic complications are generally limited to case series or case reports. We conducted a population-based study of neurologic manifestations associated with severe and fatal influenza A(H1N1)pdm09 [2009 H1N1] cases.MethodsMedical records of patients with fatal or severe laboratory-confirmed 2009 H1N1 reported to the California Department of Public Health from April 15 through December 31, 2009 were reviewed to identify those with primary neurological manifestations. Cases with secondary neurologic manifestations (e.g., hypoxia) were excluded. Primary influenza-associated neurologic complications (INC) were classified into four groups: encephalopathy/encephalitis, seizures, meningitis, and other. Severe 2009 H1N1-associated neurologic incidence was calculated by using estimates of 2009 H1N1 illnesses in California.ResultsOf 2,069 reported severe or fatal 2009 H1N1 cases, 419 (20%) had neurologic manifestations. Of these, 77 (18%) met our definition of INC: encephalopathy/encephalitis (n=29), seizures (n=44), meningitis (n=3), and other (Guillain-Barr? Syndrome) (n=1). The median age was 9 years (range 4 months-92 years); the highest rate of disease was among Asian/Pacific Islanders (API) (0.33/1,000,000) compared to white, non-Hispanics (0.15/1,000,000), Hispanics (0.19/1,000,000) and Blacks (0.22/1,000,000). The median length of stay (LOS) was 4 days (range: 1-142) and there were 4 fatalities. The estimated incidence of INCs was 1.2/100,000 symptomatic 2009 H1N1 illnesses.ConclusionINCs were observed in 3.7% of patients with fatal or severe 2009 H1N1; most often in pediatric patients and Asian/Pacific Islanders appear to be over-represented compared with the California population. Most patients with INCs had a relatively short LOS and there were few fatalities.
PMID:
22573853
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22573853
A Population-Based Study of Neurologic Manifestations of Severe Influenza A(H1N1)pdm09 in California.
Glaser C, Winter K, Dubray K, Harriman K, Uyeki TM, Sejvar J, Gilliam S, Louie J.
Source
Communicable Disease and Emergency Response Branch, Division of Communicable Disease Control, California Department of Public Health, Richmond, CA, USA.
Abstract
BackgroundReported influenza-associated neurologic complications are generally limited to case series or case reports. We conducted a population-based study of neurologic manifestations associated with severe and fatal influenza A(H1N1)pdm09 [2009 H1N1] cases.MethodsMedical records of patients with fatal or severe laboratory-confirmed 2009 H1N1 reported to the California Department of Public Health from April 15 through December 31, 2009 were reviewed to identify those with primary neurological manifestations. Cases with secondary neurologic manifestations (e.g., hypoxia) were excluded. Primary influenza-associated neurologic complications (INC) were classified into four groups: encephalopathy/encephalitis, seizures, meningitis, and other. Severe 2009 H1N1-associated neurologic incidence was calculated by using estimates of 2009 H1N1 illnesses in California.ResultsOf 2,069 reported severe or fatal 2009 H1N1 cases, 419 (20%) had neurologic manifestations. Of these, 77 (18%) met our definition of INC: encephalopathy/encephalitis (n=29), seizures (n=44), meningitis (n=3), and other (Guillain-Barr? Syndrome) (n=1). The median age was 9 years (range 4 months-92 years); the highest rate of disease was among Asian/Pacific Islanders (API) (0.33/1,000,000) compared to white, non-Hispanics (0.15/1,000,000), Hispanics (0.19/1,000,000) and Blacks (0.22/1,000,000). The median length of stay (LOS) was 4 days (range: 1-142) and there were 4 fatalities. The estimated incidence of INCs was 1.2/100,000 symptomatic 2009 H1N1 illnesses.ConclusionINCs were observed in 3.7% of patients with fatal or severe 2009 H1N1; most often in pediatric patients and Asian/Pacific Islanders appear to be over-represented compared with the California population. Most patients with INCs had a relatively short LOS and there were few fatalities.
PMID:
22573853
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22573853