tetano
Editor, Senior Moderator
J Pediatric Infect Dis Soc
. 2022 Sep 25;piac069.
doi: 10.1093/jpids/piac069. Online ahead of print.
Severe Influenza-Associated Neurological Disease in Australian Children: Seasonal Population-Based Surveillance 2008-2018
Erin Donnelley[SUP] 1 [/SUP], Suzy Teutsch[SUP] 2 3 [/SUP], Yvonne Zurynski[SUP] 2 3 4 [/SUP], Carlos Nunez[SUP] 2 3 [/SUP], Gulam Khandaker[SUP] 5 6 [/SUP], David Lester-Smith[SUP] 1 2 3 [/SUP], Marino Festa[SUP] 7 8 [/SUP], Robert Booy[SUP] 3 9 [/SUP], Elizabeth J Elliott[SUP] 2 3 [/SUP], Philip N Britton[SUP] 2 3 10 [/SUP], Contributors to the Australian Paediatric Surveillance Unit
Collaborators, Affiliations
Abstract
Background: Influenza-associated neurological disease (IAND) is uncommon but can result in death or neurological morbidity in children. We aimed to describe the incidence, risk factors, and outcome of children with IAND from seasonal influenza in Australia.
Methods: We analyzed national, population-based, surveillance data for children aged ≤ 14 years with severe influenza and neurological involvement, over 11 Australian influenza seasons, 2008-2018, by the Australian Paediatric Surveillance Unit.
Results: There were 633 laboratory-confirmed cases of severe influenza reported. Of these, 165 (26%) had IAND. The average annual incidence for IAND was 3.39 per million children aged ≤ 14 years. Compared to cases without neurological complications, those with IAND were more likely to have a pre-existing neurological disease (odds ratio [OR] 3.03, P < .001), but most children with IAND did not (n = 135, 82%). Children with IAND were more likely to receive antivirals (OR 1.80, P = .002), require intensive care (OR 1.79, P = .001), require ventilation (OR 1.99; P = .001), and die (OR 2.83, P = .004).
Conclusions: IAND is a preventable cause of mortality, predominantly in otherwise well children. Incidence estimates validate previous sentinel site estimates from Australia. IAND accounted for a quarter of all severe influenza, is associated with intensive care unit admission, and accounted for half of all influenza deaths.
Keywords: child; encephalitis; epidemiology; influenza; neurological disease.
. 2022 Sep 25;piac069.
doi: 10.1093/jpids/piac069. Online ahead of print.
Severe Influenza-Associated Neurological Disease in Australian Children: Seasonal Population-Based Surveillance 2008-2018
Erin Donnelley[SUP] 1 [/SUP], Suzy Teutsch[SUP] 2 3 [/SUP], Yvonne Zurynski[SUP] 2 3 4 [/SUP], Carlos Nunez[SUP] 2 3 [/SUP], Gulam Khandaker[SUP] 5 6 [/SUP], David Lester-Smith[SUP] 1 2 3 [/SUP], Marino Festa[SUP] 7 8 [/SUP], Robert Booy[SUP] 3 9 [/SUP], Elizabeth J Elliott[SUP] 2 3 [/SUP], Philip N Britton[SUP] 2 3 10 [/SUP], Contributors to the Australian Paediatric Surveillance Unit
Collaborators, Affiliations
- PMID: 36153667
- DOI: 10.1093/jpids/piac069
Abstract
Background: Influenza-associated neurological disease (IAND) is uncommon but can result in death or neurological morbidity in children. We aimed to describe the incidence, risk factors, and outcome of children with IAND from seasonal influenza in Australia.
Methods: We analyzed national, population-based, surveillance data for children aged ≤ 14 years with severe influenza and neurological involvement, over 11 Australian influenza seasons, 2008-2018, by the Australian Paediatric Surveillance Unit.
Results: There were 633 laboratory-confirmed cases of severe influenza reported. Of these, 165 (26%) had IAND. The average annual incidence for IAND was 3.39 per million children aged ≤ 14 years. Compared to cases without neurological complications, those with IAND were more likely to have a pre-existing neurological disease (odds ratio [OR] 3.03, P < .001), but most children with IAND did not (n = 135, 82%). Children with IAND were more likely to receive antivirals (OR 1.80, P = .002), require intensive care (OR 1.79, P = .001), require ventilation (OR 1.99; P = .001), and die (OR 2.83, P = .004).
Conclusions: IAND is a preventable cause of mortality, predominantly in otherwise well children. Incidence estimates validate previous sentinel site estimates from Australia. IAND accounted for a quarter of all severe influenza, is associated with intensive care unit admission, and accounted for half of all influenza deaths.
Keywords: child; encephalitis; epidemiology; influenza; neurological disease.