Influenza-associated encephalitis/encephalopathy identified by the Australian Childhood Encephalitis study 2013-2015

Date

2017

Authors

Britton, P.
Dale, R.
Blyth, C.
Macartney, K.
Crawford, N.
Marshall, H.
Clark, J.
Elliott, E.
Webster, R.
Cheng, A.

Editors

Advisors

Journal Title

Journal ISSN

Volume Title

Type:

Journal article

Citation

Pediatric Infectious Disease Journal, 2017; 36(11):1021-1026

Statement of Responsibility

Philip N. Britton, Russell C. Dale, Christopher C. Blyth, Kristine Macartney, Nigel W. Crawford, Helen Marshall, Julia E. Clark, Elizabeth J. Elliott, Richard I. Webster, Allen C. Cheng, Robert Booy and Cheryl A. Jones

Conference Name

DOI

10.1097/INF.0000000000001650

Abstract

Background: Influenza-associated encephalitis/encephalopathy (IAE) is an important cause of acute encephalitis syndrome in children. IAE includes a series of clinicoradiologic syndromes or acute encephalopathy syndromes that have been infrequently reported outside East Asia. We aimed to describe cases of IAE identified by the Australian Childhood Encephalitis study. Methods: Children ≤ 14 years of age with suspected encephalitis were prospectively identified in 5 hospitals in Australia. Demographic, clinical, laboratory, imaging, and outcome at discharge data were reviewed by an expert panel and cases were categorized by using predetermined case definitions. We extracted cases associated with laboratory identification of influenza virus for this analysis; among these cases, specific IAE syndromes were identified where clinical and radiologic features were consistent with descriptions in the published literature. Results: We identified 13 cases of IAE during 3 southern hemisphere influenza seasons at 5 tertiary children’s hospitals in Australia; 8 children with specific acute encephalopathy syndromes including: acute necrotizing encephalopathy, acute encephalopathy with biphasic seizures and late diffusion restriction, mild encephalopathy with reversible splenial lesion, and hemiconvulsion-hemiplegia syndrome. Use of influenza-specific antiviral therapy and prior influenza vaccination were infrequent. In contrast, death or significant neurologic morbidity occurred in 7 of the 13 children (54%). Conclusions: The conditions comprising IAE are heterogeneous with varied clinical features, magnetic resonance imaging changes, and outcomes. Overall, outcome of IAE is poor emphasizing the need for optimized prevention, early recognition, and empiric management.

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Dissertation Note

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Rights

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Grant ID

http://purl.org/au-research/grants/nhmrc/1074547
 http://purl.org/au-research/grants/nhmrc/1111596
 http://purl.org/au-research/grants/nhmrc/1068732
 http://purl.org/au-research/grants/nhmrc/1084951
 http://purl.org/au-research/grants/nhmrc/1001021
 http://purl.org/au-research/grants/nhmrc/457084
 http://purl.org/au-research/grants/nhmrc/1113851

Published Version

https://doi.org/10.1097/inf.0000000000001650

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Persistent link to this record

http://hdl.handle.net/2440/111117