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The spectrum and burden of influenza-associated neurological disease in children: combined encephalitis and influenza sentinel site surveillance from Australia 2013-2015

Date

2017

Authors

Britton, P.
Blyth, C.
Macartney, K.
Dale, R.
Li-Kim-Moy, J.
Khandaker, G.
Crawford, N.
Marshall, H.
Clark, J.
Elliott, E.

Editors

Advisors

Journal Title

Journal ISSN

Volume Title

Type:

Journal article

Citation

Clinical Infectious Diseases, 2017; 65(4):653-660

Statement of Responsibility

Philip N. Britton, Christopher C. Blyth, Kristine Macartney, Russell C. Dale, Jean Li-Kim-Moy, Gulam Khandaker, Nigel W. Crawford, Helen Marshall, Julia E. Clark, Elizabeth J. Elliott, Robert Booy, Allen C. Cheng, and Cheryl A. Jones, for the Australian Childhood Encephalitis (ACE) Study Investigators, Influenza Complications Alert Network (FluCAN) Investigators, and Paediatric Active Enhanced Disease Surveillance (PAEDS) Network

Conference Name

DOI

10.1093/clinid/cix412

Abstract

Background. There are few longitudinal studies of seasonal influenza–associated neurological disease (IAND) and none from the Southern Hemisphere. Methods. We extracted prospectively acquired Australian surveillance data from 2 studies nested within the Paediatric Active Enhanced Disease Surveillance (PAEDS) network: the Influenza Complications Alert Network (FluCAN) study and the Australian Childhood Encephalitis (ACE) study between 2013 and 2015. We described the clinical features and severity of IAND in children, including influenza-associated encephalitis/encephalopathy (IAE). We calculated the proportion of hospitalized influenza that is associated with IAND and IAE, and incidence of IAE. Results. Over 3 influenza seasons, we identified 54 cases of IAND at 2 tertiary children’s hospitals from Australia that accounted for 7.6% of hospitalized influenza. These included 10 cases of IAE (1.4% hospitalized influenza). The mean annual incidence of IAE among Australian children (aged ≤14 years) was 2.8 per 1 000 000. The spectrum of IAND was broad and included IAE (n = 10) including distinct acute encephalopathy syndromes, simple febrile seizures (n = 14), other seizures (n = 16), acute ataxia (n = 4), and other subacute syndromes (transverse myelitis [n = 1], opsoclonus myoclonus [n = 1]). Two-thirds of children with IAND were aged ≤4 years; less than half had preexisting neurological disease or other risk factors for severe influenza. IAE caused death or neurological morbidity in half of cases. Conclusions. Seasonal influenza is an important cause of acute neurological disease in Australian children. The spectrum of seasonal IAND appears similar to that described during the 2009 H1N1 pandemic. IAE is associated with high morbidity and mortality.

School/Discipline

Dissertation Note

Provenance

Description

Published online April 29, 2017

Access Status

Rights

© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

License

Grant ID

http://purl.org/au-research/grants/nhmrc/1074547
 http://purl.org/au-research/grants/nhmrc/1054414
 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/1021480
 http://purl.org/au-research/grants/nhmrc/1001021
 http://purl.org/au-research/grants/nhmrc/1102962
 http://purl.org/au-research/grants/nhmrc/1113851

Published Version

https://doi.org/10.1093/clinid/cix412

Call number

Persistent link to this record

http://hdl.handle.net/2440/107251