Serious Neurologic Events With Seasonal Influenza in Young Children

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics Pub Date : 2025-02-12 DOI:10.1016/j.acap.2025.102801

Brooke P. Quertermous MD , Derek J. Williams MD, MPH , Jean Bruce BS , Mert Sekmen BA , Yuwei Zhu MD, MS , Carlos G. Grijalva MD, MPH , James W. Antoon MD, PhD, MPH

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引用次数: 0

Abstract

Objective

The objective of this study was to determine the population-based incidence of influenza-associated serious neurologic events in children <5 years of age.

Methods

We conducted a retrospective cohort of children <5 years of age enrolled in a Medicaid program during the 2016 to 2017 through 2019 to 2020 influenza seasons. Serious influenza-associated neurologic events were defined as a neurologic event resulting in hospitalization. Population-based incidence of serious influenza-associated neurologic events was calculated by dividing the number of events by the total accrued follow-up time and expressed per 100,000 influenza person-weeks. Incidence estimates were stratified by neurologic event category, age, sex, neurologic comorbidity, influenza season, and antiviral use.

Results

A total of 79,727 influenza cases among 70,258 unique children were included. The overall incidence of serious influenza-associated neurologic events was 38.0 (95% confidence interval [CI] 27.5–51.2) per 100,000 person-weeks of influenza. The most common serious neurologic event was seizure (34.5 per 100,000 influenza person-weeks of influenza, 95% CI 24.5–47.1) whereas encephalitis and ataxia/movement disorders were least common (0.9 per 100,000 influenza person-weeks of influenza, 95% CI 0.02–4.9). Incidence rates were generally higher in children <2 years and significantly more common in children with neurologic conditions compared to those without neurologic conditions. Incidence rates were similar among those with and without influenza antiviral use.

Conclusions

Our findings reveal that serious neurologic complications are uncommon in young children with influenza but markedly higher in those with underlying neurologic conditions. These data emphasize the importance of preventing, identifying, and treating influenza in this vulnerable population.

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幼儿与季节性流感的严重神经系统事件

研究目的本研究旨在确定小于5岁儿童中流感相关严重神经系统事件的人群发病率：我们对 2016-2017 年至 2019-2020 年流感季节期间加入医疗补助计划的 5 岁以下儿童进行了回顾性队列研究。严重流感相关神经系统事件被定义为导致住院治疗的神经系统事件。严重流感相关神经系统事件的人群发病率是通过将事件数量除以累计随访总时间计算得出的，并以每10万流感人周表示。根据神经系统事件类别、年龄、性别、神经系统合并症、流感季节和抗病毒药物使用情况对发病率估计值进行了分层：结果：共纳入了 70,258 名儿童中的 79,727 例流感病例。与流感相关的严重神经系统事件的总发病率为每 10 万人周 38.0 例（95% CI 27.5-51.2）。最常见的严重神经系统事件是癫痫发作（每 100,000 流感人周 34.5 例，95% CI 24.5-47.1），而脑炎和共济失调/运动障碍最不常见（每 100,000 流感人周 0.9 例，95% CI 0.02-4.9）。儿童的发病率普遍较高结论：我们的研究结果表明，严重的神经系统并发症在患流感的幼儿中并不常见，但在有潜在神经系统疾病的幼儿中却明显较高。这些数据强调了预防、识别和治疗流感对这一易感人群的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Academic Pediatrics PEDIATRICS-

CiteScore

4.60

自引率

12.90%

发文量

300

审稿时长

60 days

期刊介绍： Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.