Neurological Manifestations of Influenza Virus and RSV Infections in Children

The most significant viral contributors to acute respiratory tract infections in children are Respiratory Syncytial Viruses (RSV) and influenza virus, causing substantial seasonal respiratory infections annually. Furthermore, severe neurological complications, notably seizures and encephalopathy, can be attributed to these viruses. Children with chronic or pre-existing neurological conditions are particularly susceptible to increased morbidity and sequelae. An active area of research to date is focused on the potential mechanisms of viral neurological invasion, which could be relevant for future therapeutic strategies. Influenza virus is frequently an important cause of epidemic or pandemic disease causing high costs of hospitalization and primary care. Furthermore, different subtypes of influenza viruses can induce various influenza-associated neurological complications, varying from mild (i.e. headache) to severe (i.e. meningoencephalitis and acute necrotizing encephalopathy), both in adults and children. While affecting the respiratory tract, RSV can also give rise to neurological manifestations, potentially resulting in long-term neurological impairment. Neurological changes associated with RSV encompass seizures, lethargy, ataxia, febrile or epileptic states, central apnea, difficulties in feeding or swallowing, tone abnormalities, strabismus, abnormalities in cerebrospinal fluid, and encephalopathy. Patients infected with RSV can also develop neuromotor difficulties or present learning impairment. In conclusion, viral respiratory infections can result in significant extrapulmonary symptoms, potentially leading to enduring health consequences in affected children. Substantial research efforts are necessary to prevent or treat these infections, particularly within the most vulnerable populations.