Neurologic complications of influenza A(H1N1)pdm09 Surveillance in 6 pediatric hospitals

被引：66

作者：

Khandaker, Gulam ^{[1
,2
]}

Zurynski, Yvonne ^{[2
,3
]}

Buttery, Jim ^{[4
,5
]}

Marshall, Helen ^{[6
,7
]}

Richmond, Peter C. ^{[8
]}

Dale, Russell C. ^{[2
]}

Royle, Jenny ^{[4
]}

Gold, Michael ^{[7
]}

Snelling, Tom ^{[1
,9
]}

Whitehead, Bruce ^{[10
]}

Jones, Cheryl ^{[2
,12
]}

Heron, Leon ^{[1
,2
,12
]}

McCaskill, Mary ^{[11
]}

Macartney, Kristine ^{[1
,2
,12
]}

Elliott, Elizabeth J. ^{[2
,3
,12
]}

Booy, Robert ^{[1
,2
,12
]}

机构：

[1] Natl Ctr Immunisat Res & Surveillance Vaccine Pre, Sydney, NSW, Australia

[2] Univ Sydney, Discipline Paediat & Child Hlth, Sydney, NSW 2006, Australia

[3] Australian Paediat Surveillance Unit, Sydney, NSW, Australia

[4] Royal Childrens Hosp, Murdoch Childrens Res Inst, Melbourne, Vic, Australia

[5] Monash Univ, Dept Paediat, Melbourne, Vic 3004, Australia

[6] Womens & Childrens Hosp, Vaccinol & Immunol Res Trials Unit, Adelaide, SA, Australia

[7] Univ Adelaide, Sch Paediat & Reprod Hlth, Adelaide, SA 5005, Australia

[8] Univ Western Australia, Sch Paediat & Child Hlth, Perth, WA 6009, Australia

[9] Sydney Childrens Hosp, Randwick, NSW, Australia

[10] John Hunter Childrens Hosp, Sydney, NSW, Australia

[11] Childrens Hosp Westmead, Dept Emergency Med, Sydney, NSW, Australia

[12] Univ Sydney, Sydney Med Sch, Sydney Inst Emerging Infect & Biosecur SEIB, Sydney, NSW 2006, Australia

来源：

NEUROLOGY | 2012年 / 79卷 / 14期

基金：

英国医学研究理事会; 澳大利亚国家健康与医学研究理事会;

关键词：

ACUTE NECROTIZING ENCEPHALOPATHY; A H1N1; UNITED-STATES; CHILDREN; VIRUS; SEIZURES; SAFETY;

D O I：

10.1212/WNL.0b013e31826d5ea7

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: We sought to determine the range and extent of neurologic complications due to pandemic influenza A (H1N1) 2009 infection (pH1N1'09) in children hospitalized with influenza. Methods: Active hospital-based surveillance in 6 Australian tertiary pediatric referral centers between June 1 and September 30, 2009, for children aged <15 years with laboratory-confirmed pH1N1'09. Results: A total of 506 children with pH1N1'09 were hospitalized, of whom 49 (9.7%) had neurologic complications; median age 4.8 years (range 0.5-12.6 years) compared with 3.7 years (0.01-14.9 years) in those without complications. Approximately one-half (55.1%) of the children with neurologic complications had preexisting medical conditions, and 42.8% had preexisting neurologic conditions. On presentation, only 36.7% had the triad of cough, fever, and coryza/runny nose, whereas 38.7% had only 1 or no respiratory symptoms. Seizure was the most common neurologic complication (7.5%). Others included encephalitis/encephalopathy (1.4%), confusion/disorientation (1.0%), loss of consciousness (1.0%), and paralysis/Guillain-Barre syndrome (0.4%). A total of 30.6% needed intensive care unit (ICU) admission, 24.5% required mechanical ventilation, and 2 (4.1%) died. The mean length of stay in hospital was 6.5 days (median 3 days) and mean ICU stay was 4.4 days (median 1.5 days). Conclusions: Neurologic complications are relatively common among children admitted with influenza, and can be life-threatening. The lack of specific treatment for influenza-related neurologic complications underlines the importance of early diagnosis, use of antivirals, and universal influenza vaccination in children. Clinicians should consider influenza in children with neurologic symptoms even with a paucity of respiratory symptoms. Neurology (R) 2012;79:1474-1481

引用

页码：1474 / 1481

页数：8

共 39 条

[21]

Lister P, 2009, LANCET, V374, P605, DOI [10.1016/S0140-6736(09)61512-9, 10.1016/S0140-6736(09)61513-0]

[22] Acute necrotizing encephalopathy in a child with H1N1 influenza infection [J].