Neurologic Manifestations of children with Influenza infections
2Pediatric Infectious Diseases Unit, Soroka University Medical Center
3Pediatric Neurology Unit, Soroka University Medical Center
4Virology Laboratory, Soroka University Medical Center
5Faculty of Health Sciences, Ben-Gurion University of the Negev
Background: Influenza virus infections are a major cause of morbidity in children, including neurologic complications.
Aim: To assess the demographic characteristics, clinical course and outcome of children with Influenza virus infections, comparing episodes with and without neurologic complications (neuro-Flu and other-Flu, respectively).
Methods: A retrospective, cohort study of hospitalized children
Results: Of overall 951 children, 250 had neuro-Flu (26.2%). The most common neurologic presentation was seizures (n=125, 13.1%), followed by headaches (n=49, 5.2%), irritability/apathy (n=18, 1.9%), positive meningeal signs (n=9, 0.9%), and symptoms presented in
Children with neuro-Flu were older than other-Flu (mean age ± SD 62±55 vs. 44±47 months; p<0.001), with significantly higher rates of males (62.0% vs. 53.7%), Jewish ethnicity (45.7% vs. 33.5%), and previous neurologic conditions (11.4% vs. 5.8%). In contrast, neuro-Flu had lower rates of cardiac/respiratory background illness (4.4% vs. 11.7%). Rates of fever were similar in the two groups (>90%), as well as the proportions of influenza type A (both 82-84%). Lymphopenia was more common in neuro-Flu (52.7% vs. 43.8%). Outcome measures, including intensive care unit admission (2.5%) and mortality (0.9%), were similar comparing the groups.
Comparing episodes with seizures with other-Flu, Jewish ethnicity, neurologic background illness and lymphopenia were more common in children with seizures.
Conclusions: neurologic complications in influenza are associated with older age, ethnicity, neurologic background illness & lymphopenia.