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Influenza-associated acute encephalopathy in Japanese children in 1994-2002

Takehiro Togashi1, Yoshihiro Matsuzono, Mitsuo Narita

  • 1Department of Pediatrics, Sapporo City General Hospital, N 11 W 13, Chuo-ku, Sapporo 060-8604, Japan. takehiro.togashi@doc.city.sapporo.jp

Virus Research
|May 28, 2004
PubMed

Insights

Influenza-associated acute encephalopathy is a serious condition in children, distinct from Reye syndrome. Early vaccination is crucial to prevent this potentially fatal neurological illness.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neuroscience

Background:

  • Influenza-associated acute encephalopathy (IAE) is a severe neurological complication observed in children during influenza seasons.
  • Distinguishing IAE from Reye syndrome is critical for accurate diagnosis and management.
  • This study investigates the incidence and characteristics of IAE in Hokkaido, Japan.

Observation:

  • Eighty-nine children diagnosed with IAE between December 1994 and April 2002 were analyzed.
  • The mean age of affected children was 3.8 years, and none had taken aspirin.
  • Most patients developed rapid coma, with or without convulsions, within 1.7 days of fever onset.

Findings:

  • A significant mortality rate of 37.1% and neurological sequelae in 19.1% of cases were reported.
  • Influenza virus infection was confirmed in 59.6% of the patients.
  • Elevated levels of Interleukin-6 and Tumor Necrosis Factor-alpha were noted in fatal cases, alongside evidence of brain edema and vasculopathy.

Implications:

  • IAE may be an underdiagnosed neurological syndrome in pediatric populations.
  • The findings underscore the importance of influenza vaccination in infants and young children to prevent severe outcomes.
  • Cytokine-mediated vascular endothelial cell damage is implicated in the pathophysiology of IAE.

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