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Published on: July 12, 2021
Influenza A and febrile seizures in childhood
Karen L Kwong1, Shu Y Lam, Tak L Que
1Department of Pediatrics, Tuen Mun Hospital, Hong Kong. karenkwong@graduate.hku.hk
Insights
Influenza A infection increases the risk of febrile seizures in children, particularly those with a prior history. Prompt diagnosis and vaccination are key preventive strategies.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Febrile seizures are common in children.
- Influenza A virus is a significant respiratory pathogen in pediatric populations.
- Understanding risk factors and characteristics of febrile seizures associated with influenza A is crucial for management.
Purpose of the Study:
- To identify predisposing factors for febrile seizures in children with influenza A infection.
- To delineate the specific clinical characteristics of febrile seizures in children diagnosed with influenza A.
- To compare febrile seizures in influenza A-positive children with those in control groups.
Main Methods:
- Retrospective case-control study design.
- Inclusion of children hospitalized with febrile seizures and confirmed influenza A.
- Age-matched control groups: influenza A without seizures and seizures without viral confirmation.
Main Results:
- History of febrile seizures, family history of seizure disorders, and gastroenteritis were significant predisposing factors.
- A history of febrile seizures was an independent risk factor (OR 7.58).
- Children with influenza A-related febrile seizures had higher maximum temperatures, shorter fever duration before seizures, and more partial seizures compared to controls.
Conclusions:
- Influenza A infection presents unique characteristics in children experiencing febrile seizures.
- Effective influenza vaccination may prevent febrile seizures, especially in high-risk children.
- Rapid influenza diagnostics are cost-effective for managing complex febrile seizures during influenza season.
Abstract:
The aims of the present study are to identify predisposing factors of febrile seizures in influenza A infection and to clarify the special characteristics of febrile seizures in children with influenza A infection. Between January and July 2005, children hospitalized because of febrile seizures and subsequently confirmed influenza A infection were enrolled as subjects. Age-matched control subjects were those admitted as a result of influenza A infection but no febrile seizures (control 1) and children who developed febrile seizures with negative viral studies (control 2). Significant factors for the development of febrile seizures include: history of febrile seizures, family history of seizure disorders, and coexisting gastroenteritis. Independent risk factor for febrile seizures was history of febrile seizures (odds ratio 7.58, 95% confidence interval CI 1.48 to 38.84, P = 0.015). When compared with children who developed febrile seizures with negative virus studies, children who developed febrile seizures in influenza A infection had a significantly higher maximum body temperature, shorter duration of fever before seizure onset, and more frequent occurrence of partial seizures. Current episode represented first seizure in 26.5% of children infected with influenza A as compared with 50% of children whose virus studies were negative (P = 0.04). The findings suggest that effective vaccination may prevent development of febrile seizures, especially in those patients with past history of febrile seizures. Rapid diagnostic testing for influenza infection in the management of complex febrile seizures, especially during influenza season, is cost-effective.
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