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Acute childhood encephalitis and encephalopathy associated with influenza: a prospective 11-year review

Reshma Amin1, Elizabeth Ford-Jones, Susan E Richardson

  • 1Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

The Pediatric Infectious Disease Journal
|April 10, 2008
PubMed

Insights

Influenza virus infections can cause acute childhood encephalitis/encephalopathy (ACE). This study found influenza linked to 5% of ACE cases, with younger children experiencing more severe outcomes and sequelae.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Influenza virus infections are known to cause various neurologic complications.
  • Acute childhood encephalitis/encephalopathy (ACE) is a serious condition requiring investigation into its causes.

Purpose of the Study:

  • To prospectively evaluate the role of influenza viruses in cases of acute childhood encephalitis/encephalopathy (ACE).

Main Methods:

  • A prospective registry of children admitted with ACE and evidence of acute influenza virus infection over 11 years.
  • Influenza infection confirmed by viral detection (nasopharyngeal) or serological evidence (4-fold rise in complement fixation titer).

Main Results:

  • Influenza virus infection was detected in 7% of 311 evaluated ACE cases.
  • 14 children were included in the main analysis; 11 were under 5 years old.
  • Neurologic manifestations occurred within 5 days of respiratory symptoms in 64%, with sequelae in over half of subjects.

Conclusions:

  • Influenza virus infection was associated with 5% of ACE cases in this prospective study.
  • Children under 5, particularly those under 2, were more susceptible to severe neurologic complications and neuroimaging abnormalities.
  • The rapid onset of neurologic symptoms suggested an acute infectious process rather than a post-infectious complication.
Abstract

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