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Influenza-Related Encephalopathy in Children: Epidemiology and Literature Review from a Tertiary Hospital in Northern
Raffaele Vitale1, Marco Denina1, Laura Badiali2
1Infectious Diseases Unit, Department of Pediatrics, Regina Margherita Children's Hospital, A.O.U. Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy.
Insights
Influenza-associated encephalopathy (IAE) in children poses risks, but recent data show no significant inter-seasonal differences in severity. Vaccination remains crucial for preventing IAE cases.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Epidemiology
Background:
- Influenza-associated encephalopathy (IAE) in children is a significant concern.
- Emerging evidence suggests potential shifts in IAE epidemiology, including possible declines in incidence and severity.
Purpose of the Study:
- To investigate the current epidemiology and clinical characteristics of pediatric IAE.
- To assess potential changes in IAE incidence and severity over two consecutive influenza seasons.
Main Methods:
- A retrospective review of pediatric patients (0-18 years) admitted with confirmed influenza and neurological involvement.
- Data collected from November 2023 to February 2025 at a tertiary hospital in Northern Italy.
- Analysis of clinical findings, neurological assessments (EEG, lumbar puncture, brain imaging), and treatment outcomes.
Main Results:
- Twenty-five unvaccinated children were diagnosed with IAE (11 in 2023/24, 14 in 2024/25).
- Neurological comorbidities were present in 40%; all had abnormal EEGs.
- While 16% experienced severe complications and 12% had persistent symptoms, no significant inter-seasonal differences in IAE burden were observed after adjusting for seasonal peak timing.
Conclusions:
- IAE continues to pose serious risks to children, highlighting the importance of preventive measures like vaccination.
- This single-center study indicates a stable, rather than declining, burden of IAE across seasons.
- Further large-scale, prospective studies are necessary to confirm these findings and explore long-term outcomes.
Introduction:
While influenza-associated encephalopathy (IAE) in children remains a serious concern, recent evidence suggests a shift in its epidemiology, with a possible decline in incidence and severity over time.
Methods:
This retrospective review includes patients aged 0-18 admitted to a tertiary hospital in Northern Italy between November 2023 and February 2025. Inclusion criteria were a positive influenza test, influenza-like symptoms, and neurological involvement. Findings are interpreted alongside current literature.
Results:
Twenty-five unvaccinated children met criteria for IAE (11 in 2023/24; 14 in 2024/25). Neurological comorbidities were present in 40%. All patients had pathological EEGs. Lumbar puncture was performed in 40%, with abnormalities in 33%. Brain imaging was conducted in 56% of cases, revealing findings in 15%. All received oseltamivir; 60% were also treated with dexamethasone. Severe complications occurred in 16%, while 12% had persistent symptoms or required therapy at discharge. After adjusting for seasonal peak timing, no significant inter-seasonal difference was observed.
Discussion:
Although IAE continues to present serious risks, recent trends suggest a changing burden. The lack of vaccination among cases underscores the need for prevention. Study limitations include its single-center design and the absence of long-term follow-up. Broader prospective studies are needed.
