Related Experiment Video
Updated: May 3, 2026
08:11
Measuring Influenza Neuraminidase Inhibition Antibody Titers by Enzyme-linked Lectin Assay
Published on: September 6, 2016
19.0K
Influenza-Associated Acute Necrotizing Encephalopathy in US Children.
, Andrew Silverman1, Rachel Walsh2
1Pediatric Neurology and Neuroimmunology, Lucile Packard Children's Hospital, Stanford University, Palo Alto, California.
JAMA
|July 30, 2025
Summary
Acute necrotizing encephalopathy (ANE) in children is a severe condition linked to influenza, causing high morbidity and mortality. Early recognition and standardized management are crucial for better outcomes in influenza-associated ANE.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Acute necrotizing encephalopathy (ANE) is a rare but severe neurological disorder with limited epidemiological and management data.
- Anecdotal reports suggest an increase in influenza-associated ANE cases in children during recent US influenza seasons.
Purpose of the Study:
- To investigate the clinical presentation, interventions, and outcomes of influenza-associated ANE in US children.
- To understand the epidemiology and risk factors associated with ANE in pediatric populations.
Main Methods:
- A multicenter case series involving children diagnosed with ANE and confirmed influenza infection.
- Data collected included clinical symptoms, vaccination status, laboratory findings, genetic testing, interventions, and clinical outcomes (modified Rankin Scale, length of stay, mortality).
- Cases were solicited from 76 US academic centers between October 1, 2023, and May 30, 2025.
Main Results:
- The study identified 41 cases of influenza-associated ANE in children, predominantly young and previously healthy individuals.
- Common presentations included fever, encephalopathy, and seizures. Influenza A was the most frequent cause.
- High rates of morbidity and mortality were observed, with 27% of patients dying and 63% of survivors experiencing moderate to severe disability.
- Genetic risk alleles, including RANBP2 variants, were identified in a significant portion of patients, and few had received influenza vaccination.
Conclusions:
- Influenza-associated ANE is a severe condition in children, characterized by high morbidity and mortality.
- The findings highlight the importance of influenza prevention, prompt diagnosis, and intensive, standardized treatment protocols.
- Further research into genetic predispositions and optimized management strategies for ANE is warranted.
Related Concept Videos
01:18Bacterial Gastroenteritis
88
Bacterial gastroenteritis, characterized by diarrhea, abdominal cramps, and vomiting, is often caused by ingestion of contaminated food or water and is frequently associated with pathogenic Escherichia coli strains. These microbes exploit two principal mechanisms to inflict disease.Shiga toxin–producing E. coli, also referred to as STEC—notably O157:H7—release Shiga toxins that target ribosomes, blocking protein synthesis. The B subunit of the toxin binds the host glycolipid...
88
01:18Viral Meningitis
199
Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
199
01:25Arboviral Encephalitis
59
Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
59
01:22Bacterial Meningitis I: Introduction
15
Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
15
01:19Encephalitis l: Introduction
15
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
15
01:26Encephalitis ll: Pathophysiology
22
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
22