Neurological Manifestations of Influenza Infection in Children and Adults: Results of a National British Surveillance Study
Neurological Manifestations of Influenza Infection in Children and Adults: Results of a National British Surveillance Study
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DOI：
10.1093/cid/cit922
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发表时间：
2014-03-15
影响因子：
11.8
通讯作者：
Kneen, Rachel
中科院分区：
文献类型：
--
作者：
Goenka, Anu;Michael, Benedict D.;Kneen, Rachel
背景随着2009年甲型H1N1流感的出现，相关神经系统表现的报告增加。我们的目的是描述神经系统表现的流感在成人和儿童在英国，提出在这个时候。从2011年2月起，通过英国成人和儿童神经监测单位进行了一项为期2年的监测研究。如果患者在确诊流感感染后1个月内符合临床病例定义，则纳入研究。确定了25例病例：21例（84%）为儿童，4例（16%）为成人。六名（29%）儿童患有既往神经系统疾病。呼吸道分泌物的聚合酶链反应鉴定了21例甲型流感（81%;其中20例[95%]为H1N1）和4例B型流感（15%）。12例患儿有脑病（1例伴运动障碍），8例有脑炎，1例有脑膜脑炎。2名成人有脑病伴运动障碍，1名有脑炎，1名有格林-巴利综合征。7名患者（6名儿童）患有特定的急性脑病综合征（4例急性坏死性脑病，1例主要累及额叶的急性婴儿脑病，1例出血性休克和脑病，1例急性出血性白质脑病）。20例（80%）需要重症监护，17例（68%）预后不良，4例（16%）死亡。这项监测研究描述了一组具有流感神经系统表现的成人和儿童。大多数是由于H1N1。发现的儿童多于成人;许多儿童有特定的脑病综合征，结果不佳。没有人接种过疫苗，尽管有8人（32%）有接种适应症。修改后的分类
Background. The emergence of influenza A(H1N1) 2009 was met with increased reports of associated neurological manifestations. We aimed to describe neurological manifestations of influenza in adults and children in the United Kingdom that presented at this time.Methods. A 2-year surveillance study was undertaken through the British adult and pediatric neurological surveillance units from February 2011. Patients were included if they met clinical case definitions within 1 month of proven influenza infection.Results. Twenty-five cases were identified: 21 (84%) in children and 4 (16%) in adults. Six (29%) children had preexisting neurological disorders. Polymerase chain reaction of respiratory secretions identified influenza A in 21 (81%; 20 of which [95%] were H1N1) and influenza B in 4 (15%). Twelve children had encephalopathy (1 with movement disorder), 8 had encephalitis, and 1 had meningoencephalitis. Two adults had encephalopathy with movement disorder, 1 had encephalitis, and 1 had Guillain-Barre syndrome. Seven individuals (6 children) had specific acute encephalopathy syndromes (4 acute necrotizing encephalopathy, 1 acute infantile encephalopathy predominantly affecting the frontal lobes, 1 hemorrhagic shock and encephalopathy, 1 acute hemorrhagic leukoencephalopathy). Twenty (80%) required intensive care, 17 (68%) had poor outcome, and 4 (16%) died.Conclusions. This surveillance study described a cohort of adults and children with neurological manifestations of influenza. The majority were due to H1N1. More children than adults were identified; many children had specific encephalopathy syndromes with poor outcomes. None had been vaccinated, although 8 (32%) had indications for this. A modified classification