Neurologic Complications and Outcomes of Pandemic (H1N1) 2009 in Korean Children

• Published in: Journal of Korean medical science Vol. 27; no. 4; pp. 402 - 407
• Main Authors: Kwon, Soonhak, Kim, Saeyoon, Cho, Min-hyun, Seo, Hyeeun
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.04.2012; 대한의학회
• Subjects: Antiviral Agents - therapeutic use; Child; Child, Preschool; Electroencephalography; Female; Humans; Infant; Influenza A Virus, H1N1 Subtype - genetics; Influenza, Human - complications; Influenza, Human - drug therapy; Influenza, Human - epidemiology; Magnetic Resonance Imaging; Male; Original; Oseltamivir - therapeutic use; Pandemics; Republic of Korea - epidemiology; Retrospective Studies; Seizures - etiology; 의학일반; Republic of Korea; Neurologic Complication; Prognosis; Influenza A H1N1; Child
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2012.27.4.402

Neurologic complications of children with influenza A H1N1 2009 pandemic, diagnosed in two consecutive influenza seasons were retrospectively reviewed to seek better outcomes in future outbreaks. Patient demographics, clinical manifestations and neurologic outcomes were reviewed. A total of 1,389 children were diagnosed with influenza A H1N1 by real-time reverse transcriptase-polymerase chain reaction. Of these, 23 (1.7%) patients had neurologic involvement. Their mean age was 5.9 ± 3.6 yr (range, 6 months to 11 yr) and 16 (69.9%) were boys. None of the 23 patients had been vaccinated for influenza A H1N1 and seasonal influenzas. Twenty-two of the 23 patients presented with seizures. Clinical features included febrile convulsion (n = 19), afebrile convulsion (n = 1), aseptic meningitis (n = 1), encephalopathy (n = 1), and acute necrotizing encephalopathy (n = 1). They all were treated with Oseltamivir twice daily for 5 days immediately after nasal and throat swab testing. Twenty-one of the subjects recovered fully, but the youngest two infants experienced severe neurological sequelae. The results indicate that neurologic complications associated with influenza A H1N1 2009 pandemic were mostly mild, but rarely were serious. Prompt intervention leads to a better outcome and vaccination may prevent the disease, thus staving off serious neurological complications following influenza, especially in young infants.