1259. Respiratory Infection Hospitalizations among Children with Neurologic Disorders — United States, July 2009 to June 2010
Session: Oral Abstract Session: Respiratory Viral Infections in Children
Saturday, October 5, 2013: 11:15 AM
Room: The Moscone Center: 200-212

Background: Children with neurologic disorders are at increased risk for complications from influenza and other respiratory infections. Although neurologic disorders are rare, one third of recent influenza-associated pediatric deaths in the United States occurred in children with these conditions. However, the burden of respiratory infections and rates of resulting hospitalization are unknown. We characterized respiratory infection hospitalizations in children with neurologic disorders compared with the general pediatric population.

Methods: We used the Medstat MarketScan Commercial Claims and Encounters Database, collected from U.S. insurance plans billing data. We included children <19 years of age as of July 2009 who, in the previous 12 months, had at least one visit with an ICD-9 diagnosis code for a specified neurologic disorder. We identified hospitalizations during July 2009 to June 2010 with primary diagnosis codes indicating a respiratory infection, and compared them to hospitalizations in a random sample of children from the same database.

Results: Among 9,382,183 children, 80,608 (0.86%) had a neurologic condition. Of 9,407 hospitalizations for these children, 1,037 (11%) were attributed to a respiratory infection. Children with neurologic conditions had 17 respiratory infection hospital admissions per 1,000 person-years, compared with 2.4/1,000 person-years in a random sample of all children in the database (1.3 million children (14%)), a relative risk (RR) of 7.1. The rate for children <2 years with neurologic conditions was 62/1,000 person-years (RR: 8.0), while for those 10–18 years, it was 9/1,000 person-years (RR: 14.7). The respiratory infection hospitalization rate was 6.8/1,000 person-years in 26,391 (33%) with isolated epilepsy; and 36/1,000 person-years in 10,766 (13%) with cerebral palsy (CP) (Figure). Among those with CP, children with concomitant epilepsy had a rate of 72/1,000 person-years versus 24/1,000 person-years in those without epilepsy.

Conclusion: Children with neurologic disorders are at high risk for hospitalization from respiratory infections, although hospitalization rates vary widely by age, disorder type and co-morbidities. Optimizing prevention strategies in these populations, such as improving influenza vaccination levels, should be aggressively pursued.

Fiona Havers, MD, MHS1, Alicia Fry, MD, MPH2, Jufu Chen, PhD1, Deborah Christensen, PhD1, Cynthia Moore, MD, PhD1, Georgina Peacock, MD, MPH3, Lyn Finelli, DrPH, MS2 and Carrie Reed, DSc, MPH4, (1)Centers for Disease Control and Prevention, Atlanta, GA, (2)Centers for Disease Control and Prevention (CDC), Atlanta, GA, (3)National Center On Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, (4)Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA


F. Havers, None

A. Fry, None

J. Chen, None

D. Christensen, None

C. Moore, None

G. Peacock, None

L. Finelli, None

C. Reed, None

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