978. Influenza-Associated Neurological disease: Cases Identified by the Australian Childhood Encephalitis (ACE) Study
Session: Poster Abstract Session: CNS Infection
Friday, October 9, 2015
Room: Poster Hall
Background:

Influenza can result in severe neurological complications. We sought to describe influenza associated neurological disease identified over two seasons by the Australian childhood encephalitis (ACE) study.

Methods:

We undertook prospective hospital surveillance for suspected encephalitis (SE) using the paediatric active enhanced disease surveillance (PAEDS) network in NSW from May 2013 and nationally (NSW, QLD, SA, VIC, WA) from 2014. Cases were ascertained by screening hospital admissions for keywords. Demographic, clinical, exposure, diagnostic and outcome data were acquired. Cases with influenza confirmed by PCR on an acute specimen were classified three months post admission as confirmed encephalitis or ‘not encephalitis’.

Results:

We identified 14 cases of influenza associated neurological disease over two seasons: nine were male; median age was three years, and eight were admitted to ICU. Eight met the definition for confirmed infectious encephalitis, all of whom were < 5 years of age and mostly lacked CSF pleocytosis. Six did not meet the definition. None of the 12 children for whom data was available had received seasonal influenza immunisation. We identified four children with well-defined influenza clinico-radiological CNS syndromes: 1 ‘acute necrotising encephalopathy’ (ANE), 1 ‘mild encephalopathy with reversible splenial lesion’ (MERS), and 2 ‘acute encephalopathy with biphasic seizures and late reduced diffusion’ (AESD). One child died (ANE), and three had significant neurological sequelae at discharge.  Influenza was associated with 10% of cases of childhood encephalitis cases in the ACE study (2013-2014).

Conclusion:

Influenza is an uncommon but important cause of childhood encephalitis in Australia which can manifest as a wide clinical spectrum of clinico-radiological syndromes. It occurs mainly in young children and can result in mortality and severe morbidity.

Philip Britton, MBBS, FRACP1,2, Russell Dale, MBChB MRCPCH MSc PhD3, Robert Booy, MBBS (Hons), MSc, MD, FRACP, FRCPCH3, Christopher Blyth, MBBS FRACP4,5,6,7, Nigel Crawford, FRACP MPH PhD8, Helen Marshall, MBBS DCH MPH MD9, Elizabeth Elliott, MD, MPhil, MBBS, FRACP, FRCPCH, FRCP,3 and Cheryl Jones, MBBS PhD FRACP10, (1)Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Westmead, Australia, (2)Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, Australia, (3)Discipline of Paediatrics and Child Health, University of Sydney, Westmead, Australia, (4)School of Paediatrics and Child Health, University of Western Australia, Perth, Australia, (5)University of New South Wales, Sydney, Australia, (6)Telethon Institute of Child Health Research, Subiaco, Perth, Australia, (7)Department of Paediatric and Adolescent Medicine, Princess Margaret Hospital for Children, Perth, Australia, (8)General Paediatrics, Royal Children's Hospital, Melbourne, Melbourne, Australia, (9)Vaccinology and Immunology Research Trials Unit, Women's and Children's Hospital, North Adelaide, Australia, (10)University of Sydney, Sydney, Australia

Disclosures:

P. Britton, None

R. Dale, None

R. Booy, None

C. Blyth, None

N. Crawford, None

H. Marshall, None

E. Elliott, None

C. Jones, None

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