Clinical features of hospitalised children with 2009 H1N1 influenza virus infection

Calitri, Carmelina; Gabiano, Clara; Garazzino, Silvia; Pinon, Michele; Zoppo, Marisa; Cuozzo, M.; Scolfaro, Carlo; Tovo, Pier-Angelo

doi:10.1007/s00431-010-1255-y

Cited by 47 publications

(35 citation statements)

References 16 publications

(33 reference statements)

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“…As described in other studies (2)(3)(4)(5)(6)(7)(8)(9)(10), many patients had extra-intestinal symptoms (diarrhea in 38% and vomiting in 31%). Bacterial co-infection, suspected in 20% of the children in our series, was considered uncommon in the 2009 HI N I epidemic (6).…”

Section: Discussionsupporting

confidence: 66%

“…The 2009 HINI epidemic, in our series and as reported by the ltalian Health Institute (www.epicentro.iss.it). covered a period of 15 weeks and it reflected the epidemic curve in Spain (9). The epidemic peaked after 2-4 weeks, before the 4-6 weeks experienced in Australia and New Zealand (4), or the 8 weeks in the pediatric cohort in Argentina (6).…”

Section: Discussionmentioning

confidence: 91%

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Detection of Respiratory Viruses in the 2009 Winter Season in Rome: 2009 Influenza a (H1N1) Complications in Children and Concomitant Type 1 Diabetes Onset

Nenna

Papoff

Moretti

et al. 2011

Int J Immunopathol Pharmacol

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We investigated clinical characteristics and complications, particularly type 1 diabetes onset, in children hospitalized for 2009 pandemic influenza A (H1N1) virus and compared number of consultations, rate of hospitalization and virus identification in children hospitalized for acute respiratory symptoms (ARS) during the winter season 2009–2010 and 2004–2005. Patients were tested for 2009 H1N1 virus and 14 respiratory viruses on pharyngeal brush/nasal aspirates, using a RT-PCR or nested PCR assays. Consultations and hospitalizations were extracted from operative system GIPSE. The total number of consultations increased by 12%, consultation rate for ARS by 13% and number of hospitalizations by 56% from 2004–2005 to 2009–2010. In 2004–2005, Influenza A virus was identified in only 7% of hospitalized children, while in 2009–2010 the 2009 H1N1 virus was identified in 21%. Three children attending the hospital for ARS and 2009 H1N1 infection had ketoacidosis as the onset manifestation of type 1 diabetes. By comparing the number of new diabetes diagnoses among the two winter seasons, we found a higher number of new diagnoses in October 2009 January 2010 than in the same period in 2004–2005 (19 vs 10). Six children (13%), all presenting with pre-existing diseases, were admitted to the pediatric intensive care unit. No children died. The outbreak of this novel virus has increased pediatric consultation rates and hospitalizations compared with previous winters without causing deaths. The children at highest risk for severe infection are those with comorbidities. The 2009 H1N1 virus seems in some way involved in the pathogenesis of type 1 diabetes.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 91%

Detection of Respiratory Viruses in the 2009 Winter Season in Rome: 2009 Influenza a (H1N1) Complications in Children and Concomitant Type 1 Diabetes Onset

Nenna

Papoff

Moretti

et al. 2011

Int J Immunopathol Pharmacol

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“…Complications following H1N1 infection may occur and the most common are those involving the respiratory tract. Neurological complications may be seen in up 10% of children with H1N1 infection the most common include acute disseminated encephalomyelitis (ADEM), acute necrotizing encephalitis (ANEC), influenza encephalitis, and Guillain-Barré syndrome have also been described 13,15,16,17,18,19 . H1N1 vaccination is an important prophylatic tool to decrease the incidence, intensity, and morbidity of the disease 20 .…”

Section: Discussionmentioning

confidence: 99%

Neurological complications after H1N1 influenza vaccination: magnetic resonance imaging findings

Lessa

Castillo²,

Azevedo

et al. 2014

Arq. Neuro-Psiquiatr.

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Objective: To report 4 different neurological complications of H1N1 virus vaccination. Method: Four patients (9, 16, 37 and 69 years of age) had neurological symptoms (intracranial hypertension, ataxia, left peripheral facial palsy of abrupt onset, altered mental status, myelitis) starting 4-15 days after H1N1 vaccination. MRI was obtained during the acute period. Results: One patient with high T2 signal in the cerebellum interpreted as acute cerebellitis; another, with left facial palsy, showed contrast enhancement within both internal auditory canals was present, however it was more important in the right side; one patient showed gyriform hyperintensities on FLAIR with sulcal effacement in the right fronto-parietal region; and the last one showed findings compatible with thoracic myelitis. Conclusion: H1N1 vaccination can result in important neurological complications probably secondary to post-vaccination inflammation. MRI detected abnormalities in all patients.Keywords: central nervous system, influenza A virus, H1N1, magnetic resonance imaging, encephalitis after vaccination. RESUMOObjetivo: Relatar quatro diferentes complicações neurológicas da vacina contra o vírus H1N1. Método: Quatro pacientes (9, 16, 37 e 69 anos) tinham sintomas neurológicos (hipertensão intracraniana, ataxia, paralisia facial esquerda de inicio abrupto, estado mental alterado e mielite) iniciando-se 4 a 15 dias após vacinação contra H1N1. RM foi realizada em quatro pacientes na fase aguda e em um paciente na fase crônica. Resultados: Dos quatro pacientes, um apresentou hipersinal em T2 no cerebelo, interpretado como cerebelite aguda; um, com paralisia facial esquerda, tinha realce dos condutos auditivos internos, maior à direita; um tinha hipersinal em T2 no cortex parietooccipital direito; um apresentou sinais compatíveis com mielite torácica. Conclusão: A vacinação contra o H1N1 pode resultar em importantes complicações neurológicas, provavelmente secundárias a inflamação pós-vacinal. A RM detectou anormalidades em todos os pacientes.Palavras-chave: sistema nervoso central, virus influenza H1N1, imagem de ressonância magnética, encefalite pós-vacinal.

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“…Susceptible groups to flu infection are children and old people, showing a range of viral infection signs such as fever, cough, petechial rash, respiratory disturbances, pulmonary disease, neurological disorder, and hematological alteration [9]. Neural complications, similar to Schizophrenia, Reye's syndrome, Parkinson, and Encephalopathy symptoms, can be seen in influenza infection [65].…”

Section: Introductionmentioning

confidence: 98%

Unique ability of pandemic influenza to downregulate the genes involved in neuronal disorders

et al. 2015

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Pandemic influenza remains as a substantial threat to humans with a widespread panic worldwide. In contrast, seasonal (non-pandemic) has a mild non-lethal infection each year. The underlying mechanisms governing the detrimental effects of pandemic influenza are yet to be known. Transcriptomic-based network discovery and gene ontology (GO) analysis of host response to pandemic influenza, compared to seasonal influenza, can shed light on the differential mechanisms which pandemic influenza is employed during evolution. Here, using microarray data of infected ferrets with pandemic and seasonal influenza (as a model), we evaluated the possible link between altered genes after pandemic infection with activation of neuronal disorders. To this end, we utilized novel computational biology techniques including differential transcriptome analysis, network construction, GO enrichment, and GO network to investigate the underlying mechanisms of pandemic influenza infection and host interaction. In comparison to seasonal influenza, pandemic influenza differentially altered the expression of 31 genes with direct involvement in activity of central nervous system (CNS). Network topology highlighted the high interactions of IRF1, NKX2-1 and NR5A1 as well as MIR27A, MIR19A, and MIR17. TGFB2, NCOA3 and SP1 were the central transcription factors in the networks. Pandemic influenza remarkably downregulated GPM6A and GTPase. GO network demonstrated the key roles of GPM6A and GTPase in regulation of important functions such as synapse assembly and neuron projection. For the first time, we showed that besides interference with cytokine/chemokine storm and neuraminidase enzyme, H1N1 pandemic influenza is able to directly affect neuronal gene networks. The possibility of application of some key regulators such as GPM6A protein, MIR128, and MIR367 as candidate therapeutic agents is discussed. The presented approach established a new way to unravel unknown pathways in virus-associated CNS dysfunction by utilizing global transcriptomic data, network and GO analysis.

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Clinical features of hospitalised children with 2009 H1N1 influenza virus infection

Cited by 47 publications

References 16 publications

Detection of Respiratory Viruses in the 2009 Winter Season in Rome: 2009 Influenza a (H1N1) Complications in Children and Concomitant Type 1 Diabetes Onset

Detection of Respiratory Viruses in the 2009 Winter Season in Rome: 2009 Influenza a (H1N1) Complications in Children and Concomitant Type 1 Diabetes Onset

Neurological complications after H1N1 influenza vaccination: magnetic resonance imaging findings

Unique ability of pandemic influenza to downregulate the genes involved in neuronal disorders

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