Effect of mass immunization against influenza encephalopathy on mortality rates in children

Ono, Shigetoo; Kudo, M; Aoki, Kazuo; Ezaki, Fusako; Misumi, Jyuji

doi:10.1111/j.1442-200x.2003.01813.x

Cited by 13 publications

(10 citation statements)

References 36 publications

(64 reference statements)

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“…Accordingly, fatal cases of encephalopathy may have significantly contributed to the increase in the number of excess deaths observed among young children, although prominent numbers of excess all-cause deaths have been noted since 1990. The authors of one report hypothesized that the discontinuation of mass vaccination of schoolchildren was responsible for the increase in the incidence of influenza-associated encephalopathy [20], and our results appear to support this hypothesis.…”

Section: Discussionsupporting

confidence: 86%

Mass Vaccination of Schoolchildren against Influenza and Its Impact on the Influenza-Associated Mortality Rate among Children in Japan

Sugaya

Takeuchi

2005

Clinical Infectious Diseases

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Section: Discussionsupporting

confidence: 86%

Mass Vaccination of Schoolchildren against Influenza and Its Impact on the Influenza-Associated Mortality Rate among Children in Japan

Sugaya

Takeuchi

2005

Clinical Infectious Diseases

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“…For seasonal influenza, three studies assessed vaccine efficacy in the general population [67]–[69], eight studies in children [68], [70]–[76], four studies in elderly populations [68], [77]–[79], two in health care workers [80], [81] and one in immunocompromised haemodialysis patients [82].…”

Section: Resultsmentioning

confidence: 99%

A Review of the Evidence to Support Influenza Vaccine Introduction in Countries and Areas of WHO's Western Pacific Region

2013

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BackgroundImmunization against influenza is considered an essential public health intervention to control both seasonal epidemics and pandemic influenza. According to the World Health Organization (WHO), there are five key policy and three key programmatic issues that decision-makers should consider before introducing a vaccine. These are (a) public health priority, (b) disease burden, (c) efficacy, quality and safety of the vaccine, (d) other inventions, (e) economic and financial issues, (f) vaccine presentation, (g) supply availability and (h) programmatic strength. We analyzed the body of evidence currently available on these eight issues in the WHO Western Pacific Region.Methodology/Principal FindingsStudies indexed in PubMed and published in English between 1 January 2000 and 31 December 2010 from the 37 countries and areas of the Western Pacific Region were screened for keywords pertaining to the five policy and three programmatic issues. Studies were grouped according to country income level and vaccine target group. There were 133 articles that met the selection criteria, with most (90%) coming from high-income countries. Disease burden (n = 34), vaccine efficacy, quality and safety (n = 27) and public health priority (n = 27) were most frequently addressed by studies conducted in the Region. Many studies assessed influenza vaccine policy and programmatic issues in the general population (42%), in the elderly (24%) and in children (17%). Few studies (2%) addressed the eight issues relating to pregnant women.Conclusions/SignificanceThe evidence for vaccine introduction in countries and areas in this Region remains limited, particularly in low- and middle-income countries that do not currently have influenza vaccination programmes. Surveillance activities and specialized studies can be used to assess the eight issues including disease burden among vaccine target groups and the cost-effectiveness of influenza vaccine. Multi-country studies should be considered to maximize resource utilization for cross-cutting issues such as vaccine presentation and other inventions.

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“…However, one study from Japan showed that the mortality rate from IAE in children was significantly lower during the era of mass influenza immunization (pre-1994) than in a subsequent era (1995)(1996)(1997)(1998)(1999)(2000) [20]. Therefore, influenza vaccination, which is recommended in young children and strongly recommended in children with underlying diseases, could avoid influenza-associated complications in our children.…”

Section: Discussionmentioning

confidence: 98%

Characteristics and Outcome of Influenza-Associated Encephalopathy/Encephalitis Among Children In A Tertiary Pediatric Hospital In Italy, 2017-2019

Mastrolia

Rubino

Resti

et al. 2019

Preprint

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BACKGROUND: Influenza is the most frequent cause of acute upper respiratory tract infections during winter season. Although rare, neurological manifestations are known to occur during influenza infection and approximatively three-quarters of cases are in children. In this study, we aimed to characterize the burden and clinical spectrum of influenza-associated encephalopathy and encephalitis in children admitted at a tertiary pediatric hospital in Italy over two influenza seasons (2017-2019).METHODS: We retrospectively analyzed clinical, laboratory, instrumental data and outcome of patients discharged with ICD9-CM 487.0 code RESULTS: Fifteen children (13.1% of those discharged with a diagnosis of influenza infection in the study period), had influenza-associated central nervous system (CNS) manifestations. Eight patients (53.3%) were diagnosed as influenza encephalitis, 7 (46.7%) as influenza encephalopathy. Median age was 27 months. In children under 2 years of age (40% of all cases) altered consciousness was the most frequent neurological manifestation while respiratory symptoms were present at admission in all cases. Younger children also required intensive care support more frequently. Five subjects (33.3%) presented comorbidity. None of the patients had received seasonal influenza vaccination. The median time from onset of respiratory signs to onset of neurological manifestations was 24 hours. Cerebrospinal fluid (CSF) analysis was normal in most patients and polymerase chain reaction for influenza virus RNA on CSF, when performed, was negative in all samples. Neuroradiological investigations, performed in 5 children, reported cortical and subcortical white matter signal alterations. Oseltamivir was administered only in 2 cases. Fourteen patients recovered without sequelae, and only a 2-year-old girl had minimal impairment in fine motor skills at discharge. CONCLUSIONS: All children presenting acute neurological features during influenza season should be evaluated for influenza-associated CNS complications even if the respiratory involvement is mild. Absence of underlying diseases or other risk factors are not protective factors against CNS influenza-associated complications. The lack of CSF pleocytosis does not exclude CNS involvement. Children under 2 years of age are at higher risk of requiring intensive care support.

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Effect of mass immunization against influenza encephalopathy on mortality rates in children

Abstract: The results of the present study suggest that mass immunization of school-aged children reduced the mortality rate from influenza-associated acute encephalopathy/encephalitis in children less than 9 years of age.

Cited by 13 publications

References 36 publications

Mass Vaccination of Schoolchildren against Influenza and Its Impact on the Influenza-Associated Mortality Rate among Children in Japan

Mass Vaccination of Schoolchildren against Influenza and Its Impact on the Influenza-Associated Mortality Rate among Children in Japan

A Review of the Evidence to Support Influenza Vaccine Introduction in Countries and Areas of WHO's Western Pacific Region

Characteristics and Outcome of Influenza-Associated Encephalopathy/Encephalitis Among Children In A Tertiary Pediatric Hospital In Italy, 2017-2019

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