Neurologic Complications of Influenza B Virus Infection in Adults, Romania

Popescu, Corneliu Petru; Florescu, Simin Aysel; Lupulescu, Emilia; Zaharia, Mihaela; Țârdei, Grațiela; Lazăr, Mihaela; Ceauşu, Emanoil; Ruță, Simona

doi:10.3201/eid2304.161317

Cited by 34 publications

(28 citation statements)

References 37 publications

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“…Acute encephalopathy syndromes as a complication of influenza infection has been previously described by other authors in children and adults, but our observation in unvaccinated adult population with risk factors to develop influenza complications underscores the need for higher vaccination coverage in at risk population despite age. [14][15][16] There are some limitations to be taken into account, such as the fact that the total hospitalization burden including non-severe hospital admitted cases with laboratory confirmed influenza is not included. This data would be desirable to be included in influenza surveillance in order to have a broader assessment of influenza burden of disease in the population and in turn have a more exhaustive treatment and vaccine effectiveness estimation.…”

Section: Discussionmentioning

confidence: 99%

Seasonal influenza surveillance: Observational study on the 2017–2018 season with predominant B influenza virus circulation

Basile¹,

Torner

Martı́nez

et al. 2019

Vacunas

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publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. v a c u n a s . 2 0 1 9;2 0(2):53-59 a b s t r a c t Introduction: Influenza is a common respiratory infectious disease affecting population worldwide yearly. The aim of this work is to describe the 2017-2018 influenza season and how it affected elderly population in Catalonia despite moderate vaccine coverage among this age group. Methods: Influenza surveillance based on a primary care sentinel surveillance, virological indicators systematic sampling of ILI attended and severe influenza confirmed cases (SHLCI) admitted to hospital. Analysis of data by Chi-squared, ANOVA, multiple regression and negative control test or case to case for vaccine effectiveness assessment in primary care and SHLCI respectively. Results: Moderate-high intensity and early onset season with predominance of influenza B virus (IVB) (63%) followed by an increase of circulation of influenza A virus (IVA). A total of 419 IV from primary care samples. Vaccine effectiveness (VE) in primary care setting was 14% (95%CI: 0-47%). 1306 severe cases (adjusted cumulative incidence 18.54/100,000 inhabitants (95%CI: 17.54-19.55)). The highest proportion of severe cases were in the >64 (65.1%) (aOR 15.70; 95%CI: 12.06-20.46; p < 0.001) followed by 45-64 yo (25.4%) (aOR 6.03; 95%CI: 4.57-7.97).VE in preventing intensive care unit (ICU) admission was 35% (95%CI: 10-54%). Final outcome death while hospitalized occurred in 175 SHLCI cases with a case fatality rate of 13.4%.Conclusions: 2017-2018 influenza season was an unusual epidemic season with an early onset, great predominance of influenza B (Yamagata strain) virus with a high hospitalization rate of severe cases among elderly stressing the need to upgrade vaccine uptake in this age group.Conclusiones: La temporada de gripe 2017-2018 fue una temporada epidémica inusual con un inicio temprano, gran predominio del VGB (cepa Yamagata) con una elevada tasa de hospitalización de casos graves en ancianos, lo que subraya la necesidad de mejorar la aceptación de la vacuna en este grupo de edad.

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Section: Discussionmentioning

confidence: 99%

Seasonal influenza surveillance: Observational study on the 2017–2018 season with predominant B influenza virus circulation

Basile¹,

Torner

Martı́nez

et al. 2019

Vacunas

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“…Associated with all major pandemics since the beginning of the 20th century, circulating influenza A presents the greatest threat to human health. Most influenza virus infections remain confined to the upper respiratory tract, although some can lead to severe cases and may result in pneumonia, acute respiratory distress syndrome (ARDS) [30,149] and complications involving the CNS [150][151][152]. Several studies have shown that influenza A can be associated with encephalitis, Reye's syndrome, febrile seizure, Guillain-Barré syndrome, acute necrotizing encephalopathy and possibly acute disseminated encephalomyelitis (ADEM) [153][154][155][156][157][158].…”

Section: Respiratory Viruses With Neuroinvasive and Neurotropic Propementioning

confidence: 99%

Human Coronaviruses and Other Respiratory Viruses: Underestimated Opportunistic Pathogens of the Central Nervous System?

Desforges

Coupanec

Dubeau

et al. 2019

Viruses

941

997

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Respiratory viruses infect the human upper respiratory tract, mostly causing mild diseases. However, in vulnerable populations, such as newborns, infants, the elderly and immune-compromised individuals, these opportunistic pathogens can also affect the lower respiratory tract, causing a more severe disease (e.g., pneumonia). Respiratory viruses can also exacerbate asthma and lead to various types of respiratory distress syndromes. Furthermore, as they can adapt fast and cross the species barrier, some of these pathogens, like influenza A and SARS-CoV, have occasionally caused epidemics or pandemics, and were associated with more serious clinical diseases and even mortality. For a few decades now, data reported in the scientific literature has also demonstrated that several respiratory viruses have neuroinvasive capacities, since they can spread from the respiratory tract to the central nervous system (CNS). Viruses infecting human CNS cells could then cause different types of encephalopathy, including encephalitis, and long-term neurological diseases. Like other well-recognized neuroinvasive human viruses, respiratory viruses may damage the CNS as a result of misdirected host immune responses that could be associated with autoimmunity in susceptible individuals (virus-induced neuro-immunopathology) and/or viral replication, which directly causes damage to CNS cells (virus-induced neuropathology). The etiological agent of several neurological disorders remains unidentified. Opportunistic human respiratory pathogens could be associated with the triggering or the exacerbation of these disorders whose etiology remains poorly understood. Herein, we present a global portrait of some of the most prevalent or emerging human respiratory viruses that have been associated with possible pathogenic processes in CNS infection, with a special emphasis on human coronaviruses.

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“…Antiviral therapy achieved complete resolution in symptoms over a shorter duration of time as compared with patients who did not receive this. Interestingly, two patients in the study by Popescu et al did not receive vaccination prior to neurological complications,6 while influenza vaccination was administered in our patient. Unfortunately, the vaccination status in patients with influenza-associated meningoencephalitis was not studied in other literature.…”

Section: Discussionmentioning

confidence: 66%

“…illustrates the characteristics of influenza B-related encephalitis in patients for whom information is available. It is more common among women, with one patient reporting having previous history of Influenza A encephalitis 6. No clear predisposing factors were identified on review.…”

Section: Discussionmentioning

confidence: 99%

Influenza B-related meningoencephalitis in adults

Chen¹,

Vallat

Norton

2018

BMJ Case Reports

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We present a case involving an 85-year-old man with acute confusion and new onset seizure following a 1-week history of respiratory prodrome. This case report describes a case of influenza B-related meningoencephalitis supported by evidence of an influenza B infection and temporal relation of the neurological event and respiratory illness in the absence of other identifiable cause. Diagnosis is guided by cerebrospinal fluid profile and nasopharyngeal PCR. Treatment is largely supportive and the effect of vaccination on prevention of this neurological complication remains unclear.

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Neurologic Complications of Influenza B Virus Infection in Adults, Romania

Abstract: Infection with this virus should be considered as an etiologic factor for encephalitis.

Cited by 34 publications

References 37 publications

Seasonal influenza surveillance: Observational study on the 2017–2018 season with predominant B influenza virus circulation

Seasonal influenza surveillance: Observational study on the 2017–2018 season with predominant B influenza virus circulation

Human Coronaviruses and Other Respiratory Viruses: Underestimated Opportunistic Pathogens of the Central Nervous System?

Influenza B-related meningoencephalitis in adults

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