Vaccination against swine flu caused narcolepsy in several european countries

Abstract

Narcolepsy is a rare sleeping disorder that gives sleep onset rapid eye movement periods and excessive daytime sleepiness. It is divided into two subgroups, narcolepsy type 1 where there also is orexin deficiency and cataplexy and narcolepsy type 2 that lack these features. Narcolepsy type 1 is assumed to be an autoimmune disease with destruction of orexinproducing cells. The pathology behind is unclear. There is a strong association to a class II HLA allele, HLADQB1*06:02 and the H1N1-virus and streptococcal infections has also been associated with narcolepsy. The severity of narcolepsy differs between patients from those who can manage their disease without medication to those who has a severe impact on their everyday life. There is a diagnostic delay between the onset of symptoms and time for diagnosis that in some cases can be more than a decade. The global mean prevalence is 30 per 100 000 inhabitants. The incidence in children in northern Europe has risen since 2010. An early study of the 2009 H1N1 influenza A pandemic indicated a high mortality and prompted efforts to rapidly come up with a vaccine. One of these was Pandemrix that was the most widely used in Europe and 61 % of the inhabitants in Sweden was vaccinated. Studies have shown an increased incidence of narcolepsy type 1 in European countries that had used Pandemrix, but no increased risk was seen in countries that had used other vaccines than Pandemrix.

Narcolepsy treatment in Sweden: An observational study

“…16 Comorbidities associated with narcolepsy, such as psychiatric disorders, can delay the narcolepsy diagnosis 2 as well as mild disease without prominent cataplexy. 17 The exact prevalence of narcolepsy in Sweden is not known. It is estimated that, in the Western world, the lower bound is 20 individuals 18,19 and the upper bound is 50 or 60 per 100,000 individuals.…”

SPHYNCS: The Use of the Swiss Narcolepsy Scale in a New Cohort of Patients with Narcolepsy and Its Borderland and Review of the Literature

“…A case report by Roya et al [25] describes NT1 onset following COVID-19 recovery. Pandemrix-related narcolepsy has been associated with a diagnostic delay of up to a decade, with previous misdiagnoses including anemia, asthma, psychosocial problems, depression, and unspecified tiredness [26]. These scenarios emphasize the crucial role of readily available diagnostic tools in general practice and pediatrics to decrease the risk of delayed diagnoses.…”