Burden of Seasonal Influenza in Children With Neurodevelopmental Conditions

Abstract

The burden of influenza infection in children with NNC, even those whose conditions do not obviously compromise respiratory function, is significant. All children with NNC should be recognized as having a high risk of complicated influenza infection and be targeted to receive influenza immunization.

Identification of children at risk of influenza-related complications in primary and ambulatory care: a systematic review and meta-analysis

“…49 Children with neurological conditions which do not obviously compromise handling of respiratory secretions have been proposed as an 'at risk' group due to the high burden of influenza observed in these children. 50 However, this recommendation was based only on data collected from children who had already been hospitalised. Data available for this review were not reported in sufficient detail to separately assess risk of hospitalisation associated with neurological conditions which did or did not compromise handling of respiratory secretions.…”

Impact of Influenza on Outpatient Visits, Hospitalizations, and Deaths by Using a Time Series Poisson Generalized Additive Model

“…The average annual incidence of influenza-associated hospitalizations is particularly high in children <5 years of age [12,13], greatly promoting the development of vaccination strategies. The findings of a population-based study indicated that the influenzaassociated disease burden on young children were mainly derived from outpatients, involved a high attendance rate, common complications, and immeasurable missed work/absenteeism, followed by influenza-associated hospitalizations, and death-related disease burden caused by influenza was comparatively low [14]. Studies to date have been primarily performed in developed temperate countries, as well as in a few high-income districts in tropical and subtropical countries [2,4,10].…”

Influenza in High-Risk Hosts—Lessons Learned from Animal Models

“…Interestingly, CF transmembrane conductance regulator gene heterozygotic mice have improved outcomes postinfection, including reduced acute lung injury, because of increased TGF-β-induced IL-6 production and stimulation of alveolar macrophages (Aeffner et al 2013;Woods et al 2015). Murine models of other genetic diseases, including sickle cell and neurodevelopmental disorders, display increased disease severity and blunted antiviral immunity, thus supporting the higher burdens and increased morbidity reported in clinical and epidemiological studies (Bundy et al 2010;Strouse et al 2010; Centers for Disease Control and Prevention 2012; Burton et al 2014;Cronk et al 2017;Karlsson et al 2017b).…”