Massachusetts health officials have issued an advisory to health care providers and parents about a possible increase in a rare neurologic complication in children tied to the flu.
Initial reports of the complication came from pediatricians at the end of January.
“They were seeing a pretty rare complication of influenza called acute necrotizing encephalopathy,” said Dr. Larry Madoff, medical director for the bureau of Infectious Disease and Lab Science at the Massachusetts Department of Public Health.
Typical flu symptoms include a loss of appetite, coughing and vomiting.
Experts say with parents should keep their eye on their children and seek medical help if they notice neurological changes.
“If there’s a change in consciousness, if there’s a seizure in the child, they’re sleeping and they can’t be aroused. I mean, those are signs that they should definitely see a healthcare provider right away in the case of the flu,” Madoff said.
Difficulty talking or unusual behavior could also be cause for concern.
“I think the important thing to know is that this is incredibly rare,” said Molly Wilson-Murphy, attending neurologist at Boston Children’s Hospital, who specializes in infectious and autoimmune diseases in the nervous system of children.
Parents can also take comfort in the knowledge that most instances of the neurologic complication have resolved themselves.
“Most of the cases of neurologic involvement in the flu across the country have been brief, self-resolving, and symptoms that improve and go back to normal on their own without intervention,” she explains.
Wilson-Murphy said there have only been a handful of cases of neurologic involvement in children in Massachusetts, and the apparent rise could be because of the active flu season across the country.
Flu cases in Massachusetts are at the highest level in five years.
Health officials attribute the volume in part to the fact that only 38% of Massachusetts residents have gotten a flu shot this season. Madoff said flu vaccinations rates in children are also low, with less than a third of young children receiving the flu vaccination.
So far this year in Massachusetts, 191 people have died from the flu , including 185 adults and six children. Nationally, there have been over 80 cases of pediatric deaths due to the flu.
Dr. Vandana Madhavan, clinical director pediatric infectious disease at Mass General for Children, said this year the severity of flu has been greater, and so are the number of hospitalizations.
She said infections like influenza lower the threshold for neurologic complications.
“Seizures can occur with infections, including influenza. Even in children who haven’t had seizures before,” she said. “The seizures may be related to a high fever, or it could be a febrile seizure, which is a common entity in in younger children.”
State officials can’t pinpoint an exact cause and effect of the neurologic complication, and said it’s part of an ongoing investigation and careful epidemiologic analysis to try and figure out what’s going on.
