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Encephalitis after influenza in Sweden 1987-1998: a rare complication of a common infection.

https://arctichealth.org/en/permalink/ahliterature89622
Source
Eur Neurol. 2009;61(5):289-94
Publication Type
Article
Date
2009
Author
Hjalmarsson Anders
Blomqvist Paul
Brytting Maria
Linde Annika
Sköldenberg Birgit
Author Affiliation
Infectious Diseases Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. anders.hjalmarsson@ki.se
Source
Eur Neurol. 2009;61(5):289-94
Date
2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Encephalitis, Viral - epidemiology - etiology - mortality
Female
Humans
Incidence
Influenza, Human - complications - epidemiology - mortality
Male
Middle Aged
Registries
Sweden - epidemiology
Young Adult
Abstract
The aim of this study was to investigate the incidence of influenza-related encephalitis in Sweden during 11.5 years. Studies from Japan report an increased incidence of influenza-related encephalitis/encephalopathy. Few other studies are available. We conducted a retrospective register-based study on the Swedish National Inpatient Register, which covers all Swedish hospitals. In 1987-1998, a total number of 14,250 hospitalized individuals had an influenza diagnosis (population incidence: 137 per million person-years). In-hospital mortality was 4.1%. Using three different approaches, only 21 cases of influenza-related encephalitis were found, corresponding to a rate of 1.5 per 1,000 hospitalized persons with an influenza diagnosis (population incidence 0.21 per million person-years). We conclude that encephalitis following influenza occurs rarely, or is an infrequently recognized, diagnosed or reported complication. The cases we studied in detail have all recovered without sequels.
PubMed ID
19295216 View in PubMed
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Herpes simplex encephalitis in Sweden, 1990-2001: incidence, morbidity, and mortality.

https://arctichealth.org/en/permalink/ahliterature83492
Source
Clin Infect Dis. 2007 Oct 1;45(7):875-80
Publication Type
Article
Date
Oct-1-2007
Author
Hjalmarsson Anders
Blomqvist Paul
Sköldenberg Birgit
Author Affiliation
Infectious Diseases Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. anders.hjalmarsson@ki.se
Source
Clin Infect Dis. 2007 Oct 1;45(7):875-80
Date
Oct-1-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Encephalitis, Herpes Simplex - complications - mortality
Humans
Incidence
Infant
Infant, Newborn
Middle Aged
Morbidity
Recurrence
Registries
Retrospective Studies
Simplexvirus - pathogenicity
Sweden - epidemiology
Abstract
BACKGROUND: Herpes simplex encephalitis (HSE) is a devastating disease. METHODS: In Sweden, a nationwide retrospective study of the incidence, morbidity, and mortality associated with HSE during the 12-year period 1990-2001 was conducted. The national inpatient register data were used, and diagnostic data from the virus laboratories were validated. RESULTS: In the study period, 638 patients hospitalized in Sweden received a primary diagnosis of HSE. Of these, 236 patients had a confirmed infection of the central nervous system due to herpes simplex virus type 1. This corresponds to an incidence of confirmed HSE due to herpes simplex virus type 1 of 2.2 cases per million population per year. Of the survivors, 87% were readmitted to the hospital. The most frequent diagnosis at readmission was epilepsy, which was found in 49 patients (21% of the 236 total patients; 24% of 203 survivors), with a median onset 9.3 months after the diagnosis of HSE. This corresponds to a 60- to 90-fold increase in risk, compared with that for the general population. Neuropsychiatric sequelae were evident in 45 (22%) of 203 surviving patients. The incidence of venous thromboembolism, including pulmonary embolism, was 5-14 times higher than that in the general population. Among patients with HSE due to herpes simplex virus type 1, the 1-year mortality was 14% (33 of 236 patients died), which was 8 times higher than expected. CONCLUSIONS: This is, to our knowledge, the first study to report long-term, nationwide follow-up data for patients with virologically confirmed HSE. There is considerable morbidity after HSE, with epilepsy being the most common diagnosis. This demonstrates the need for expanding our knowledge of the pathogenesis of HSE to direct more effective antiviral and antiinflammatory treatments.
Notes
Comment In: Clin Infect Dis. 2007 Oct 1;45(7):881-217806054
PubMed ID
17806053 View in PubMed
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