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Relationship between the population incidence of febrile convulsions in young children in Sydney, Australia and seasonal epidemics of influenza and respiratory syncytial virus, 2003-2010: a time series analysis.
BMC Infect Dis. 2011 Oct 26; 11:291.BI

Abstract

BACKGROUND

In 2010, intense focus was brought to bear on febrile convulsions in Australian children particularly in relation to influenza vaccination. Febrile convulsions are relatively common in infants and can lead to hospital admission and severe outcomes. We aimed to examine the relationships between the population incidence of febrile convulsions and influenza and respiratory syncytial virus (RSV) seasonal epidemics in children less than six years of age in Sydney Australia using routinely collected syndromic surveillance data and to assess the feasibility of using this data to predict increases in population rates of febrile convulsions.

METHODS

Using two readily available sources of routinely collected administrative data; the NSW Emergency Department (ED) patient management database (1 January 2003 - 30 April 2010) and the Ambulance NSW dispatch database (1 July 2006 - 30 April 2010), we used semi-parametric generalized additive models (GAM) to determine the association between the population incidence rate of ED presentations and urgent ambulance dispatches for 'convulsions', and the population incidence rate of ED presentations for 'influenza-like illness' (ILI) and 'bronchiolitis' - proxy measures of influenza and RSV circulation, respectively.

RESULTS

During the study period, when the weekly all-age population incidence of ED presentations for ILI increased by 1/100,000, the 0 to 6 year-old population incidence of ED presentations for convulsions increased by 6.7/100,000 (P < 0.0001) and that of ambulance calls for convulsions increased by 3.2/100,000 (P < 0.0001). The increase in convulsions occurred one week earlier relative to the ED increase in ILI. The relationship was weaker during the epidemic of pandemic (H1N1) 2009 influenza virus.When the 0 to 3 year-old population incidence of ED presentations for bronchiolitis increased by 1/100,000, the 0 to 6 year-old population incidence of ED presentations for convulsions increased by 0.01/100,000 (P < 0.01). We did not find a meaningful and statistically significant association between bronchiolitis and ambulance calls for convulsions.

CONCLUSIONS

Influenza seasonal epidemics are associated with a substantial and statistically significant increase in the population incidence of hospital attendances and ambulance dispatches for reported febrile convulsions in young children. Monitoring syndromic ED and ambulance data facilitates rapid surveillance of reported febrile convulsions at a population level.

Authors+Show Affiliations

Public Health Officer Training Program, New South Wales Ministry of Health, (Miller Street), North Sydney, (2059), Australia. bpolk@doh.health.nsw.gov.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22029484

Citation

Polkinghorne, Benjamin G., et al. "Relationship Between the Population Incidence of Febrile Convulsions in Young Children in Sydney, Australia and Seasonal Epidemics of Influenza and Respiratory Syncytial Virus, 2003-2010: a Time Series Analysis." BMC Infectious Diseases, vol. 11, 2011, p. 291.
Polkinghorne BG, Muscatello DJ, Macintyre CR, et al. Relationship between the population incidence of febrile convulsions in young children in Sydney, Australia and seasonal epidemics of influenza and respiratory syncytial virus, 2003-2010: a time series analysis. BMC Infect Dis. 2011;11:291.
Polkinghorne, B. G., Muscatello, D. J., Macintyre, C. R., Lawrence, G. L., Middleton, P. M., & Torvaldsen, S. (2011). Relationship between the population incidence of febrile convulsions in young children in Sydney, Australia and seasonal epidemics of influenza and respiratory syncytial virus, 2003-2010: a time series analysis. BMC Infectious Diseases, 11, 291. https://doi.org/10.1186/1471-2334-11-291
Polkinghorne BG, et al. Relationship Between the Population Incidence of Febrile Convulsions in Young Children in Sydney, Australia and Seasonal Epidemics of Influenza and Respiratory Syncytial Virus, 2003-2010: a Time Series Analysis. BMC Infect Dis. 2011 Oct 26;11:291. PubMed PMID: 22029484.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between the population incidence of febrile convulsions in young children in Sydney, Australia and seasonal epidemics of influenza and respiratory syncytial virus, 2003-2010: a time series analysis. AU - Polkinghorne,Benjamin G, AU - Muscatello,David J, AU - Macintyre,C Raina, AU - Lawrence,Glenda L, AU - Middleton,Paul M, AU - Torvaldsen,Siranda, Y1 - 2011/10/26/ PY - 2011/02/14/received PY - 2011/10/26/accepted PY - 2011/10/28/entrez PY - 2011/10/28/pubmed PY - 2012/2/9/medline SP - 291 EP - 291 JF - BMC infectious diseases JO - BMC Infect Dis VL - 11 N2 - BACKGROUND: In 2010, intense focus was brought to bear on febrile convulsions in Australian children particularly in relation to influenza vaccination. Febrile convulsions are relatively common in infants and can lead to hospital admission and severe outcomes. We aimed to examine the relationships between the population incidence of febrile convulsions and influenza and respiratory syncytial virus (RSV) seasonal epidemics in children less than six years of age in Sydney Australia using routinely collected syndromic surveillance data and to assess the feasibility of using this data to predict increases in population rates of febrile convulsions. METHODS: Using two readily available sources of routinely collected administrative data; the NSW Emergency Department (ED) patient management database (1 January 2003 - 30 April 2010) and the Ambulance NSW dispatch database (1 July 2006 - 30 April 2010), we used semi-parametric generalized additive models (GAM) to determine the association between the population incidence rate of ED presentations and urgent ambulance dispatches for 'convulsions', and the population incidence rate of ED presentations for 'influenza-like illness' (ILI) and 'bronchiolitis' - proxy measures of influenza and RSV circulation, respectively. RESULTS: During the study period, when the weekly all-age population incidence of ED presentations for ILI increased by 1/100,000, the 0 to 6 year-old population incidence of ED presentations for convulsions increased by 6.7/100,000 (P < 0.0001) and that of ambulance calls for convulsions increased by 3.2/100,000 (P < 0.0001). The increase in convulsions occurred one week earlier relative to the ED increase in ILI. The relationship was weaker during the epidemic of pandemic (H1N1) 2009 influenza virus.When the 0 to 3 year-old population incidence of ED presentations for bronchiolitis increased by 1/100,000, the 0 to 6 year-old population incidence of ED presentations for convulsions increased by 0.01/100,000 (P < 0.01). We did not find a meaningful and statistically significant association between bronchiolitis and ambulance calls for convulsions. CONCLUSIONS: Influenza seasonal epidemics are associated with a substantial and statistically significant increase in the population incidence of hospital attendances and ambulance dispatches for reported febrile convulsions in young children. Monitoring syndromic ED and ambulance data facilitates rapid surveillance of reported febrile convulsions at a population level. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/22029484/Relationship_between_the_population_incidence_of_febrile_convulsions_in_young_children_in_Sydney_Australia_and_seasonal_epidemics_of_influenza_and_respiratory_syncytial_virus_2003_2010:_a_time_series_analysis_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-11-291 DB - PRIME DP - Unbound Medicine ER -