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Increased incidence and clinical picture of childhood narcolepsy following the 2009 H1N1 pandemic vaccination campaign in Finland.
PLoS One. 2012; 7(3):e33723.Plos

Abstract

BACKGROUND

Narcolepsy is a rare neurological sleep disorder especially in children who are younger than 10 years. In the beginning of 2010, an exceptionally large number of Finnish children suffered from an abrupt onset of excessive daytime sleepiness (EDS) and cataplexy. Therefore, we carried out a systematic analysis of the incidence of narcolepsy in Finland between the years 2002-2010.

METHODS

All Finnish hospitals and sleep clinics were contacted to find out the incidence of narcolepsy in 2010. The national hospital discharge register from 2002 to 2009 was used as a reference.

FINDINGS

Altogether 335 cases (all ages) of narcolepsy were diagnosed in Finland during 2002-2009 giving an annual incidence of 0.79 per 100,000 inhabitants (95% confidence interval 0.62-0.96). The average annual incidence among subjects under 17 years of age was 0.31 (0.12-0.51) per 100,000 inhabitants. In 2010, 54 children under age 17 were diagnosed with narcolepsy (5.3/100,000; 17-fold increase). Among adults ≥20 years of age the incidence rate in 2010 was 0.87/100,000, which equals that in 2002-2009. Thirty-four of the 54 children were HLA-typed, and they were all positive for narcolepsy risk allele DQB1*0602/DRB1*15. 50/54 children had received Pandemrix vaccination 0 to 242 days (median 42) before onset. All 50 had EDS with abnormal multiple sleep latency test (sleep latency <8 min and ≥2 sleep onset REM periods). The symptoms started abruptly. Forty-seven (94%) had cataplexy, which started at the same time or soon after the onset of EDS. Psychiatric symptoms were common. Otherwise the clinical picture was similar to that described in childhood narcolepsy.

INTERPRETATION

A sudden increase in the incidence of abrupt childhood narcolepsy was observed in Finland in 2010. We consider it likely that Pandemrix vaccination contributed, perhaps together with other environmental factors, to this increase in genetically susceptible children.

Authors+Show Affiliations

Helsinki Sleep Clinic, Vitalmed Research Centre, Helsinki, Finland. markku.partinen@helsinki.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

22470463

Citation

Partinen, Markku, et al. "Increased Incidence and Clinical Picture of Childhood Narcolepsy Following the 2009 H1N1 Pandemic Vaccination Campaign in Finland." PloS One, vol. 7, no. 3, 2012, pp. e33723.
Partinen M, Saarenpää-Heikkilä O, Ilveskoski I, et al. Increased incidence and clinical picture of childhood narcolepsy following the 2009 H1N1 pandemic vaccination campaign in Finland. PLoS One. 2012;7(3):e33723.
Partinen, M., Saarenpää-Heikkilä, O., Ilveskoski, I., Hublin, C., Linna, M., Olsén, P., Nokelainen, P., Alén, R., Wallden, T., Espo, M., Rusanen, H., Olme, J., Sätilä, H., Arikka, H., Kaipainen, P., Julkunen, I., & Kirjavainen, T. (2012). Increased incidence and clinical picture of childhood narcolepsy following the 2009 H1N1 pandemic vaccination campaign in Finland. PloS One, 7(3), e33723. https://doi.org/10.1371/journal.pone.0033723
Partinen M, et al. Increased Incidence and Clinical Picture of Childhood Narcolepsy Following the 2009 H1N1 Pandemic Vaccination Campaign in Finland. PLoS One. 2012;7(3):e33723. PubMed PMID: 22470463.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased incidence and clinical picture of childhood narcolepsy following the 2009 H1N1 pandemic vaccination campaign in Finland. AU - Partinen,Markku, AU - Saarenpää-Heikkilä,Outi, AU - Ilveskoski,Ismo, AU - Hublin,Christer, AU - Linna,Miika, AU - Olsén,Päivi, AU - Nokelainen,Pekka, AU - Alén,Reija, AU - Wallden,Tiina, AU - Espo,Merimaaria, AU - Rusanen,Harri, AU - Olme,Jan, AU - Sätilä,Heli, AU - Arikka,Harri, AU - Kaipainen,Pekka, AU - Julkunen,Ilkka, AU - Kirjavainen,Turkka, Y1 - 2012/03/28/ PY - 2011/11/09/received PY - 2012/02/15/accepted PY - 2012/4/4/entrez PY - 2012/4/4/pubmed PY - 2012/8/4/medline SP - e33723 EP - e33723 JF - PloS one JO - PLoS One VL - 7 IS - 3 N2 - BACKGROUND: Narcolepsy is a rare neurological sleep disorder especially in children who are younger than 10 years. In the beginning of 2010, an exceptionally large number of Finnish children suffered from an abrupt onset of excessive daytime sleepiness (EDS) and cataplexy. Therefore, we carried out a systematic analysis of the incidence of narcolepsy in Finland between the years 2002-2010. METHODS: All Finnish hospitals and sleep clinics were contacted to find out the incidence of narcolepsy in 2010. The national hospital discharge register from 2002 to 2009 was used as a reference. FINDINGS: Altogether 335 cases (all ages) of narcolepsy were diagnosed in Finland during 2002-2009 giving an annual incidence of 0.79 per 100,000 inhabitants (95% confidence interval 0.62-0.96). The average annual incidence among subjects under 17 years of age was 0.31 (0.12-0.51) per 100,000 inhabitants. In 2010, 54 children under age 17 were diagnosed with narcolepsy (5.3/100,000; 17-fold increase). Among adults ≥20 years of age the incidence rate in 2010 was 0.87/100,000, which equals that in 2002-2009. Thirty-four of the 54 children were HLA-typed, and they were all positive for narcolepsy risk allele DQB1*0602/DRB1*15. 50/54 children had received Pandemrix vaccination 0 to 242 days (median 42) before onset. All 50 had EDS with abnormal multiple sleep latency test (sleep latency <8 min and ≥2 sleep onset REM periods). The symptoms started abruptly. Forty-seven (94%) had cataplexy, which started at the same time or soon after the onset of EDS. Psychiatric symptoms were common. Otherwise the clinical picture was similar to that described in childhood narcolepsy. INTERPRETATION: A sudden increase in the incidence of abrupt childhood narcolepsy was observed in Finland in 2010. We consider it likely that Pandemrix vaccination contributed, perhaps together with other environmental factors, to this increase in genetically susceptible children. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/22470463/Increased_incidence_and_clinical_picture_of_childhood_narcolepsy_following_the_2009_H1N1_pandemic_vaccination_campaign_in_Finland_ L2 - https://dx.plos.org/10.1371/journal.pone.0033723 DB - PRIME DP - Unbound Medicine ER -