Elsevier

The Journal of Pediatrics

Volume 145, Issue 6, December 2004, Pages 800-805
The Journal of Pediatrics

Original Article
Recurrence of febrile seizures in the respiratory season is associated with influenza A

https://doi.org/10.1016/j.jpeds.2004.08.075Get rights and content

Objectives

To investigate the association of viral infections and febrile seizures (FS).

Study design

From April 1998 to April 2002, a prospective, population-based study was carried out among general practitioners to assess the incidence of FS in their practices. Data thus obtained were compared with the incidence of common viral infections recorded in a national registry. Poisson regression analysis was performed to investigate whether the season or the type of infection was associated with the variation observed in FS incidence.

Results

Throughout the 4-year period, 267 of 303 (88%) of general practitioners in the Dutch province of Friesland participated in the study. The estimated observation period was approximately 160,000 patient-years. We registered 654 cases of FS in 429 children. The estimated incidence of FS was 2.4 in 1000 patient-years. Poisson regression analysis revealed a positive correlation between recurrent FS and influenza A (P = .01).

Conclusions

Our study suggests a relation between recurrent FS and influenza A. Influenza vaccination should be considered in all children with a history of FS.

Section snippets

Methods

A febrile seizure was defined as a seizure during a febrile illness without other neurologic conditions (eg, intracranial infection, history of unprovoked seizures, or chronic anti-epileptic medication) occurring in children between the age of 3 months and 5 years.15 Single, generalized FS lasting for 15 minutes or less with full neurologic recovery within 24 hours was scored as simple FS. FS either with focal features or with recurrence within 24 hours or of long duration (>15 minutes) was

Results

The majority of GPs in Friesland (267 of 303; 88%) participated in the study. A total of 241 GPs (79%) returned 8 or more notification cards. A total of 54 GPs returned fewer than 8 cards. Among these were 26 GPs (number of cards: mean, 5.2; range, 3 to 7) who notified at least one case with an FS (mean, 2.4; range, 1 to 5).

The size of the population at risk (children between 3 months and 5 years of age) was approximately 45,000. After correction for GP nonparticipation, the study cohort had a

Discussion

With a total observation period of 160,000 patient-years, this is one of the larger population-based studies on FS. Its findings show that the yearly peaks of FS occurring in the winter are substantially associated with influenza A virus activity. There was no clear association with any of the other respiratory viruses. For RSV infections, which show similar seasonal variation and higher incidence rates, compared with influenza A, there was a clear mismatch with the occurrence of FS. This

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    Supported by a grant from the Scientific Committee of the Medical Center Leeuwarden, Leeuwarden, The Netherlands.

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