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

Research Article

David J Muscatello¹  Benjamin G Polkinghorne²  Siranda Torvaldsen³  C Raina MacIntyre³  Glenda L Lawrence³  Paul M Middleton⁴ 

[1] Centre for Epidemiology and Research, New South Wales Ministry of Health, (Miller Street), (2059), North Sydney, Australia;School of Public Health and Community Medicine, The University of New South Wales, (High Street), (2031), Randwick, Australia;Public Health Officer Training Program, New South Wales Ministry of Health, (Miller Street), (2059), North Sydney, Australia;School of Public Health and Community Medicine, The University of New South Wales, (High Street), (2031), Randwick, Australia;School of Public Health and Community Medicine, The University of New South Wales, (High Street), (2031), Randwick, Australia;School of Public Health and Community Medicine, The University of New South Wales, (High Street), (2031), Randwick, Australia;Ambulance Research Institute, Ambulance Service of New South Wales, (Church Street), (2039), Rozelle, Australia;

关键词: Influenza;    Emergency Department;    Respiratory Syncytial Virus;    Bronchiolitis;    Western Australia;   

DOI  :  10.1186/1471-2334-11-291

 received in 2011-02-14, accepted in 2011-10-26,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundIn 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.MethodsUsing 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.ResultsDuring 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.ConclusionsInfluenza 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.

【 授权许可】

CC BY   
© Polkinghorne et al; licensee BioMed Central Ltd. 2011