Clinical characteristics of neurological manifestations in influenza-A (H1N1) among children in a tertiary care hospital, South India, during 2019

Abstract

Objective: The objective of the study was to study the neurological manifestations of influenza-A in children. Materials and Methods: This retrospective study was conducted in a tertiary care hospital in South India during the seasonal epidemic of flu in 2019. All children aged 1 month–12 years with evidence of neurological manifestations and positive nasopharyngeal swab for influenza A were evaluated for the clinical features, treatment, and outcome. Results: Sixteen patients had neurological manifestations and 44% of them were <2 years of age. The most common manifestations in this cohort was altered sensorium (87.5%) followed by seizures (62.5%). Fourteen patients developed symptoms within 5 days of onset. Only two children had cerebrospinal fluid pleocytosis and five children had abnormal neuroimaging findings. Intensive care management was required for 81% of children and the cause specific mortality was 18.75%. Conclusion: Neurological manifestation in influenza-A should be considered in children during epidemics and intensive care management can go a long way in improving the survival rates.