An observational study of febrile seizures

The importance of viral infection and immunization

Joshua R. Francis, Peter Richmond, Christine Robins, Katie Lindsay, Avram Levy, Paul V. Effler, Meredith Borland, Christopher C. Blyth

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    Abstract

    Background: Febrile seizures are common in young children. Annual peaks in incidence mirror increased respiratory virus activity during winter. Limited virological data are available using modern diagnostic techniques for children with febrile seizures. We aimed to determine the frequency of detection of specific viral pathogens in children with febrile seizures, to describe risk factors including recent vaccination and clinical features associated with specific etiologies. 

    Methods: An observational study was performed. Children aged 6 months to 5 years presenting to the Emergency Department of a tertiary children's hospital in Western Australia with febrile seizures were enrolled between March 2012 and October 2013. Demographic, clinical data and vaccination history were collected, and virological testing was performed on per-nasal and per-rectal samples. 

    Results: One hundred fifty one patients (72 female; median age 1.7y; range 6 m-4y9m) were enrolled. Virological testing was completed for 143/151 (95%). At least one virus was detected in 102/143 patients (71%). The most commonly identified were rhinoviruses (31/143, 22%), adenovirus (30/151, 21%), enteroviruses, (28/143, 20%), influenza (19/143, 13%) and HHV6 (17/143, 12%). More than one virus was found in 48/143 (34%). No significant clinical differences were observed when children with a pathogen identified were compared with those with no pathogen detected. Febrile seizures occurred within 14 days of vaccine administration in 16/151 (11%). 

    Conclusion: At least one virus was detected in over two thirds of cases tested (commonly picornaviruses, adenovirus and influenza). Viral co-infections were frequently identified. Febrile seizures occurred infrequently following immunization.

    Original languageEnglish
    Article number202
    Pages (from-to)1-6
    Number of pages6
    JournalBMC Pediatrics
    Volume16
    Issue number1
    DOIs
    Publication statusPublished - 3 Dec 2016

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    Febrile Seizures
    Virus Diseases
    Observational Studies
    Immunization
    Viruses
    Adenoviridae
    Human Influenza
    Vaccination
    Picornaviridae
    Human Herpesvirus 6
    Rhinovirus
    Western Australia
    Enterovirus
    Coinfection
    Nose
    Tertiary Care Centers
    Hospital Emergency Service
    Vaccines
    History
    Demography

    Cite this

    Francis, J. R., Richmond, P., Robins, C., Lindsay, K., Levy, A., Effler, P. V., ... Blyth, C. C. (2016). An observational study of febrile seizures: The importance of viral infection and immunization. BMC Pediatrics, 16(1), 1-6. [202]. https://doi.org/10.1186/s12887-016-0740-5
    Francis, Joshua R. ; Richmond, Peter ; Robins, Christine ; Lindsay, Katie ; Levy, Avram ; Effler, Paul V. ; Borland, Meredith ; Blyth, Christopher C. / An observational study of febrile seizures : The importance of viral infection and immunization. In: BMC Pediatrics. 2016 ; Vol. 16, No. 1. pp. 1-6.
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    title = "An observational study of febrile seizures: The importance of viral infection and immunization",
    abstract = "Background: Febrile seizures are common in young children. Annual peaks in incidence mirror increased respiratory virus activity during winter. Limited virological data are available using modern diagnostic techniques for children with febrile seizures. We aimed to determine the frequency of detection of specific viral pathogens in children with febrile seizures, to describe risk factors including recent vaccination and clinical features associated with specific etiologies. Methods: An observational study was performed. Children aged 6 months to 5 years presenting to the Emergency Department of a tertiary children's hospital in Western Australia with febrile seizures were enrolled between March 2012 and October 2013. Demographic, clinical data and vaccination history were collected, and virological testing was performed on per-nasal and per-rectal samples. Results: One hundred fifty one patients (72 female; median age 1.7y; range 6 m-4y9m) were enrolled. Virological testing was completed for 143/151 (95{\%}). At least one virus was detected in 102/143 patients (71{\%}). The most commonly identified were rhinoviruses (31/143, 22{\%}), adenovirus (30/151, 21{\%}), enteroviruses, (28/143, 20{\%}), influenza (19/143, 13{\%}) and HHV6 (17/143, 12{\%}). More than one virus was found in 48/143 (34{\%}). No significant clinical differences were observed when children with a pathogen identified were compared with those with no pathogen detected. Febrile seizures occurred within 14 days of vaccine administration in 16/151 (11{\%}). Conclusion: At least one virus was detected in over two thirds of cases tested (commonly picornaviruses, adenovirus and influenza). Viral co-infections were frequently identified. Febrile seizures occurred infrequently following immunization.",
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    author = "Francis, {Joshua R.} and Peter Richmond and Christine Robins and Katie Lindsay and Avram Levy and Effler, {Paul V.} and Meredith Borland and Blyth, {Christopher C.}",
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    Francis, JR, Richmond, P, Robins, C, Lindsay, K, Levy, A, Effler, PV, Borland, M & Blyth, CC 2016, 'An observational study of febrile seizures: The importance of viral infection and immunization', BMC Pediatrics, vol. 16, no. 1, 202, pp. 1-6. https://doi.org/10.1186/s12887-016-0740-5

    An observational study of febrile seizures : The importance of viral infection and immunization. / Francis, Joshua R.; Richmond, Peter; Robins, Christine; Lindsay, Katie; Levy, Avram; Effler, Paul V.; Borland, Meredith; Blyth, Christopher C.

    In: BMC Pediatrics, Vol. 16, No. 1, 202, 03.12.2016, p. 1-6.

    Research output: Contribution to journalArticleResearchpeer-review

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    T2 - The importance of viral infection and immunization

    AU - Francis, Joshua R.

    AU - Richmond, Peter

    AU - Robins, Christine

    AU - Lindsay, Katie

    AU - Levy, Avram

    AU - Effler, Paul V.

    AU - Borland, Meredith

    AU - Blyth, Christopher C.

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    N2 - Background: Febrile seizures are common in young children. Annual peaks in incidence mirror increased respiratory virus activity during winter. Limited virological data are available using modern diagnostic techniques for children with febrile seizures. We aimed to determine the frequency of detection of specific viral pathogens in children with febrile seizures, to describe risk factors including recent vaccination and clinical features associated with specific etiologies. Methods: An observational study was performed. Children aged 6 months to 5 years presenting to the Emergency Department of a tertiary children's hospital in Western Australia with febrile seizures were enrolled between March 2012 and October 2013. Demographic, clinical data and vaccination history were collected, and virological testing was performed on per-nasal and per-rectal samples. Results: One hundred fifty one patients (72 female; median age 1.7y; range 6 m-4y9m) were enrolled. Virological testing was completed for 143/151 (95%). At least one virus was detected in 102/143 patients (71%). The most commonly identified were rhinoviruses (31/143, 22%), adenovirus (30/151, 21%), enteroviruses, (28/143, 20%), influenza (19/143, 13%) and HHV6 (17/143, 12%). More than one virus was found in 48/143 (34%). No significant clinical differences were observed when children with a pathogen identified were compared with those with no pathogen detected. Febrile seizures occurred within 14 days of vaccine administration in 16/151 (11%). Conclusion: At least one virus was detected in over two thirds of cases tested (commonly picornaviruses, adenovirus and influenza). Viral co-infections were frequently identified. Febrile seizures occurred infrequently following immunization.

    AB - Background: Febrile seizures are common in young children. Annual peaks in incidence mirror increased respiratory virus activity during winter. Limited virological data are available using modern diagnostic techniques for children with febrile seizures. We aimed to determine the frequency of detection of specific viral pathogens in children with febrile seizures, to describe risk factors including recent vaccination and clinical features associated with specific etiologies. Methods: An observational study was performed. Children aged 6 months to 5 years presenting to the Emergency Department of a tertiary children's hospital in Western Australia with febrile seizures were enrolled between March 2012 and October 2013. Demographic, clinical data and vaccination history were collected, and virological testing was performed on per-nasal and per-rectal samples. Results: One hundred fifty one patients (72 female; median age 1.7y; range 6 m-4y9m) were enrolled. Virological testing was completed for 143/151 (95%). At least one virus was detected in 102/143 patients (71%). The most commonly identified were rhinoviruses (31/143, 22%), adenovirus (30/151, 21%), enteroviruses, (28/143, 20%), influenza (19/143, 13%) and HHV6 (17/143, 12%). More than one virus was found in 48/143 (34%). No significant clinical differences were observed when children with a pathogen identified were compared with those with no pathogen detected. Febrile seizures occurred within 14 days of vaccine administration in 16/151 (11%). Conclusion: At least one virus was detected in over two thirds of cases tested (commonly picornaviruses, adenovirus and influenza). Viral co-infections were frequently identified. Febrile seizures occurred infrequently following immunization.

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    KW - Enterovirus

    KW - Febrile seizures

    KW - Immunization

    KW - Influenza

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    Francis JR, Richmond P, Robins C, Lindsay K, Levy A, Effler PV et al. An observational study of febrile seizures: The importance of viral infection and immunization. BMC Pediatrics. 2016 Dec 3;16(1):1-6. 202. https://doi.org/10.1186/s12887-016-0740-5