title: Neurologic disorders among pediatric deaths associated with the 2009 pandemic influenza.
abstract: OBJECTIVE
  The goal of this study was to describe reported influenza A (H1N1)pdm09 virus (pH1N1)-associated deaths in children with underlying neurologic disorders.
  
  
  METHODS
  The study compared demographic characteristics, clinical course, and location of death of pH1N1-associated deaths among children with and without underlying neurologic disorders reported to the Centers for Disease Control and Prevention.
  
  
  RESULTS
  Of 336 pH1N1-associated pediatric deaths with information on underlying conditions, 227 (68%) children had at least 1 underlying condition that conferred an increased risk of complications of influenza. Neurologic disorders were most frequently reported (146 of 227 [64%]), and, of those disorders, neurodevelopmental disorders such as cerebral palsy and intellectual disability were most common. Children with neurologic disorders were older (P = .02), had a significantly longer duration of illness from onset to death (P < .01), and were more likely to die in the hospital versus at home or in the emergency department (P < .01) compared with children without underlying medical conditions. Many children with neurologic disorders had additional risk factors for influenza-related complications, especially pulmonary disorders (48%). Children without underlying conditions were significantly more likely to have a positive result from a sterile-site bacterial culture than were those with an underlying neurologic disorder (P < .01).
  
  
  CONCLUSIONS
  Neurologic disorders were reported in nearly two-thirds of pH1N1-associated pediatric deaths with an underlying medical condition. Because of the potential for severe outcomes, children with underlying neurologic disorders should receive influenza vaccine and be treated early and aggressively if they develop influenza-like illness.
authors.affiliation: Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. lblanton@cdc.gov
authors.forename: Lenee
authors.initials: L
authors.lastname: Blanton
authors.forename: Georgina
authors.initials: G
authors.lastname: Peacock
authors.forename: Chad
authors.initials: C
authors.lastname: Cox
authors.forename: Michael
authors.initials: M
authors.lastname: Jhung
authors.forename: Lyn
authors.initials: L
authors.lastname: Finelli
authors.forename: Cynthia
authors.initials: C
authors.lastname: Moore
mesh_terms: D000293:Adolescent; D001424:Bacterial Infections / Q000150:complications; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications / Q000401:mortality*; D008297:Male; D009422:Nervous System Diseases / Q000150:complications*