title: Incidence of Narcolepsy in Germany.
abstract: OBJECTIVE
  Following the 2009 pandemic, reports of an association between an AS03 adjuvanted H1N1 pandemic influenza vaccine and narcolepsy were published. Besides determining background incidence rates for narcolepsy in Germany this study aimed at investigating whether there was a change in incidence rates of narcolepsy between the pre-pandemic, pandemic, and the post-pandemic period on the population level.
  
  
  METHODS
  Retrospective epidemiological study on the incidence of narcolepsy with additional capture-recapture analysis.
  
  
  METHODS
  German sleep centers.
  
  
  METHODS
  Eligible were patients with an initial diagnosis of narcolepsy (ICD10 Code G47.4) within the period from January 1, 2007 to December 31, 2011.
  
  
  METHODS
  None; observational study.
  
  
  RESULTS
  A total of 342 sleep centers were invited to participate in the study. Adequate and suitable data were provided by 233 sleep centers (68.1%). A total of 1,198 patients with an initial diagnosis of narcolepsy within the observed period were included, of whom 106 (8.8%) were children and adolescents under the age of 18 years and 1,092 (91.2%) were adults. In children and adolescents, the age-standardized adjusted incidence rate significantly increased from 0.14/100,000 person-years in the pre-pandemic period to 0.50/100,000 person-years in the post-pandemic period (incidence density ratio, IDR 3.57; 95% CI 1.94-7.00). In adults, no significant change was detectable. This increase started in spring 2009.
  
  
  CONCLUSIONS
  For the years 2007-2011, valid estimates for the incidence of narcolepsy in Germany were provided. In individuals under 18, the incidence rates continuously increased from spring 2009.
authors.affiliation: Department Safety of Medicinal Products and Medical Devices, Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany.
authors.forename: Doris
authors.initials: D
authors.lastname: Oberle
authors.affiliation: Department Safety of Medicinal Products and Medical Devices, Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany.
authors.forename: Ursula
authors.initials: U
authors.lastname: Drechsel-Bäuerle
authors.affiliation: IMBEI Institute of Medical Biometry, Epidemiology and Informatics, Johannes Gutenberg University of Mainz, Germany.
authors.forename: Irene
authors.initials: I
authors.lastname: Schmidtmann
authors.affiliation: Hephata-Klinik, Schwalmstadt-Treysa, Germany.
authors.forename: Geert
authors.initials: G
authors.lastname: Mayer
authors.affiliation: Department Safety of Medicinal Products and Medical Devices, Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Keller-Stanislawski
mesh_terms: D000276:Adjuvants, Immunologic; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007252:Influenza Vaccines / Q000009:adverse effects* / Q000276:immunology*; D007251:Influenza, Human / Q000276:immunology* / Q000821:virology*; D008297:Male; D009290:Narcolepsy / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012621:Seasons; D012890:Sleep; D014611:Vaccination / Q000009:adverse effects / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D000276:Adjuvants, Immunologic; D007252:Influenza Vaccines
keywords: Germany; epidemiology; incidence; narcolepsy