Pandemic H1N1 Vaccination and Incidence of Acute Disseminated Encephalomyelitis in Manitoba.
Identifieur interne : 000134 ( Main/Exploration ); précédent : 000133; suivant : 000135Pandemic H1N1 Vaccination and Incidence of Acute Disseminated Encephalomyelitis in Manitoba.
Auteurs : Alan C. Jackson [Canada] ; Luiz C. Mostaço-Guidolin [Canada] ; Hasantha Sinnock [Canada] ; Songul Bozat-Emre [Canada] ; Michael Routledge [Canada] ; Salaheddin M. Mahmud [Canada]Source :
- The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques [ 0317-1671 ] ; 2016.
Descripteurs français
- KwdFr :
- MESH :
- effets indésirables : Vaccins antigrippaux.
- immunologie : Sous-type H1N1 du virus de la grippe A.
- épidémiologie : Encéphalomyélite aigüe disséminée, Manitoba.
- Adolescent, Enfant, Femelle, Humains, Incidence, Mâle, Études longitudinales, Études rétrospectives.
English descriptors
- KwdEn :
- MESH :
- chemical , adverse effects : Influenza Vaccines.
- epidemiology : Encephalomyelitis, Acute Disseminated, Manitoba.
- immunology : Influenza A Virus, H1N1 Subtype.
- Adolescent, Child, Female, Humans, Incidence, Longitudinal Studies, Male, Retrospective Studies.
Abstract
BACKGROUND
An increased incidence of hospital admissions coded as acute disseminated encephalomyelitis (ADEM) was noted in Winnipeg, Manitoba, Canada, during the second wave of the influenza pandemic from October 2009 to March 2010. However, it was not clear whether this was due to heightened awareness of potential neurological complications of influenza or influenza vaccination or an actual increase in the number of cases.
METHODS
We extracted data from the charts of 139 patients hospitalized with an International Classification of Diseases-10 discharge code indicating ADEM (G04.0) or unspecified noninfectious encephalitis or myelitis (G04.8, G04.9) between January 2006 and December 2012. Clinical and laboratory data were reviewed by a neurologist, and diagnoses were determined using the Brighton criteria.
RESULTS
Over the entire study period, there were 22 cases of ADEM. During the peak pandemic period (April-December 2009), seven patients were hospitalized with ADEM, corresponding to a rate of 7.8/million/year; 4.7 (95% confidence interval: 1.9-11.4) times higher than the rate before or after the pandemic period. Only one patient with ADEM had received the monovalent A(H1N1)pdm09 vaccine within 12 weeks of hospitalization.
CONCLUSIONS
We have found an increased incidence of ADEM during the pandemic period that may be related, at least in part, to the increased incidence of influenza during that period. However, there was no temporal relationship with the administration of A(H1N1)pdm09 or seasonal influenza vaccines. Our study provides reassurance that use of these vaccines was not associated with increased risk of ADEM.
DOI: 10.1017/cjn.2016.291
PubMed: 27608932
Affiliations:
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Jackson</name><affiliation wicri:level="1"><nlm:affiliation>1Department of Internal Medicine (Neurology), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB,Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>1Department of Internal Medicine (Neurology), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB</wicri:regionArea><wicri:noRegion>MB</wicri:noRegion></affiliation></author><author><name sortKey="Mostaco Guidolin, Luiz C" sort="Mostaco Guidolin, Luiz C" uniqKey="Mostaco Guidolin L" first="Luiz C" last="Mostaço-Guidolin">Luiz C. Mostaço-Guidolin</name><affiliation wicri:level="1"><nlm:affiliation>3Department of Community Health Sciences (Vaccine and Drug Evaluation Centre), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB,Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>3Department of Community Health Sciences (Vaccine and Drug Evaluation Centre), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB</wicri:regionArea><wicri:noRegion>MB</wicri:noRegion></affiliation></author><author><name sortKey="Sinnock, Hasantha" sort="Sinnock, Hasantha" uniqKey="Sinnock H" first="Hasantha" last="Sinnock">Hasantha Sinnock</name><affiliation wicri:level="1"><nlm:affiliation>3Department of Community Health Sciences (Vaccine and Drug Evaluation Centre), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB,Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>3Department of Community Health Sciences (Vaccine and Drug Evaluation Centre), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB</wicri:regionArea><wicri:noRegion>MB</wicri:noRegion></affiliation></author><author><name sortKey="Bozat Emre, Songul" sort="Bozat Emre, Songul" uniqKey="Bozat Emre S" first="Songul" last="Bozat-Emre">Songul Bozat-Emre</name><affiliation wicri:level="1"><nlm:affiliation>3Department of Community Health Sciences (Vaccine and Drug Evaluation Centre), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB,Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>3Department of Community Health Sciences (Vaccine and Drug Evaluation Centre), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB</wicri:regionArea><wicri:noRegion>MB</wicri:noRegion></affiliation></author><author><name sortKey="Routledge, Michael" sort="Routledge, Michael" uniqKey="Routledge M" first="Michael" last="Routledge">Michael Routledge</name><affiliation wicri:level="1"><nlm:affiliation>3Department of Community Health Sciences (Vaccine and Drug Evaluation Centre), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB,Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>3Department of Community Health Sciences (Vaccine and Drug Evaluation Centre), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB</wicri:regionArea><wicri:noRegion>MB</wicri:noRegion></affiliation></author><author><name sortKey="Mahmud, Salaheddin M" sort="Mahmud, Salaheddin M" uniqKey="Mahmud S" first="Salaheddin M" last="Mahmud">Salaheddin M. Mahmud</name><affiliation wicri:level="1"><nlm:affiliation>3Department of Community Health Sciences (Vaccine and Drug Evaluation Centre), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB,Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>3Department of Community Health Sciences (Vaccine and Drug Evaluation Centre), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB</wicri:regionArea><wicri:noRegion>MB</wicri:noRegion></affiliation></author></analytic><series><title level="j">The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques</title><idno type="ISSN">0317-1671</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Child</term><term>Encephalomyelitis, Acute Disseminated (epidemiology)</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Influenza A Virus, H1N1 Subtype (immunology)</term><term>Influenza Vaccines (adverse effects)</term><term>Longitudinal Studies</term><term>Male</term><term>Manitoba (epidemiology)</term><term>Retrospective Studies</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Encéphalomyélite aigüe disséminée (épidémiologie)</term><term>Enfant</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Manitoba (épidémiologie)</term><term>Mâle</term><term>Sous-type H1N1 du virus de la grippe A (immunologie)</term><term>Vaccins antigrippaux (effets indésirables)</term><term>Études longitudinales</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Vaccins antigrippaux</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Encephalomyelitis, Acute Disseminated</term><term>Manitoba</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Sous-type H1N1 du virus de la grippe A</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Influenza A Virus, H1N1 Subtype</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Encéphalomyélite aigüe disséminée</term><term>Manitoba</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Child</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Longitudinal Studies</term><term>Male</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Enfant</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Mâle</term><term>Études longitudinales</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>An increased incidence of hospital admissions coded as acute disseminated encephalomyelitis (ADEM) was noted in Winnipeg, Manitoba, Canada, during the second wave of the influenza pandemic from October 2009 to March 2010. However, it was not clear whether this was due to heightened awareness of potential neurological complications of influenza or influenza vaccination or an actual increase in the number of cases.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We extracted data from the charts of 139 patients hospitalized with an International Classification of Diseases-10 discharge code indicating ADEM (G04.0) or unspecified noninfectious encephalitis or myelitis (G04.8, G04.9) between January 2006 and December 2012. Clinical and laboratory data were reviewed by a neurologist, and diagnoses were determined using the Brighton criteria.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Over the entire study period, there were 22 cases of ADEM. During the peak pandemic period (April-December 2009), seven patients were hospitalized with ADEM, corresponding to a rate of 7.8/million/year; 4.7 (95% confidence interval: 1.9-11.4) times higher than the rate before or after the pandemic period. Only one patient with ADEM had received the monovalent A(H1N1)pdm09 vaccine within 12 weeks of hospitalization.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>We have found an increased incidence of ADEM during the pandemic period that may be related, at least in part, to the increased incidence of influenza during that period. However, there was no temporal relationship with the administration of A(H1N1)pdm09 or seasonal influenza vaccines. Our study provides reassurance that use of these vaccines was not associated with increased risk of ADEM.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27608932</PMID><DateCompleted><Year>2017</Year><Month>02</Month><Day>21</Day></DateCompleted><DateRevised><Year>2017</Year><Month>08</Month><Day>17</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">0317-1671</ISSN><JournalIssue CitedMedium="Internet"><Volume>43</Volume><Issue>6</Issue><PubDate><Year>2016</Year><Month>Nov</Month></PubDate></JournalIssue><Title>The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques</Title><ISOAbbreviation>Can J Neurol Sci</ISOAbbreviation></Journal><ArticleTitle>Pandemic H1N1 Vaccination and Incidence of Acute Disseminated Encephalomyelitis in Manitoba.</ArticleTitle><Pagination><MedlinePgn>819-823</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">An increased incidence of hospital admissions coded as acute disseminated encephalomyelitis (ADEM) was noted in Winnipeg, Manitoba, Canada, during the second wave of the influenza pandemic from October 2009 to March 2010. However, it was not clear whether this was due to heightened awareness of potential neurological complications of influenza or influenza vaccination or an actual increase in the number of cases.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We extracted data from the charts of 139 patients hospitalized with an International Classification of Diseases-10 discharge code indicating ADEM (G04.0) or unspecified noninfectious encephalitis or myelitis (G04.8, G04.9) between January 2006 and December 2012. Clinical and laboratory data were reviewed by a neurologist, and diagnoses were determined using the Brighton criteria.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Over the entire study period, there were 22 cases of ADEM. During the peak pandemic period (April-December 2009), seven patients were hospitalized with ADEM, corresponding to a rate of 7.8/million/year; 4.7 (95% confidence interval: 1.9-11.4) times higher than the rate before or after the pandemic period. Only one patient with ADEM had received the monovalent A(H1N1)pdm09 vaccine within 12 weeks of hospitalization.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">We have found an increased incidence of ADEM during the pandemic period that may be related, at least in part, to the increased incidence of influenza during that period. However, there was no temporal relationship with the administration of A(H1N1)pdm09 or seasonal influenza vaccines. Our study provides reassurance that use of these vaccines was not associated with increased risk of ADEM.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Jackson</LastName><ForeName>Alan C</ForeName><Initials>AC</Initials><AffiliationInfo><Affiliation>1Department of Internal Medicine (Neurology), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB,Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mostaço-Guidolin</LastName><ForeName>Luiz C</ForeName><Initials>LC</Initials><AffiliationInfo><Affiliation>3Department of Community Health Sciences (Vaccine and Drug Evaluation Centre), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB,Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sinnock</LastName><ForeName>Hasantha</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>3Department of Community Health Sciences (Vaccine and Drug Evaluation Centre), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB,Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bozat-Emre</LastName><ForeName>Songul</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>3Department of Community Health Sciences (Vaccine and Drug Evaluation Centre), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB,Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Routledge</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>3Department of Community Health Sciences (Vaccine and Drug Evaluation Centre), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB,Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mahmud</LastName><ForeName>Salaheddin M</ForeName><Initials>SM</Initials><AffiliationInfo><Affiliation>3Department of Community Health Sciences (Vaccine and Drug Evaluation Centre), Faculty of Health Sciences,University of Manitoba,Winnipeg,MB,Canada.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>09</Month><Day>09</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Can J Neurol Sci</MedlineTA><NlmUniqueID>0415227</NlmUniqueID><ISSNLinking>0317-1671</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007252">Influenza Vaccines</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004673" MajorTopicYN="N">Encephalomyelitis, Acute Disseminated</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053118" MajorTopicYN="N">Influenza A Virus, H1N1 Subtype</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="Y">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007252" MajorTopicYN="N">Influenza Vaccines</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008137" MajorTopicYN="N">Longitudinal Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008350" MajorTopicYN="N">Manitoba</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">A (H1N1) pdm09 vaccine</Keyword><Keyword MajorTopicYN="N">Encephalomyelitis</Keyword><Keyword MajorTopicYN="N">Epidemiology</Keyword><Keyword MajorTopicYN="N">Influenza</Keyword><Keyword MajorTopicYN="N">Vaccine</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>9</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>2</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>9</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">27608932</ArticleId><ArticleId IdType="pii">S0317167116002912</ArticleId><ArticleId IdType="doi">10.1017/cjn.2016.291</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Canada</li></country></list><tree><country name="Canada"><noRegion><name sortKey="Jackson, Alan C" sort="Jackson, Alan C" uniqKey="Jackson A" first="Alan C" last="Jackson">Alan C. Jackson</name></noRegion><name sortKey="Bozat Emre, Songul" sort="Bozat Emre, Songul" uniqKey="Bozat Emre S" first="Songul" last="Bozat-Emre">Songul Bozat-Emre</name><name sortKey="Mahmud, Salaheddin M" sort="Mahmud, Salaheddin M" uniqKey="Mahmud S" first="Salaheddin M" last="Mahmud">Salaheddin M. Mahmud</name><name sortKey="Mostaco Guidolin, Luiz C" sort="Mostaco Guidolin, Luiz C" uniqKey="Mostaco Guidolin L" first="Luiz C" last="Mostaço-Guidolin">Luiz C. Mostaço-Guidolin</name><name sortKey="Routledge, Michael" sort="Routledge, Michael" uniqKey="Routledge M" first="Michael" last="Routledge">Michael Routledge</name><name sortKey="Sinnock, Hasantha" sort="Sinnock, Hasantha" uniqKey="Sinnock H" first="Hasantha" last="Sinnock">Hasantha Sinnock</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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