Skip to main content
Top
Published in: BMC Pediatrics 1/2016

Open Access 01-12-2016 | Research article

An observational study of febrile seizures: the importance of viral infection and immunization

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

Published in: BMC Pediatrics | Issue 1/2016

Login to get access

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.
Literature
1.
go back to reference Graves RC, Oehler K, Tingle LE. Febrile seizures: risks, evaluation, and prognosis. Am Fam Physician. 2012;85(2):149–53. Epub 2012/02/18.PubMed Graves RC, Oehler K, Tingle LE. Febrile seizures: risks, evaluation, and prognosis. Am Fam Physician. 2012;85(2):149–53. Epub 2012/02/18.PubMed
3.
go back to reference Manfredini R, Vergine G, Boari B, Faggioli R, Borgna-Pignatti C. Circadian and seasonal variation of first febrile seizures. J Pediatr. 2004;145(6):838–9. Epub 2004/12/08.CrossRefPubMed Manfredini R, Vergine G, Boari B, Faggioli R, Borgna-Pignatti C. Circadian and seasonal variation of first febrile seizures. J Pediatr. 2004;145(6):838–9. Epub 2004/12/08.CrossRefPubMed
4.
go back to reference Millichap JG, Millichap JJ. Role of viral infections in the etiology of febrile seizures. Pediatr Neurol. 2006;35(3):165–72. Epub 2006/08/31.CrossRefPubMed Millichap JG, Millichap JJ. Role of viral infections in the etiology of febrile seizures. Pediatr Neurol. 2006;35(3):165–72. Epub 2006/08/31.CrossRefPubMed
5.
6.
7.
go back to reference Landau YE, Grisaru-Soen G, Reif S, Fattal-Valevski A. Pediatric Neurologic Complications Associated With Influenza A H1N1. Pediatr Neurol. 2011;44(1):47–51. Epub 2010/12/15.CrossRefPubMed Landau YE, Grisaru-Soen G, Reif S, Fattal-Valevski A. Pediatric Neurologic Complications Associated With Influenza A H1N1. Pediatr Neurol. 2011;44(1):47–51. Epub 2010/12/15.CrossRefPubMed
8.
go back to reference Chiu SS, Tse CY, Lau YL, Peiris M. Influenza A infection is an important cause of febrile seizures. Pediatrics. 2001;108(4):E63. Epub 2001/10/03.CrossRefPubMed Chiu SS, Tse CY, Lau YL, Peiris M. Influenza A infection is an important cause of febrile seizures. Pediatrics. 2001;108(4):E63. Epub 2001/10/03.CrossRefPubMed
9.
go back to reference Millichap JG, Millichap JJ. Influenza virus and febrile convulsions. J Infect Dis. 2004;189(3):564. author reply −5. Epub 2004/01/28.CrossRefPubMed Millichap JG, Millichap JJ. Influenza virus and febrile convulsions. J Infect Dis. 2004;189(3):564. author reply −5. Epub 2004/01/28.CrossRefPubMed
10.
go back to reference Barlow WE, Davis RL, Glasser JW, Rhodes PH, Thompson RS, Mullooly JP, et al. The risk of seizures after receipt of whole-cell pertussis or measles, mumps, and rubella vaccine. N Engl J Med. 2001;345(9):656–61. Epub 2001/09/08.CrossRefPubMed Barlow WE, Davis RL, Glasser JW, Rhodes PH, Thompson RS, Mullooly JP, et al. The risk of seizures after receipt of whole-cell pertussis or measles, mumps, and rubella vaccine. N Engl J Med. 2001;345(9):656–61. Epub 2001/09/08.CrossRefPubMed
11.
go back to reference Sun Y, Christensen J, Hviid A, Li J, Vedsted P, Olsen J, et al. Risk of febrile seizures and epilepsy after vaccination with diphtheria, tetanus, acellular pertussis, inactivated poliovirus, and Haemophilus influenzae type B. JAMA. 2012;307(8):823–31. Epub 2012/02/24.CrossRefPubMed Sun Y, Christensen J, Hviid A, Li J, Vedsted P, Olsen J, et al. Risk of febrile seizures and epilepsy after vaccination with diphtheria, tetanus, acellular pertussis, inactivated poliovirus, and Haemophilus influenzae type B. JAMA. 2012;307(8):823–31. Epub 2012/02/24.CrossRefPubMed
12.
go back to reference Hambidge SJ, Newcomer SR, Narwaney KJ, Glanz JM, Daley MF, Xu S, et al. Timely versus delayed early childhood vaccination and seizures. Pediatrics. 2014;133(6):e1492–9. Epub 2014/05/21.CrossRefPubMed Hambidge SJ, Newcomer SR, Narwaney KJ, Glanz JM, Daley MF, Xu S, et al. Timely versus delayed early childhood vaccination and seizures. Pediatrics. 2014;133(6):e1492–9. Epub 2014/05/21.CrossRefPubMed
13.
go back to reference Klein NP, Fireman B, Yih WK, Lewis E, Kulldorff M, Ray P, et al. Measles-mumps-rubella-varicella combination vaccine and the risk of febrile seizures. Pediatrics. 2010;126(1):e1–8. Epub 2010/07/01.CrossRefPubMed Klein NP, Fireman B, Yih WK, Lewis E, Kulldorff M, Ray P, et al. Measles-mumps-rubella-varicella combination vaccine and the risk of febrile seizures. Pediatrics. 2010;126(1):e1–8. Epub 2010/07/01.CrossRefPubMed
14.
go back to reference Demicheli V, Rivetti A, Debalini MG, Di Pietrantonj C. Vaccines for measles, mumps and rubella in children. Cochrane Database Syst Rev. 2012;2:CD004407. Epub 2012/02/18. Demicheli V, Rivetti A, Debalini MG, Di Pietrantonj C. Vaccines for measles, mumps and rubella in children. Cochrane Database Syst Rev. 2012;2:CD004407. Epub 2012/02/18.
15.
go back to reference Klein NP, Lewis E, Fireman B, Hambidge SJ, Naleway A, Nelson JC, et al. Safety of measles-containing vaccines in 1-year-old children. Pediatrics. 2015;135(2):e321–9. Epub 2015/01/07.CrossRefPubMed Klein NP, Lewis E, Fireman B, Hambidge SJ, Naleway A, Nelson JC, et al. Safety of measles-containing vaccines in 1-year-old children. Pediatrics. 2015;135(2):e321–9. Epub 2015/01/07.CrossRefPubMed
16.
go back to reference Macartney KK, Gidding HF, Trinh L, Wang H, McRae J, Crawford N, et al. Febrile seizures following measles and varicella vaccines in young children in Australia. Vaccine. 2015;33(11):1412–7. Epub 2014/12/03.CrossRefPubMed Macartney KK, Gidding HF, Trinh L, Wang H, McRae J, Crawford N, et al. Febrile seizures following measles and varicella vaccines in young children in Australia. Vaccine. 2015;33(11):1412–7. Epub 2014/12/03.CrossRefPubMed
17.
go back to reference Blyth CC, Currie AJ, Wiertsema SP, Conway N, Kirkham LA, Fuery A, et al. Trivalent influenza vaccine and febrile adverse events in Australia, Clinical features and potential mechanisms. Vaccine. 2010;2011. Epub 2011/06/07. Blyth CC, Currie AJ, Wiertsema SP, Conway N, Kirkham LA, Fuery A, et al. Trivalent influenza vaccine and febrile adverse events in Australia, Clinical features and potential mechanisms. Vaccine. 2010;2011. Epub 2011/06/07.
18.
go back to reference Bonhoeffer J, Menkes J, Gold MS, de Souza-Brito G, Fisher MC, Halsey N, et al. Generalized convulsive seizure as an adverse event following immunization: case definition and guidelines for data collection, analysis, and presentation. Vaccine. 2004;22(5–6):557–62. Epub 2004/01/27.CrossRefPubMed Bonhoeffer J, Menkes J, Gold MS, de Souza-Brito G, Fisher MC, Halsey N, et al. Generalized convulsive seizure as an adverse event following immunization: case definition and guidelines for data collection, analysis, and presentation. Vaccine. 2004;22(5–6):557–62. Epub 2004/01/27.CrossRefPubMed
19.
go back to reference Chidlow G, Harnett G, Williams S, Levy A, Speers D, Smith DW. Duplex real-time reverse transcriptase PCR assays for rapid detection and identification of pandemic (H1N1) 2009 and seasonal influenza A/H1, A/H3, and B viruses. J Clin Microbiol. 2010;48(3):862–6. Epub 2010/01/15.CrossRefPubMedPubMedCentral Chidlow G, Harnett G, Williams S, Levy A, Speers D, Smith DW. Duplex real-time reverse transcriptase PCR assays for rapid detection and identification of pandemic (H1N1) 2009 and seasonal influenza A/H1, A/H3, and B viruses. J Clin Microbiol. 2010;48(3):862–6. Epub 2010/01/15.CrossRefPubMedPubMedCentral
20.
go back to reference Chidlow GR, Harnett GB, Shellam GR, Smith DW. An economical tandem multiplex real-time PCR technique for the detection of a comprehensive range of respiratory pathogens. Viruses. 2009;1(1):42–56. Epub 2009/06/01.CrossRefPubMedPubMedCentral Chidlow GR, Harnett GB, Shellam GR, Smith DW. An economical tandem multiplex real-time PCR technique for the detection of a comprehensive range of respiratory pathogens. Viruses. 2009;1(1):42–56. Epub 2009/06/01.CrossRefPubMedPubMedCentral
21.
go back to reference Hyypia T, Auvinen P, Maaronen M. Polymerase chain reaction for human picornaviruses. J Gen Virol. 1989;70(Pt 12):3261–8. Epub 1989/12/01.CrossRefPubMed Hyypia T, Auvinen P, Maaronen M. Polymerase chain reaction for human picornaviruses. J Gen Virol. 1989;70(Pt 12):3261–8. Epub 1989/12/01.CrossRefPubMed
22.
go back to reference Ireland DC, Kent J, Nicholson KG. Improved detection of rhinoviruses in nasal and throat swabs by seminested RT-PCR. J Med Virol. 1993;40(2):96–101. Epub 1993/06/01.CrossRefPubMed Ireland DC, Kent J, Nicholson KG. Improved detection of rhinoviruses in nasal and throat swabs by seminested RT-PCR. J Med Virol. 1993;40(2):96–101. Epub 1993/06/01.CrossRefPubMed
23.
go back to reference Grinde B, Jonassen TO, Ushijima H. Sensitive detection of group A rotaviruses by immunomagnetic separation and reverse transcription-polymerase chain reaction. J Virol Methods. 1995;55(3):327–38. Epub 1995/11/01.CrossRefPubMed Grinde B, Jonassen TO, Ushijima H. Sensitive detection of group A rotaviruses by immunomagnetic separation and reverse transcription-polymerase chain reaction. J Virol Methods. 1995;55(3):327–38. Epub 1995/11/01.CrossRefPubMed
24.
go back to reference Dawood FS, Chaves SS, Perez A, Reingold A, Meek J, Farley MM, et al. Complications and associated bacterial coinfections among children hospitalized with seasonal or pandemic influenza, United States, 2003–2010. J Infect Dis. 2014;209(5):686–94. Epub 2013/08/30.CrossRefPubMed Dawood FS, Chaves SS, Perez A, Reingold A, Meek J, Farley MM, et al. Complications and associated bacterial coinfections among children hospitalized with seasonal or pandemic influenza, United States, 2003–2010. J Infect Dis. 2014;209(5):686–94. Epub 2013/08/30.CrossRefPubMed
25.
go back to reference Wood NJ, Blyth CC, Willis GA, Richmond P, Gold MS, Buttery JP, et al. The safety of seasonal influenza vaccines in Australian children in 2013. Med J Aust. 2014;201(10):596–600. Epub 2014/11/13.CrossRefPubMed Wood NJ, Blyth CC, Willis GA, Richmond P, Gold MS, Buttery JP, et al. The safety of seasonal influenza vaccines in Australian children in 2013. Med J Aust. 2014;201(10):596–600. Epub 2014/11/13.CrossRefPubMed
26.
go back to reference Wiertsema SP, Chidlow GR, Kirkham LA, Corscadden KJ, Mowe EN, Vijayasekaran S, et al. High detection rates of nucleic acids of a wide range of respiratory viruses in the nasopharynx and the middle ear of children with a history of recurrent acute otitis media. J Med Virol. 2011;83(11):2008–17. Epub 2011/09/15.CrossRefPubMed Wiertsema SP, Chidlow GR, Kirkham LA, Corscadden KJ, Mowe EN, Vijayasekaran S, et al. High detection rates of nucleic acids of a wide range of respiratory viruses in the nasopharynx and the middle ear of children with a history of recurrent acute otitis media. J Med Virol. 2011;83(11):2008–17. Epub 2011/09/15.CrossRefPubMed
27.
go back to reference Singleton RJ, Bulkow LR, Miernyk K, DeByle C, Pruitt L, Hummel KB, et al. Viral respiratory infections in hospitalized and community control children in Alaska. J Med Virol. 2010;82(7):1282–90. Epub 2010/06/01.CrossRefPubMed Singleton RJ, Bulkow LR, Miernyk K, DeByle C, Pruitt L, Hummel KB, et al. Viral respiratory infections in hospitalized and community control children in Alaska. J Med Virol. 2010;82(7):1282–90. Epub 2010/06/01.CrossRefPubMed
Metadata
Title
An observational study of febrile seizures: the importance of viral infection and immunization
Authors
Joshua R. Francis
Peter Richmond
Christine Robins
Katie Lindsay
Avram Levy
Paul V. Effler
Meredith Borland
Christopher C. Blyth
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2016
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-016-0740-5

Other articles of this Issue 1/2016

BMC Pediatrics 1/2016 Go to the issue