New 2013 incidence peak in childhood narcolepsy: more than vaccination?
Details
Serval ID
serval:BIB_DB08359CE91B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
New 2013 incidence peak in childhood narcolepsy: more than vaccination?
Journal
Sleep
ISSN
1550-9109 (Electronic)
ISSN-L
0161-8105
Publication state
Published
Issued date
12/02/2021
Peer-reviewed
Oui
Volume
44
Number
2
Pages
zsaa172
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
Increased incidence rates of narcolepsy type-1 (NT1) have been reported worldwide after the 2009-2010 H1N1 influenza pandemic (pH1N1). While some European countries found an association between the NT1 incidence increase and the H1N1 vaccination Pandemrix, reports from Asian countries suggested the H1N1 virus itself to be linked to the increased NT1 incidence. Using robust data-driven modeling approaches, that is, locally estimated scatterplot smoothing methods, we analyzed the number of de novo NT1 cases (n = 508) in the last two decades using the European Narcolepsy Network database. We confirmed the peak of NT1 incidence in 2010, that is, 2.54-fold (95% confidence interval [CI]: [2.11, 3.19]) increase in NT1 onset following 2009-2010 pH1N1. This peak in 2010 was found in both childhood NT1 (2.75-fold increase, 95% CI: [1.95, 4.69]) and adulthood NT1 (2.43-fold increase, 95% CI: [2.05, 2.97]). In addition, we identified a new peak in 2013 that is age-specific for children/adolescents (i.e. 2.09-fold increase, 95% CI: [1.52, 3.32]). Most of these children/adolescents were HLA DQB1*06:02 positive and showed a subacute disease onset consistent with an immune-mediated type of narcolepsy. The new 2013 incidence peak is likely not related to Pandemrix as it was not used after 2010. Our results suggest that the increased NT1 incidence after 2009-2010 pH1N1 is not unique and our study provides an opportunity to develop new hypotheses, for example, considering other (influenza) viruses or epidemiological events to further investigate the pathophysiology of immune-mediated narcolepsy.
Keywords
Adolescent, Adult, Asia, Child, Europe, Humans, Incidence, Influenza A Virus, H1N1 Subtype, Influenza Vaccines, Influenza, Human/epidemiology, Influenza, Human/prevention & control, Narcolepsy/epidemiology, Narcolepsy/etiology, Vaccination, H1N1 influenza, childhood narcolepsy, narcolepsy
Pubmed
Web of science
Create date
19/09/2020 14:20
Last modification date
16/11/2021 6:39