Increased Incidence and Clinical Picture of Childhood Narcolepsy following the 2009 H1N1 Pandemic Vaccination Campaign in Finland
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{"title"=>"Increased incidence and clinical picture of childhood narcolepsy following the 2009 H1N1 pandemic vaccination campaign in Finland", "type"=>"journal", "authors"=>[{"first_name"=>"Markku", "last_name"=>"Partinen", "scopus_author_id"=>"7007114725"}, {"first_name"=>"Outi", "last_name"=>"Saarenpää-Heikkilä", "scopus_author_id"=>"6602558936"}, {"first_name"=>"Ismo", "last_name"=>"Ilveskoski", "scopus_author_id"=>"16739966700"}, {"first_name"=>"Christer", "last_name"=>"Hublin", "scopus_author_id"=>"8916476500"}, {"first_name"=>"Miika", "last_name"=>"Linna", "scopus_author_id"=>"7004060414"}, {"first_name"=>"Päivi", "last_name"=>"Olsén", "scopus_author_id"=>"7103247296"}, {"first_name"=>"Pekka", "last_name"=>"Nokelainen", "scopus_author_id"=>"6701650684"}, {"first_name"=>"Reija", "last_name"=>"Alén", "scopus_author_id"=>"16633369400"}, {"first_name"=>"Tiina", "last_name"=>"Wallden", "scopus_author_id"=>"6505851069"}, {"first_name"=>"Merimaaria", "last_name"=>"Espo", "scopus_author_id"=>"6507068773"}, {"first_name"=>"Harri", "last_name"=>"Rusanen", "scopus_author_id"=>"6603243079"}, {"first_name"=>"Jan", "last_name"=>"Olme", "scopus_author_id"=>"55151320500"}, {"first_name"=>"Heli", "last_name"=>"Sätilä", "scopus_author_id"=>"8397532100"}, {"first_name"=>"Harri", "last_name"=>"Arikka", "scopus_author_id"=>"36704385400"}, {"first_name"=>"Pekka", "last_name"=>"Kaipainen", "scopus_author_id"=>"6506527127"}, {"first_name"=>"Ilkka", "last_name"=>"Julkunen", "scopus_author_id"=>"7006355527"}, {"first_name"=>"Turkka", "last_name"=>"Kirjavainen", "scopus_author_id"=>"6701372638"}], "year"=>2012, "source"=>"PLoS ONE", "identifiers"=>{"scopus"=>"2-s2.0-84859027226", "sgr"=>"84859027226", "issn"=>"19326203", "doi"=>"10.1371/journal.pone.0033723", "pmid"=>"22470463", "isbn"=>"1932-6203", "pui"=>"364528368"}, "id"=>"c54d68e0-6f90-35b1-b7f1-325880bacd1a", "abstract"=>"BACKGROUND Narcolepsy is a rare neurological sleep disorder especially in children who are younger than 10 years. In the beginning of 2010, an exceptionally large number of Finnish children suffered from an abrupt onset of excessive daytime sleepiness (EDS) and cataplexy. Therefore, we carried out a systematic analysis of the incidence of narcolepsy in Finland between the years 2002-2010. METHODS All Finnish hospitals and sleep clinics were contacted to find out the incidence of narcolepsy in 2010. The national hospital discharge register from 2002 to 2009 was used as a reference. FINDINGS Altogether 335 cases (all ages) of narcolepsy were diagnosed in Finland during 2002-2009 giving an annual incidence of 0.79 per 100,000 inhabitants (95% confidence interval 0.62-0.96). The average annual incidence among subjects under 17 years of age was 0.31 (0.12-0.51) per 100,000 inhabitants. In 2010, 54 children under age 17 were diagnosed with narcolepsy (5.3/100,000; 17-fold increase). Among adults ≥20 years of age the incidence rate in 2010 was 0.87/100,000, which equals that in 2002-2009. Thirty-four of the 54 children were HLA-typed, and they were all positive for narcolepsy risk allele DQB1*0602/DRB1*15. 50/54 children had received Pandemrix vaccination 0 to 242 days (median 42) before onset. All 50 had EDS with abnormal multiple sleep latency test (sleep latency <8 min and ≥2 sleep onset REM periods). The symptoms started abruptly. Forty-seven (94%) had cataplexy, which started at the same time or soon after the onset of EDS. Psychiatric symptoms were common. Otherwise the clinical picture was similar to that described in childhood narcolepsy. INTERPRETATION A sudden increase in the incidence of abrupt childhood narcolepsy was observed in Finland in 2010. We consider it likely that Pandemrix vaccination contributed, perhaps together with other environmental factors, to this increase in genetically susceptible children.", "link"=>"http://www.mendeley.com/research/increased-incidence-clinical-picture-childhood-narcolepsy-following-2009-h1n1-pandemic-vaccination-c", "reader_count"=>92, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Professor > Associate Professor"=>4, "Researcher"=>20, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>16, "Student > Postgraduate"=>6, "Student > Master"=>9, "Other"=>9, "Student > Bachelor"=>16, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>2, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>3, "Professor > Associate Professor"=>4, "Researcher"=>20, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>16, "Student > Postgraduate"=>6, "Student > Master"=>9, "Other"=>9, "Student > Bachelor"=>16, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>2, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>11, "Biochemistry, Genetics and Molecular Biology"=>4, "Agricultural and Biological Sciences"=>18, "Medicine and Dentistry"=>34, "Philosophy"=>1, "Neuroscience"=>3, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Psychology"=>8, "Social Sciences"=>3, "Computer Science"=>1, "Immunology and Microbiology"=>7, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>34}, "Neuroscience"=>{"Neuroscience"=>3}, "Social Sciences"=>{"Social Sciences"=>3}, "Psychology"=>{"Psychology"=>8}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>7}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>18}, "Computer Science"=>{"Computer Science"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>4}, "Unspecified"=>{"Unspecified"=>11}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}, "Philosophy"=>{"Philosophy"=>1}}, "reader_count_by_country"=>{"United States"=>3, "Denmark"=>1, "United Kingdom"=>1, "Germany"=>1, "Spain"=>1}, "group_count"=>5}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/662316"], "description"=>"<p>Number of new diagnoses of narcolepsy among adults aged 20 years or more by year of diagnosis.</p>", "links"=>[], "tags"=>["diagnoses", "narcolepsy", "adults", "aged", "20", "years"], "article_id"=>332784, "categories"=>["Neuroscience", "Medicine", "Immunology"], "users"=>["Markku Partinen", "Outi Saarenpää-Heikkilä", "Ismo Ilveskoski", "Christer Hublin", "Miika Linna", "Päivi Olsén", "Pekka Nokelainen", "Reija Alén", "Tiina Wallden", "Merimaaria Espo", "Harri Rusanen", "Jan Olme", "Heli Sätilä", "Harri Arikka", "Pekka Kaipainen", "Ilkka Julkunen", "Turkka Kirjavainen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0033723.g002", "stats"=>{"downloads"=>1, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Number_of_new_diagnoses_of_narcolepsy_among_adults_aged_20_years_or_more_by_year_of_diagnosis_/332784", "title"=>"Number of new diagnoses of narcolepsy among adults aged 20 years or more by year of diagnosis.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-03-28 00:46:24"}
  • {"files"=>["https://ndownloader.figshare.com/files/339361", "https://ndownloader.figshare.com/files/339429", "https://ndownloader.figshare.com/files/339468"], "description"=>"<div><h3>Background</h3><p>Narcolepsy is a rare neurological sleep disorder especially in children who are younger than 10 years. In the beginning of 2010, an exceptionally large number of Finnish children suffered from an abrupt onset of excessive daytime sleepiness (EDS) and cataplexy. Therefore, we carried out a systematic analysis of the incidence of narcolepsy in Finland between the years 2002–2010.</p> <h3>Methods</h3><p>All Finnish hospitals and sleep clinics were contacted to find out the incidence of narcolepsy in 2010. The national hospital discharge register from 2002 to 2009 was used as a reference.</p> <h3>Findings</h3><p>Altogether 335 cases (all ages) of narcolepsy were diagnosed in Finland during 2002–2009 giving an annual incidence of 0.79 per 100 000 inhabitants (95% confidence interval 0.62–0.96). The average annual incidence among subjects under 17 years of age was 0.31 (0.12–0.51) per 100 000 inhabitants. In 2010, 54 children under age 17 were diagnosed with narcolepsy (5.3/100 000; 17-fold increase). Among adults ≥20 years of age the incidence rate in 2010 was 0.87/100 000, which equals that in 2002–2009. Thirty-four of the 54 children were HLA-typed, and they were all positive for narcolepsy risk allele DQB1*0602/DRB1*15. 50/54 children had received Pandemrix vaccination 0 to 242 days (median 42) before onset. All 50 had EDS with abnormal multiple sleep latency test (sleep latency <8 min and ≥2 sleep onset REM periods). The symptoms started abruptly. Forty-seven (94%) had cataplexy, which started at the same time or soon after the onset of EDS. Psychiatric symptoms were common. Otherwise the clinical picture was similar to that described in childhood narcolepsy.</p> <h3>Interpretation</h3><p>A sudden increase in the incidence of abrupt childhood narcolepsy was observed in Finland in 2010. We consider it likely that Pandemrix vaccination contributed, perhaps together with other environmental factors, to this increase in genetically susceptible children.</p> </div>", "links"=>[], "tags"=>["incidence", "narcolepsy", "2009", "h1n1", "pandemic", "vaccination", "finland"], "article_id"=>127083, "categories"=>["Neuroscience", "Medicine", "Immunology"], "users"=>["Markku Partinen", "Outi Saarenpää-Heikkilä", "Ismo Ilveskoski", "Christer Hublin", "Miika Linna", "Päivi Olsén", "Pekka Nokelainen", "Reija Alén", "Tiina Wallden", "Merimaaria Espo", "Harri Rusanen", "Jan Olme", "Heli Sätilä", "Harri Arikka", "Pekka Kaipainen", "Ilkka Julkunen", "Turkka Kirjavainen"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0033723.s001", "https://dx.doi.org/10.1371/journal.pone.0033723.s002", "https://dx.doi.org/10.1371/journal.pone.0033723.s003"], "stats"=>{"downloads"=>3, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Increased_Incidence_and_Clinical_Picture_of_Childhood_Narcolepsy_following_the_2009_H1N1_Pandemic_Vaccination_Campaign_in_Finland/127083", "title"=>"Increased Incidence and Clinical Picture of Childhood Narcolepsy following the 2009 H1N1 Pandemic Vaccination Campaign in Finland", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2012-03-28 01:58:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/662523"], "description"=>"§<p>This table contains information of only those 6 subjects who were aged≤17 years at diagnosis. The other 10 of the 16 subjects reported by Dauvilliers et al.2010<sup>34</sup> were older. They were not included to enable comparisons.</p>#<p>We defined weight gain as an increase of body mass index (BMI) >5%. Aran et al<sup>40</sup> defined it as >4 kg weight gain. NC: narcolepsy and cataplexy; NwC: narcolepsy without cataplexy. N/A: Not applicable; SD: standard deviation; SEM: standard error of mean. Statistically significant differences between our study and other studies are marked as.</p>***<p>for P<0.001,</p>**<p>for P<0.01 and,</p>*<p>for P<0.05. The numbers (N = ) in parenthesis refer to number of subjects with data.</p><p>Comparison of the present study and published studies from literature for children aged≤17 years.</p>", "links"=>[], "tags"=>["immunology", "pediatrics and child health", "neurological disorders"], "article_id"=>332979, "categories"=>["Neuroscience", "Medicine", "Immunology"], "users"=>["Markku Partinen", "Outi Saarenpää-Heikkilä", "Ismo Ilveskoski", "Christer Hublin", "Miika Linna", "Päivi Olsén", "Pekka Nokelainen", "Reija Alén", "Tiina Wallden", "Merimaaria Espo", "Harri Rusanen", "Jan Olme", "Heli Sätilä", "Harri Arikka", "Pekka Kaipainen", "Ilkka Julkunen", "Turkka Kirjavainen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0033723.t001", "stats"=>{"downloads"=>1, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Clinical_findings_/332979", "title"=>"Clinical findings.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-03-28 00:49:39"}
  • {"files"=>["https://ndownloader.figshare.com/files/662204"], "description"=>"<p>Number of new diagnoses of narcolepsy among children and adolescents aged under 20 years of age by year of diagnosis.</p>", "links"=>[], "tags"=>["diagnoses", "narcolepsy", "children", "adolescents", "aged", "20", "years"], "article_id"=>332665, "categories"=>["Neuroscience", "Medicine", "Immunology"], "users"=>["Markku Partinen", "Outi Saarenpää-Heikkilä", "Ismo Ilveskoski", "Christer Hublin", "Miika Linna", "Päivi Olsén", "Pekka Nokelainen", "Reija Alén", "Tiina Wallden", "Merimaaria Espo", "Harri Rusanen", "Jan Olme", "Heli Sätilä", "Harri Arikka", "Pekka Kaipainen", "Ilkka Julkunen", "Turkka Kirjavainen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0033723.g001", "stats"=>{"downloads"=>1, "page_views"=>59, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Number_of_new_diagnoses_of_narcolepsy_among_children_and_adolescents_aged_under_20_years_of_age_by_year_of_diagnosis_/332665", "title"=>"Number of new diagnoses of narcolepsy among children and adolescents aged under 20 years of age by year of diagnosis.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-03-28 00:44:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/662433"], "description"=>"<p>Annual incidence of narcolepsy by age group and year of diagnosis.</p>", "links"=>[], "tags"=>["incidence", "narcolepsy"], "article_id"=>332897, "categories"=>["Neuroscience", "Medicine", "Immunology"], "users"=>["Markku Partinen", "Outi Saarenpää-Heikkilä", "Ismo Ilveskoski", "Christer Hublin", "Miika Linna", "Päivi Olsén", "Pekka Nokelainen", "Reija Alén", "Tiina Wallden", "Merimaaria Espo", "Harri Rusanen", "Jan Olme", "Heli Sätilä", "Harri Arikka", "Pekka Kaipainen", "Ilkka Julkunen", "Turkka Kirjavainen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0033723.g003", "stats"=>{"downloads"=>0, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Annual_incidence_of_narcolepsy_by_age_group_and_year_of_diagnosis_/332897", "title"=>"Annual incidence of narcolepsy by age group and year of diagnosis.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-03-28 00:48:17"}

PMC Usage Stats | Further Information

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Relative Metric

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