Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0009952 (febrile convulsions)
 1,215 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this review we discuss the relationship between commonly administered childhood vaccines such as diphtheria-tetanus-whole cell pertussis (DTP) and measles-mumps-rubella (MMR), and the risk of nonfebrile and febrile seizure. We summarize data from the Vaccine Safety Datalink Study and other studies that suggest that DTP and MMR vaccine are associated with a transiently increased risk of febrile seizures, and cause between 5-9 and 25-34 additional extra febrile seizures per 100 000 immunized children, respectively. DTP and MMR do not appear to increase the risk of nonfebrile seizures. We discuss some methodologic challenges in studies of vaccines and seizures. Because there is no adequate comparison group that would allow for the study of seizures long after vaccination, studies of seizures are limited to acute events shortly following vaccination. Additionally, while seizures following vaccination are worrisome to parents and physicians alike, observational studies of the neurodevelopmental outcomes of these children are particularly problematic. We discuss how such studies are confounded by the natural history of predisposition to febrile seizures and by the increased diagnostic scrutiny that children with febrile seizures might undergo. Nevertheless, current data suggest that children with febrile seizures do not experience long-term negative effects.Finally, we discuss the creation of new clinics designed specifically to assist physicians in managing the vaccination of children with a personal or family history of seizures. Data from these clinics suggest that vaccination is safe for children with a personal or family history of seizures, but statistical power has been limited. We conclude by discussing the introduction of new vaccines, and note that, even with widespread use, it will take many years before we can be knowledgeable about the risk of rare events with these newly licensed products.
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PMID:Placing the risk of seizures with pediatric vaccines in a clinical context. 1458 Feb 21

For over 50 years, concerns have been raised about the risk of pertussis vaccine-induced childhood encephalopathy and epilepsy. This article reviews the scientific literature, and the social and historical context in which the scientific, public health and societal views have not always been aligned. Large-scale studies of this issue have produced conflicting results, although the recent consensus is that the risk of vaccine-induced encephalopathy and/or epilepsy, if it exists at all, is extremely low. Risk estimates in the literature have included: risk of a febrile seizure 1 per 19,496 vaccinations; risk of an afebrile seizure 1 per 76,133 vaccinations; risk of encephalopathy after pertussis infection nil-3 cases per million vaccinations. A recent study showed that encephalopathy in 11 out of the 14 children studied, although previously attributed to vaccination, was in fact due an inherited genetic defect of the SCNIA gene that codes for the voltage gated neuronal sodium channel. This study is important because it provides a solid alternative explanation for the perceived pertussis vaccine-encephalopathy association. The interesting possibility is raised that the encephalopathy apparently due to pertussis itself may, in some cases, be due to an SCNIA mutation. It may also, by analogy, shed some light on the continuing debate about other serious long-term adverse effects of vaccination in general.
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PMID:Pertussis vaccination and epilepsy--an erratic history, new research and the mismatch between science and social policy. 1809 46

We linked the Australian Childhood Immunisation Register (ACIR) to South Australian (SA) hospital outcome data in order to evaluate the association between Measles Mumps and Rubella (MMR) and Diphtheria Tetanus Pertussis (DTP) vaccines and convulsions. Linkage occurred using probabilistic matching and data was analysed using the self-controlled case series methodology. An increase in febrile convulsions 6-11 days post-MMR vaccination was demonstrated which equates to a vaccine-attributable risk of 1 convulsion per 6753 vaccines. This study confirms the known association between MMR vaccination and febrile convulsions and in doing so demonstrates the feasibility of using the ACIR for data linkage and vaccine safety surveillance.
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PMID:Use of the Australian Childhood Immunisation Register for vaccine safety data linkage. 2043 Jan 23

Reports of childhood epilepsies in temporal association with vaccination have had a great impact on the acceptance of vaccination programs by health care providers, but little is known about this possible temporal association and about the types of seizures following vaccinations. For these reasons the Italian League Against Epilepsy (LICE), in collaboration with other Italian scientific societies, has decided to generate Guidelines on Vaccinations and Epilepsy. The aim of Guidelines on Vaccinations and Epilepsy is to present recent unequivocal evidence from published reports on the possible relationship between vaccines and epilepsy in order to provide information about contraindications and risks of vaccinations in patients with epilepsy. The following main issues have been addressed: (1) whether contraindications to vaccinations exist in patients with febrile convulsions, epilepsy, and/or epileptic encephalopathies; and (2) whether any vaccinations can cause febrile seizures, epilepsy, and/or epileptic encephalopathies. Diphtheria-tetanus-pertussis (DTP) vaccination and measles, mumps, and rubella vaccination (MMR) increase significantly the risk of febrile seizures. Recent observations and data about the relationships between vaccination and epileptic encephalopathy show that some cases of apparent vaccine-induced encephalopathy could in fact be caused by an inherent genetic defect with no causal relationship with vaccination.
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PMID:Epilepsy and vaccinations: Italian guidelines. 2409 52

Question Parents of a 12-month-old boy are bringing their son in to my family practice clinic for his well-baby visit. As the infant is due for his 12-month vaccine series, the parents are concerned after hearing about the association between certain vaccinations and an increased risk of febrile seizures, and are wondering if they should administer prophylactic antipyretics to decrease the risk of febrile seizure. What vaccinations are associated with increased risk of febrile seizure, and is there evidence supporting prophylactic administration of antipyretics to prevent febrile seizures? Answer Vaccinations associated with increased risk of febrile seizure include the following: the measles-mumps-rubella vaccine; the measles-mumps-rubella-varicella vaccine; the combined diphtheria, tetanus, acellular pertussis, polio, and Haemophilus influenzae type b vaccine; the whole-cell pertussis vaccine; the 7-valent pneumococcal conjugate vaccine; and concomitant administration of the trivalent inactivated influenza vaccine with either the 7-valent pneumococcal conjugate vaccine or the diphtheria, tetanus, and acellular pertussis vaccine. Despite being a higher-risk group, children receiving these vaccinations should not receive prophylactic antipyretics, as no statistically significant reduction in the rate of febrile seizures has been documented, and prophylactic antipyretic use potentially decreases the immune response to certain vaccines.
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PMID:Prophylactic antipyretics for prevention of febrile seizures following vaccination. 2820 78

Sentinel surveillance of acute hospitalisations in response to infectious disease emergencies such as the 2009 influenza A(H1N1)pdm09 pandemic is well described, but recognition of its potential to supplement routine public health surveillance and provide scalability for emergency responses has been limited. We summarise the achievements of two national paediatric hospital surveillance networks relevant to vaccine programmes and emerging infectious diseases in Canada (Canadian Immunization Monitoring Program Active; IMPACT from 1991) and Australia (Paediatric Active Enhanced Disease Surveillance; PAEDS from 2007) and discuss opportunities and challenges in applying their model to other contexts. Both networks were established to enhance capacity to measure vaccine preventable disease burden, vaccine programme impact, and safety, with their scope occasionally being increased with emerging infectious diseases' surveillance. Their active surveillance has increased data accuracy and utility for syndromic conditions (e.g. encephalitis), pathogen-specific diseases (e.g. pertussis, rotavirus, influenza), and adverse events following immunisation (e.g. febrile seizure), enabled correlation of biological specimens with clinical context and supported responses to emerging infections (e.g. pandemic influenza, parechovirus, COVID-19). The demonstrated long-term value of continuous, rather than incident-related, operation of these networks in strengthening routine surveillance, bridging research gaps, and providing scalable public health response, supports their applicability to other countries.
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PMID:Active surveillance of acute paediatric hospitalisations demonstrates the impact of vaccination programmes and informs vaccine policy in Canada and Australia. 3261 39


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