BOSTON (State House News Service) — Public health officials have advised healthcare providers in Massachusetts about a possible increase in children dealing with neurologic complications tied to the flu.

In a clinical advisory, state officials could not pinpoint the reason for an increase, but said it could be caused by the high volume of flu cases, the type of strain circulating here, or an affected population that has a higher risk than before. The Department of Public Health said that seizure is the most typical complication, which DPH said is followed by encephalopathy or encephalitis.

"Recently, Massachusetts clinicians treating children have observed a possible increase in the number of cases of children with influenza with neurologic complications compared to prior seasons," DPH said in a Feb. 14 advisory that the Massachusetts Health and Hospital Association shared widely on Monday. "Similar possible increases have been observed in other jurisdictions throughout the US."

Children who are unvaccinated against the flu or who have pre-existing conditions are at higher risk of developing flu-related neurologic complications, according to the advisory.

DPH urged care providers to consider seeking "urgent" neurology and infectious diseases consultation and neurologic imaging for patients with new neurologic symptoms after recently having the flu or a flu-like illness. Providers must also "promptly report" information to DPH about patients under age 21 with new neurologic symptoms and positive flu tests, and submit those patients' flu specimens to the state public health lab.

"[M]ost children with neurologic complications of influenza do not have chronic conditions," DPH said. "Hospital length of stay, rate of ICU admission and death are greater in children with neurologic complications of influenza compared with those without these complications. Unfortunately, surviving children with the severest forms of neurologic complications (ANE) are likely to have substantial persistent health impacts."

DPH currently estimates the severity of influenza as "very high" in all parts of Massachusetts and reports 191 flu deaths so far this season, including six among pediatric patients.

Written by Alison Kuznitz/SHNS