Document Detail

Narcolepsy onset is seasonal and increased following the 2009 H1N1 pandemic in China.
MedLine Citation:
PMID:  21866560     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Narcolepsy is caused by the loss of hypocretin/orexin neurons in the hypothalamus, which is likely the result of an autoimmune process. Recently, concern has been raised over reports of narcolepsy in northern Europe following H1N1 vaccination.
METHODS: The study is a retrospective analysis of narcolepsy onset in subjects diagnosed in Beijing, China (1998-2010). Self-reported month and year of onset were collected from 629 patients (86% children). Graphical presentation, autocorrelations, chi-square, and Fourier analysis were used to assess monthly variation in onset. Finally, 182 patients having developed narcolepsy after October 2009 were asked for vaccination history.
RESULTS: The occurrence of narcolepsy onset was seasonal, significantly influenced by month and calendar year. Onset was least frequent in November and most frequent in April, with a 6.7-fold increase from trough to peak. Studying year-to-year variation, we found a 3-fold increase in narcolepsy onset following the 2009 H1N1 winter influenza pandemic. The increase is unlikely to be explained by increased vaccination, as only 8 of 142 (5.6%) patients recalled receiving an H1N1 vaccination. Cross-correlation indicated a significant 5- to 7-month delay between the seasonal peak in influenza/cold or H1N1 infections and peak in narcolepsy onset occurrences.
INTERPRETATION: In China, narcolepsy onset is highly correlated with seasonal and annual patterns of upper airway infections, including H1N1 influenza. In 2010, the peak seasonal onset of narcolepsy was phase delayed by 6 months relative to winter H1N1 infections, and the correlation was independent of H1N1 vaccination in the majority of the sample.
Fang Han; Ling Lin; Simon C Warby; Juliette Faraco; Jing Li; Song X Dong; Pei An; Long Zhao; Ling H Wang; Qian Y Li; Han Yan; Zhan C Gao; Yuan Yuan; Kingman P Strohl; Emmanuel Mignot
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2011-08-22
Journal Detail:
Title:  Annals of neurology     Volume:  70     ISSN:  1531-8249     ISO Abbreviation:  Ann. Neurol.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-09     Completed Date:  2011-10-31     Revised Date:  2011-11-11    
Medline Journal Info:
Nlm Unique ID:  7707449     Medline TA:  Ann Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  410-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American Neurological Association.
Department of Pulmonary Medicine, Beijing University People's Hospital, Beijing, China.
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MeSH Terms
China / epidemiology
Common Cold / epidemiology
Data Interpretation, Statistical
Influenza A Virus, H1N1 Subtype*
Influenza Vaccines
Influenza, Human / epidemiology*
Middle Aged
Narcolepsy / epidemiology*
Retrospective Studies
Vaccination / statistics & numerical data
Young Adult
Grant Support
Reg. No./Substance:
0/Influenza Vaccines
Comment In:
Nat Rev Neurol. 2011;7(10):537   [PMID:  21984118 ]
Ann Neurol. 2011 Sep;70(3):A5-6   [PMID:  21866561 ]

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