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Pediatrics

Influenza-Associated Acute Necrotizing Encephalopathy (ANE) Threatens Children

Strategic Insights

— 1 min read

Recently, the Centers for Disease Control and Prevention (CDC) received reports of children with influenza-associated acute necrotizing encephalopathy (ANE), a severe form of influenza-associated encephalopathy or encephalitis (IAE). In response, the CDC examined trends in the proportions of cases with IAE among influenza-associated pediatric deaths reported during the 2010-11 through 2024-25 influenza seasons, including demographic and clinical characteristics of identified cases.

Key Takeaways:

  • Among 1,840 pediatric influenza-associated deaths during the 2010-11 through 2024-25 influenza seasons, 166 (9%) had IAE, ranging from 0% (2020-21 season) to 14% (2011-12 season).
  • Preliminary data for the 2024-25 season (through February 8, 2025) indicate that nine of 68 (13%) had IAE.
  • The median age of patients with fatal IAE was 6 years, with 54% having no underlying medical conditions, and only 20% having received influenza vaccination.
  • No dedicated national surveillance for IAE or ANE exists, making it unknown if the numbers of cases this season vary from expected numbers.
  • Health care providers should consider IAE in children with acute febrile illness and neurologic signs or symptoms lasting 24 hours.
  • Evaluation should include testing for influenza and other viruses and neuroimaging; clinical management should include early antiviral treatment for suspected or confirmed influenza and supportive critical care management as needed.
  • Influenza vaccination is recommended for all eligible persons aged = 6 months as long as influenza viruses are circulating.
  • The research was peer-reviewed and published in the Mmwr-morbidity and Mortality Weekly Report Volume 74, Issue 6 (2025) pp. 91-95.

Statistics:

  • 1,840 pediatric influenza-associated deaths during the 2010-11 through 2024-25 influenza seasons.
  • 166 (9%) had IAE among 1,840 pediatric influenza-associated deaths.
  • 9 of 68 (13%) had IAE in preliminary data for the 2024-25 season (through February 8, 2025).
  • 54% had no underlying medical conditions among patients with fatal IAE.
  • 20% had received influenza vaccination among patients with fatal IAE.
  • 6 years was the median age of patients with fatal IAE.

Sources:

  • Reports of Encephalopathy Among Children With Influenza-associated Mortality - United States, 2010-11 Through 2024-25 Influenza Seasons. Mmwr-morbidity and Mortality Weekly Report, 2025;74(6):91-95.
  • Centers Disease Control & Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA.
  • Amara Fazal, Centers for Disease Control and Prevention, Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, GA 30333, United States.

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