Recent infection boosts pediatric stroke risk

Recent infection ups pediatric stroke risk
Recent infection ups pediatric stroke risk

HealthDay News -- Minor infections may trigger rare ischemic stroke in kids, according to researchers at the American Heart Association's International Stroke Conference.

A significantly higher proportion of pediatric patients who experienced an ischemic stroke reported an infection in the previous week compared with patients making routine visits or urgent visits for trauma (17% vs. 3%, P<0.0001), according to Nancy Hills, PhD, of the University of California San Francisco.

Furthermore, children who received some or fewer of the recommended childhood vaccinations had a higher risk for stroke compared with those who received most or all (OR 6.72, 95% CI: 2.30-19.60).

"This is not something that parents need to worry about. It's just something that could be a risk factor for children who have some other more complicating risk factor, like cardiac disease," Hills said at a press conference.

In a second presentation at the conference, Heather J. Fullerton, MD, from the University of California in San Francisco, and colleagues analyzed data from the Vascular Effects of Infection in Pediatric Stroke (VIPS) study, a prospective study involving 40 centers in North America, South America, Asia, Australia and Europe.

Study participants were aged younger than 19 years and had clinical and radiograph confirmed ischemic stroke or had undergone routine visits for annual check-ups, migraine or developmental delay, or urgent visits for trauma. The current analysis included 310 stroke cases and 289 controls. Median patient age in both groups was 8 years. Parents were interviewed to determine recent infections and vaccination history.

The most common type of infection participants experienced were colds and other types of respiratory tract infections, which similar to overall infections, occurred more commonly among those who experienced stroke (8% vs. 2.4%).

Specific type of infection does not appear to influence stroke risk -- additional analyses of VIPS data showed similar relationships between recent herpes virus, parvovirus B19 infection and stroke risk, the researchers noted. Blood tests indicated that 41% of stroke patients had an active herpes infection, compared with 9% of non-stroke patients.

Ever having received measles-mumps-rubella (MMR), polio, varicella or pneumococcus vaccine was associated with a lower risk for ischemic stroke (P≤0.05 for all), after adjusting for age.

Study limitations included the potential for recall bias due to relying on parental reporting to determine infection occurrence.

References

  1. Hills N et al. Abstract #39. "Infection, vaccination, and childhood stroke: preliminary results of the Vascular Effects of Infection in Pediatric Stroke (VIPS) study."
  2. Fullerton H et al. Abstract #38. "Herpes viruses in childhood arterial ischemic stroke: interim results of the VIPS study."

Both Presented at American Heart Association International Stroke Conference 2014; San Diego: Feb. 12-14, 2014.

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