Unvaccinated Children at Higher Risk for Stroke | Loyola Medicine

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Wednesday, September 30, 2015

Loyola neurologist comments on study linking strokes in children to infections and inadequate vaccinations

Pediatric patient resting in hospital bed.

MAYWOOD, Ill. – Children who have suffered recent infections or have not received most or all of their vaccinations are at a higher risk for stroke, according to research published in the Sept. 30 issue of Neurology®, the medical journal of the American Academy of Neurology.

The findings conceivably will be “seminal in drafting further stroke prevention strategies” in children, according to an accompanying editorial by senior author Jose Biller, MD, of Loyola University Medical Center and Loyola University Chicago Stritch School of Medicine. Co-author of the editorial is Geoffrey L. Heyer, MD of Nationwide Children’s Hospital and Ohio State University.

The editorial by Drs. Biller and Heyer, who were not involved in the study, is titled “A call for new attitudes on infection, vaccination and childhood stroke.”

There are between 2.6 and 13 strokes per 100,000 children per year. Developmental, genetic and environmental factors are major contributors to pediatric strokes. Infections also may temporarily increase the risk of stroke. Such infections include flu, upper respiratory tract infections, bacterial and viral infections and, to a lesser extent, urinary tract infections and gastrointestinal infections, according to the editorial.

In the accompanying study in Neurology, Heather J. Fullerton, MD of the University of California at San Francisco and colleagues report latest results from the Vascular Effects of Infection in Pediatric Stroke (VIPS) study. Researchers in the multicenter, case-control study enrolled 355 children between the ages of 29 days and 18 years who had suffered ischemic strokes. (Ischemic strokes are caused by blood clots that block blood flow in the brain.)

Eighteen percent of these children had experienced infections during the week prior to their strokes. By comparison, only 3 percent of children in the control group had suffered infections during the week prior to being interviewed. Children who suffered strokes also were less likely to have received all or most of the recommended vaccinations.

Commenting on the study, Drs. Biller and Heyer note that minor infections are common in children. “While further study is needed to clarify how infection increases stroke risk, one can speculate that the physiologic changes related to infection (systemic inflammation, dehydration and activation of the coagulation system) could tip the balance in a child who is already at risk for stroke,” Drs. Biller and Heyer write.

Dr. Biller is an internationally known expert on strokes in children and young adults. He has written a textbook on the topic and is a co-author of the American Heart Association’s guidelines for management of stroke in infants and children.

Dr. Biller is chair of the Department of Neurology of Loyola University Chicago Stritch School of Medicine. 

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 92 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 129,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.