Peer-reviewed article
Impact of Postpandemic Pediatric Infection Rebound on Febrile Seizures: A Nationwide Cohort Study, 2013-2023.
Okubo Y, Hayakawa I, Sugitate R, Nariai H ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how febrile seizures (convulsions triggered by fever) in young children changed during and after the COVID-19 pandemic in Japan. Febrile seizures dropped sharply in 2020 when infections fell, but rebounded by 2023 to levels higher than before the pandemic as childhood infections returned. The study found that the seizure risk per infection remained the same, meaning the increase was due to more infections in the community rather than children becoming more vulnerable to seizures.
Key points
- Febrile seizure incidence fell 59.9% in 2020 during pandemic lockdowns, then rose to 71.7 per 1000 person-years in 2023, exceeding prepandemic levels
- The increase in febrile seizures after 2020 was proportional to the rise in community pediatric infections
- The risk of seizure per infection was identical in 2023 to prepandemic years, indicating no change in host susceptibility
- Estimated national burden: 260,000-340,000 febrile seizure episodes annually before the pandemic, halving in 2020 and recovering to 270,000 by 2023
- Annual healthcare costs ranged from 10-12 billion Japanese yen before the pandemic, fell in 2020, and returned to 10.5 billion yen by 2023
Limitations
This study is limited to Japan and uses administrative claims data, so findings may not generalise to other countries with different healthcare systems, infection patterns, or vaccination rates. The study does not examine individual risk factors or mechanisms that might explain variation in febrile seizure susceptibility across different populations.
Abstract
Background Febrile seizures (FSs) affect younger children and typically accompany common infectious diseases. The COVID-19 pandemic disrupted pediatric infectious disease patterns, yet how these changes have influenced incidence rates of FS and associated health care resource use after the pandemic remains unknown. Methods We conducted a cohort study using a nationwide administrative claims database among children from fiscal year 2013-2023, totaling 5.5 million person-years. We estimated incidence rates of FS, with relevant hospitalization risks, health care costs, and health care resource utilizations using multivariable generalized linear models with direct standardization. Geospatial microsimulation models were used to estimate the national burden of FS over the period. Results The incidence rate of FS among children aged 6 months to <5 years was stable at 58.6-69.2 cases per 1000 person-years during 2013-2018, fell by 59.9% in 2020, and rose to 71.7 per 1000 person-years in 2023, surpassing prepandemic levels. The incidence rates of FS changed in direct proportion to the community pediatric infectious disease rates, and the seizure-per-infection risks were identical in 2023 to those observed before the COVID-19 pandemic. Microsimulation models estimated 260,000-340,000 FS episodes, 13,000-16,000 hospitalizations, and 10-12 billion Japanese yen in annual costs before the COVID-19 pandemic, halving in 2020 and recovering to 270,000 episodes, 13,000 admissions, and 10.5 billion Japanese yen by 2023. Conclusions The postpandemic surge in FS reflects restored infection pressure, not heightened host susceptibility. Responsive pediatric care could be guided by real-time infection surveillance to align clinical capacity and resources with shifting community infection burden.