ArticleSleep2023
Changed epidemiology of narcolepsy before, during, and after the 2009 H1N1 pandemic: a nationwide narcolepsy surveillance network study in mainland China, 1990-2017.
Article in Sleep, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed.
- Exploring the Development of Vaccine Platforms, With a Particular Focus on the COVID-19 Pandemic.Acta paediatrica (Oslo, Norway : 1992) · 2026Review
- Narcolepsy is (not) an autoimmune disease.Nature reviews. Neurology · 2026Review
- Rapid Eye Movement Sleep-Related Indicators with Promising Performance in Diagnosing Narcolepsy.Nature and science of sleep · 2026Article
- HLA-DQB1*03:01 strongly affects age of onset of type 1 narcolepsy independently of DQA1 and ethnicity.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- Global estimates of vaccine-associated narcolepsy from 1967 to 2023.Scientific reports · 2025Article
- The Role of T Cells in the Pathogenesis of Narcolepsy Type 1: A Narrative Review.International journal of molecular sciences · 2024Review
- Mapping the landscape of sleep medicine training across Asia.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Exploring sleep characteristics in Chinese patients with narcolepsy: insights from the nocturnal sleep onset rapid eye movement period (nSOREMP).Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Epidemiology and distribution of 207 rare diseases in China: A systematic literature review.Intractable & rare diseases research · 2024Review
- Characterization of the Increase in Narcolepsy following the 2009 H1N1 Pandemic in Sweden.Journal of clinical medicine · 2024Article
- Epidemiology, patient characteristics, and treatment patterns of patients with narcolepsy in Sweden: a non-interventional study using secondary data.Sleep advances : a journal of the Sleep Research Society · 2024Article
- What triggered narcolepsy: H1N1 vaccination, virus, or both? Important lessons learned from China.Sleep · 2023Article
Corrections and comments
- Commented on by
Authors and funding
28 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesIncreased incidence of narcolepsy was reported in children during the 2009 H1N1 pandemic following Pandemrix, a H1N1 flu vaccine. A link with A(H1N1) pdm09 infections remains controversial. Using nationwide surveillance data from China (1990 to 2017), the epidemiology of narcolepsy was analyzed.
methodsIndividual records of narcolepsy patients were collected from 15 of 42 hospitals across China known to diagnose cases. Incidence was estimated assuming the representativeness of these hospitals. Age-specific incidence, epidemiological and clinical characteristics of patients were evaluated before, during, and after the 2009 H1N1 pandemic. Sensitivity analyses were conducted by including NT1 cases only and excluding the effect of the 2009 H1N1 vaccination.
resultsAverage annual incidence was 0.79 per 100 000 person-years (PY) from 1990 to 2017 and 1.08 per 100 000 PY from 2003 to 2017. Incidence increased 4.17 (95% CI 4.12, 4.22) and 1.42 (95% CI 1.41, 1.44) fold during and after the 2009 H1N1 pandemic when compared to baseline. These results were robust in sensitivity analyses. Patients with the onset of narcolepsy during the pandemic period were younger (notably in 5-9-year-old strata), and the age shift toward younger children reversed to baseline following the pandemic.
conclusionsIncreased incidence of narcolepsy was observed during the 2009 H1N1 pandemic period. This is likely to be associated with the circulation of the wild type A(H1N1)pdm09 virus. This observation should be considered for future influenza pandemic preparedness plans.
Indexed as
Identifiers
36595587What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.