A study conducted by Stanford Medicine and published in JAMA has revealed that a condition known as acute necrotizing encephalopathy (ANE), though rare, can be life-threatening — especially in children with severe flu.

Between 2023 and 2025, 41 cases of ANE were recorded in the United States. Nearly a quarter of the affected children died, and among the survivors, 63% experienced moderate to severe impairments three months after the illness.

ANE involves brain swelling and an excessive immune response triggered by a viral infection. In mild cases, the changes may be reversible, but with ANE, they can critically endanger a child’s life.

Causes and Consequences

Only 16% of the children had been vaccinated against the flu, significantly below the average pediatric vaccination rate of around 50%.

Timely access to intensive care — including treatments for brain swelling and immune-modulating therapies such as steroids or plasmapheresis — increases the chances of recovery.

Conclusions and Recommendations

This complication develops rapidly and aggressively, so it is crucial to seek medical attention immediately at the first signs of neurological changes (such as seizures, confusion, or unusual behavior).

Flu vaccination remains a key strategy in preventing severe complications — not only ANE, but also conditions like pneumonia or respiratory failure.

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