Incidence and prevalence of headache in influenza: A 2010-2021 surveillance-based study

Eur J Neurol. 2024 Aug;31(8):e16349. doi: 10.1111/ene.16349. Epub 2024 May 21.

Abstract

Background and purpose: Influenza is a common cause of acute respiratory infection, with headache being one of the symptoms included in the European Commission case definition. The prevalence of headache as a symptom of influenza remains unknown. We aimed to describe the incidence and prevalence of headache in patients with influenza.

Methods: All consecutive patients who met the definition criteria of influenza-like illness during the influenza seasons 2010-2011 through 2021-2022 were included. The seasonal cumulative incidence of influenza per 1000 patients at risk and the prevalence of headache as an influenza symptom were calculated, including the 95% confidence intervals (CIs). Subgroup analyses were done based on patients' sex, age group, microbiological confirmation, vaccination status, and influenza type/subtype/lineage.

Results: During the study period, 8171 patients were eligible. The incidence of headache in the context of influenza varied between 0.24 cases per 1000 patients (season 2020-2021) and 21.69 cases per 1000 patients (season 2017-2018). The prevalence of headache was 66.1% (95% CI = 65.1%-67.1%), varying between 49.6% (season 2021-2022) and 80.1% (season 2010-2011). The prevalence of headache was higher in women (67.9% vs. 65.7%, p = 0.03) and higher in patients between 15 and 65 years old. Headache was more prevalent in patients infected with B subtypes than A subtypes (68.7% vs. 56.9%, p < 0.001). There were no notable differences regarding vaccination status or microbiological confirmation of the infection.

Conclusions: Headache is a common symptom in patients with influenza, with a prevalence higher than that observed in other viral infections.

Keywords: epidemiology; headache disorders; infections; migraine; virus diseases.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Female
  • Headache* / epidemiology
  • Humans
  • Incidence
  • Infant
  • Influenza, Human* / complications
  • Influenza, Human* / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Young Adult