{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:46:38Z","timestamp":1790297198592,"version":"4.1.0"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T00:00:00Z","timestamp":1672704000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100014219","name":"National Science Fund for Distinguished Young Scholars","doi-asserted-by":"publisher","award":["81525023"],"award-info":[{"award-number":["81525023"]}],"id":[{"id":"10.13039\/501100014219","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82070091"],"award-info":[{"award-number":["82070091"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82020108001"],"award-info":[{"award-number":["82020108001"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Study Objectives<\/jats:title>\n                    <jats:p>Increased 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Individual 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Average 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\u20139-year-old strata), and the age shift toward younger children reversed to baseline following the pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Increased 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/sleep\/zsac325","type":"journal-article","created":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T15:14:32Z","timestamp":1672758872000},"source":"Crossref","is-referenced-by-count":22,"title":["Changed epidemiology of narcolepsy before, during, and after the 2009 H1N1 pandemic: a nationwide narcolepsy surveillance network study in mainland China, 1990\u20132017"],"prefix":"10.1093","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7164-6189","authenticated-orcid":false,"given":"Xiling","family":"Wang","sequence":"first","affiliation":[{"name":"School of Public Health, Key Laboratory of Public Health Safety, Fudan University , Ministry of Education, Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fulong","family":"Xiao","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine, Peking University People\u2019s Hospital , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2754-7498","authenticated-orcid":false,"given":"Yiping","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Public Health, Key Laboratory of Public Health Safety, Fudan University , Ministry of Education, Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowei","family":"Deng","sequence":"additional","affiliation":[{"name":"School of Public Health, Key Laboratory of Public Health Safety, Fudan University , Ministry of Education, Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyuan","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Public Health, Key Laboratory of Public Health Safety, Fudan University , Ministry of Education, Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaosong","family":"Dong","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine, Peking University People\u2019s Hospital , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Public Health, Key Laboratory of Public Health Safety, Fudan University , Ministry of Education, Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenyang","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine, Peking University People\u2019s Hospital , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhifei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Beijing Children\u2019s Hospital , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijuan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shanghai Changzheng Hospital , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Yu","sequence":"additional","affiliation":[{"name":"Sleep and Wake Disorders\u2019 Center of Fudan University, Neurology Department of Huashan Hospital, Fudan University, National Center for Neurological Disorders , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changjun","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tangdu Hospital, Fourth Military Medical University , Xi\u2019an, Shaanxi , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, First Bethune Hospital of Jilin University , Changchun, Jilin , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangdong","family":"Tang","sequence":"additional","affiliation":[{"name":"The Sleep Center, West China Hospital of Sichuan University , Chengdu, Sichuan , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunhui","family":"Lv","sequence":"additional","affiliation":[{"name":"The Sleep Center, The First People\u2019s Hospital of Yunnan Province , Kunming, Yunnan , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6276-9104","authenticated-orcid":false,"given":"Yun","family":"Li","sequence":"additional","affiliation":[{"name":"The Sleep Center, Shantou University Mental Health Center , Shantou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuchen","family":"Sun","sequence":"additional","affiliation":[{"name":"The Sleep Center, Guang\u2019anmen Hospital , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junying","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital of Soochow University , Suzhou, Jiangsu , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijuan","family":"Hao","sequence":"additional","affiliation":[{"name":"The Sleep Center, Qinghai Red Cross Hospital , Xining, Qinghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Xiamen Xianyue Hospital , Xiamen, Fujian , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liying","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Second Affiliated Hospital of Nanchang University , Nanchang, Jiangxi , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Shu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Child Psychiatry, Chang Gung Memorial University Hospital , Tao-Yuan, Taipei , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4976-3039","authenticated-orcid":false,"given":"Jihui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong , Shatin, Hong Kong SAR , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5745-5474","authenticated-orcid":false,"given":"Yun-Kwok","family":"Wing","sequence":"additional","affiliation":[{"name":"Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong , Shatin, Hong Kong SAR , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking University People\u2019s Hospital , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6928-5310","authenticated-orcid":false,"given":"Emmanuel","family":"Mignot","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Stanford University Center for Sleep Sciences and Medicine , Palo Alto, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0364-8457","authenticated-orcid":false,"given":"Fang","family":"Han","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine, Peking University People\u2019s Hospital , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongjie","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University , Shanghai , China"},{"name":"Key Laboratory of Public Health Safety, Fudan University , Ministry of Education, Shanghai , China"},{"name":"Shanghai Institute of Infectious Disease and Biosecurity, Fudan University , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,1,3]]},"reference":[{"issue":"9","key":"2023030906564939100_","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1038\/s41582-019-0226-9","article-title":"Narcolepsy - clinical spectrum, aetiopathophysiology, diagnosis and treatment","volume":"15","author":"Bassetti","year":"2019","journal-title":"Nat Rev 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