{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:42:21Z","timestamp":1792424541008,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The prevalence of meningitis and encephalitis of unknown aetiology in Spanish children has not been specifically documented before. The aim of this study is to describe the epidemiology and trends of these clinical conditions between 2016 and 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Retrospective study analysing hospitalised children &lt;\u200915\u2009years with meningitis and encephalitis\/encephalomyelitis of unknown origin (\n                      <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\n                      \u201010 codes) in Spain (2016\u20132020). Data from National Registry of Hospitalizations and National Institute for Statistics were used to calculate age\u2010stratified hospitalisation rates (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      ). Statistical analysis included Poisson regression to calculate hospitalisation rate ratios (\n                      <jats:styled-content style=\"fixed-case\">HRR<\/jats:styled-content>\n                      ) by age groups and years and forecasting methods to predict 2020\n                      <jats:styled-content style=\"fixed-case\">HRs<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Four thousand six hundred childrens were hospitalised with viral meningitis and encephalitis\u2010encephalomyelitis of unknown origin, resulting in a\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      of 7.8\/10\n                      <jats:sup>5<\/jats:sup>\n                      inhabitants. The highest\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      was observed in children under 1\u2009year (49.1\/10\n                      <jats:sup>5<\/jats:sup>\n                      ) and those aged 5\u20139 (10.4\/10\n                      <jats:sup>5<\/jats:sup>\n                      ). The global\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      for viral meningitis (3.64\/10\n                      <jats:sup>5<\/jats:sup>\n                      ) was lower than for encephalitis\u2010encephalomyelitis (4.2\/10\n                      <jats:sup>5<\/jats:sup>\n                      ). Hospitalisations decreased from 1475 (2016) to 452 (2020), attributed to enhanced pathogen detection methods and\n                      <jats:styled-content style=\"fixed-case\">COVID<\/jats:styled-content>\n                      \u201019 preventive measures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Undiagnosed central nervous system entities remain a significant cause of paediatric hospitalisations in Spain, despite a declining incidence. Enhanced diagnostic strategies, including expanded microbiological testing and molecular epidemiology surveillance, could prove beneficial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.70107","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T03:48:02Z","timestamp":1745380082000},"page":"2298-2305","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Trends in Paediatric Viral Meningitis and Encephalitis With Unconfirmed Aetiology: A Spanish Population\u2010Based Study, 2016\u20132020"],"prefix":"10.1111","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4249-2045","authenticated-orcid":false,"given":"Marina","family":"Pons\u2010Espinal","sequence":"first","affiliation":[{"name":"Pediatrics Department Hospital Sant Joan de D\u00e9u  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5132-314X","authenticated-orcid":false,"given":"Noemi","family":"L\u00f3pez\u2010Perea","sequence":"additional","affiliation":[{"name":"National Institute of Epidemiology Instituto de Salud Carlos III  Madrid Spain"},{"name":"CIBER Epidemiology and Public Health (CIBERESP)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2725-417X","authenticated-orcid":false,"given":"Josefa","family":"Masa\u2010Calles","sequence":"additional","affiliation":[{"name":"National Institute of Epidemiology Instituto de Salud Carlos III  Madrid Spain"},{"name":"CIBER Epidemiology and Public Health (CIBERESP)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5586-404X","authenticated-orcid":false,"given":"Carmen","family":"Mu\u00f1oz\u2010Almagro","sequence":"additional","affiliation":[{"name":"CIBER Epidemiology and Public Health (CIBERESP)  Madrid Spain"},{"name":"Infectious Diseases and Microbiome Institut de Recerca Sant Joan de D\u00e9u  Barcelona Spain"},{"name":"Department of Medicine Universitat Internacional de Catalunya  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1298-3089","authenticated-orcid":false,"given":"David","family":"Tarrag\u00f3","sequence":"additional","affiliation":[{"name":"CIBER Epidemiology and Public Health (CIBERESP)  Madrid Spain"},{"name":"National Center for Microbiology Instituto de Salud Carlos III  Majadahonda Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0913-9303","authenticated-orcid":false,"given":"Cristian","family":"Launes","sequence":"additional","affiliation":[{"name":"Pediatrics Department Hospital Sant Joan de D\u00e9u  Barcelona Spain"},{"name":"CIBER Epidemiology and Public Health (CIBERESP)  Madrid Spain"},{"name":"Infectious Diseases and Microbiome Institut de Recerca Sant Joan de D\u00e9u  Barcelona Spain"},{"name":"Faculty of Medicine and Health Sciences, Department of Medicine and Surgical Medical Specialties University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000922"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.20634.1"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit458"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eimce.2020.03.008"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(23)00195\u20103"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2007.04.058"},{"key":"e_1_2_10_8_1","volume-title":"StatPearls","author":"Cantu R. 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