Recent infection doubles the risk of childhood stroke

New Monash University-led research has, for the first time in Australia, found that children with an infection in the past 60 days had roughly twice the risk of stroke. Published in Neurology, the study provides the first population-wide estimates on the incidence of childhood stroke in Australia and also tracks risk factors for this rare event.

In this study, over a seven-year period in Victoria, 571 childhood strokes occurred, equivalent to one stroke per 18,000 children. While rare, childhood stroke is associated with serious adverse health outcomes, including death and long-term disability. Childhood strokes were more common among boys, particularly infants <1y of age.

Importantly, this study identified patients with a recent infection had a two-fold increased risk of childhood stroke. The risk of childhood stroke is not just immediate, but the risk is highest in the two weeks after an infection and stays elevated for up to six months. This finding could change the way we care for children after common infections and suggests doctors and parents need to think beyond the recovery period and watch for warning signs long after the illness has passed.

The data was accessed from the Vaccine Safety Health Link (VSHL), a data asset established in 2021 to strengthen existing vaccine surveillance methods. This includes data from all Victorians across vaccination, infection, and hospital datasets. Using complete data on all vaccinations administered since birth, the researchers were unable to detect a significant association between recent vaccination and childhood stroke.

Research lead, Dr. Lachlan Dalli, from the School of Clinical Sciences at Monash Health said this study emphasizes that stroke is not just a disease of the elderly, it can affect anyone, at any age. “Childhood stroke is rare but serious, and our research shows infections can double this risk,” Dr. Dalli said. “Parents should know that infections like the flu or RSV can increase stroke risk in children for up to six months. Simple steps like vaccination and handwashing could make a big difference.

“This research underscores the importance of infection prevention strategies to protect kids from life-changing outcomes, like childhood stroke.”

Specific infections associated with childhood stroke include severe infections such as meningitis/encephalitis, sepsis, lower respiratory infections, but also common infections such as gastrointestinal infections and RSV.

Senior author Professor Jim Buttery from Murdoch Children’s Research Institute and University of Melbourne said this study adds to the increasing body of evidence showing the effect of common, preventable infections upon other health conditions. “With this and other studies, we are beginning to see the impact of common childhood viruses potentially triggering many other rarer childhood illnesses, ranging from febrile seizures to chilblains and now stroke. We can use these results to understand how these rarer diseases may be protected, at least in part, by things as simple as vaccines.”

The research team would like GPs to be aware of the growing evidence implicating common infections as risk factors for childhood stroke and actively promote preventive strategies, including timely vaccination, to mitigate the risk.