Don't forget how severe varicella can be-complications of varicella in children in a defined Polish population

Family Medicine Department, Poznan University of Medical Sciences, 49, Przybyszewskiego Str., 60-355 Poznan, Poland. Electronic address: .
International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases (Impact Factor: 1.86). 01/2013; 17(7). DOI: 10.1016/j.ijid.2012.11.024
Source: PubMed


BACKGROUND: This study aimed to analyze the causes of hospitalization in children with varicella, based on a defined Polish population. METHODS: This was a retrospective analysis of causes of hospitalization in children under 18 years of age with varicella, treated on the Infectious Diseases Ward of the Children's Hospital in Poznan, Poland from January 2007 to June 2012. The ward serves almost the entire child population of the Greater Poland region (10% of the Polish population - almost 600 000 children). The analysis was based on hospital records. Patients were identified using the International Classification of Diseases Tenth Revision (ICD-10) codes. The case definition consisted of physical evidence of varicella. RESULTS: A total of 224 children were hospitalized for varicella complications. The median age of admitted patients was 37.5 months (range 6 days to 17 years). Rates of hospitalization decreased with age. The highest rates were among children during their first year. Ninety-two percent of children were healthy prior to hospitalization (no chronic diseases). The most common complications were respiratory tract infections (26%), followed by skin infections (21%) and neurological symptoms (18%). Twenty-five patients (11%) had more than one complication. The most common coexisting conditions were dehydration and otitis media. CONCLUSIONS: The results presented here serve to remind us that varicella may to lead to severe complications in unvaccinated children and adolescents, and demonstrate the benefits of varicella vaccination. Most children hospitalized with varicella were immunologically healthy. Meningitis was more common in older children (>6 years of age). Streptococcus pyogenes was the most commonly identified bacterial pathogen.

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Available from: Ewelina Gowin, Apr 16, 2015
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    • "The bacteria responsible for secondary bacterial infection in patients with varicella were most commonly Staphylococcus aureus followed by group A streptococci [34] [35] [37] [38] [44]. Imöhl et al., in Germany, studied invasive group A streptococcal (iGAS) disease and its association with varicella and found that 1.6% of iGAS samples were associated with varicella. "
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    ABSTRACT: There is no consensus as regards the European varicella immunisation policy; some countries have introduced varicella vaccination in their routine childhood immunisation programs whereas others have decided against or are debating. With the aim of providing an overview of the epidemiology of varicella in Europe and addressing the different strategies and the experiences so far, we performed a review of epidemiological studies done in Europe from 2004 to 2014. Varicella is mainly a disease of childhood, but sero-epidemiological studies show regional differences in the proportion of susceptible adults. Hospitalisation due to varicella is not common, but complications and hospitalisation mainly affect previously healthy children, which underlines the importance of not dismissing varicella as a disease of little importance. The experience with universal vaccination in Europe shows that vaccination leads to a rapid reduction of disease incidence. Vaccine effectiveness is high and a protective herd effect is obtained. Experience with vaccination in Europe has not been long enough, though, to draw conclusions on benefits and drawbacks with vaccination as well as the capacity for national programs in Europe to maintain a sufficiently high coverage to prevent a change in age group distribution to older children and young adults or on the impact that varicella immunisation may have on the epidemiology of shingles. Copyright © 2015. Published by Elsevier Ltd.
    Full-text · Article · Mar 2015 · Vaccine
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    Full-text · Article · Jul 2013 · International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases
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    ABSTRACT: Varicella vaccines available in Spain were marketed in 1998 and 2003 for non-routine use. Since 2006 some regions decided to include varicella vaccination in their regional routine vaccination programmes at 15-18 months of age. Other regions chose the strategy of vaccinating susceptible adolescents. This study shows the trends in severe varicella zoster virus infections through the analysis of the hospital discharges related to varicella and herpes zoster in the general population from 2005 to 2010 in Spain. A total of 11,125 hospital discharges related to varicella and 27,736 related to herpes zoster were reported during the study period. The overall annual rate of hospitalization was 4.14 cases per 100,000 for varicella and 10.33 cases per 100,000 for herpes zoster. In children younger than 5 years old varicella hospitalization rate significantly decreased from 46.77 in 2005 to 26.55 per 100,000 in 2010. The hospitalization rate related to herpes zoster slightly increased from 9.71 in 2005 to 10.90 per 100,000 in 2010. This increase was mainly due to the significant increase occurring in the >84 age group, from 69.55 to 97.68 per 100,000. When gathering for regions taking into account varicella vaccine strategy, varicella related hospitalizations decreased significantly more in those regions which included the vaccine at 15-18 months of age as a routine vaccine comparing with those vaccinating at 10-14 years old. No significant differences were found in herpes zoster hospitalization rates regarding the varicella vaccination strategy among regions. Severe varicella infections decreased after implementation of varicella vaccination in Spain. This decrease was significantly higher in regions including the vaccine at 15-18 months of age compared with those vaccinating susceptible adolescents.
    No preview · Article · Nov 2013 · Vaccine
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