Chickenpox complications in Saudi Arabia: Is it time for routine varicella vaccination?

Almuneef, Maha; Memish, Ziad A.; Balkhy, Hanan H.; Alotaibi, Badriyah; Helmy, Magda

doi:10.1016/j.ijid.2005.02.008

Cited by 38 publications

(39 citation statements)

References 30 publications

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“…In contrast, some studies have reported a predominance of neurologic complications as 61.3% from Germany [38] and 38.3% in Italy [29]. However, studies from Saudi Arabia and France showed that neurological complications in only 7% and 7.8% of patients, respectively [1,17]. Uncomplicated varicella seems to be a frequent cause of admission in Greece; the percentage observed is similar to that in our study (20%) [36].…”

Section: Incidence Of Varicella Related Hospitalization (Per 100000 supporting

confidence: 77%

The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the pre-vaccine era (VARICOMP study)

Dinleyici¹,

Kurugöl²,

Türel³

et al. 2011

Eur J Pediatr

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Varicella can cause complications that are potentially serious and require hospitalization. Our current understanding of the causes and incidence of varicella-related hospitalization in Turkey is limited and sufficiently accurate epidemiological and economical information is lacking. The aim of this study was to estimate the annual incidence of varicella-related hospitalizations, describe the complications, and estimate the annual mortality and cost of varicella in children. VARICOMP is a multi-center study that was performed to provide epidemiological and economic data on hospitalization for varicella in children between 0 and 15 years of age from October 2008 to September 2010 in Turkey. According to medical records from 27 health care centers in 14 cities (representing 49.3% of the childhood population in Turkey), 824 children (73% previously healthy) were hospitalized for varicella over the 2-year period. Most cases occurred in the spring and early summer months. Most cases were in children under 5 years of age, and 29.5% were in children under 1 year of age. The estimated incidence of varicella-related hospitalization was 5.29-6.89 per 100,000 in all children between 0-15 years of age in Turkey, 21.7 to 28 per 100,000 children under 1 year of age, 9.8-13.8 per 100,000 children under 5 years of age, 3.96-6.52 per 100,000 children between 5 and 10 years of age and 0.42 to 0.71 per 100,000 children between 10 and 15 years of age. Among the 824 children, 212 (25.7%) were hospitalized because of primary varicella infection. The most common complications in children were secondary bacterial infection (23%), neurological (19.1%), and respiratory (17.5%) complications. Secondary bacterial infections (p < 0.001) and neurological complications (p < 0.001) were significantly more common in previously healthy children, whereas hematological complications (p < 0.001) were more commonly observed in children with underlying conditions. The median length of the hospital stay was 6 days, and it was longer in children with underlying conditions (<0.001). The median cost of hospitalization per patient was $338 and was significantly higher in children with underlying conditions (p < 0.001). The estimated direct annual cost (not including the loss of parental work time and school absence) of varicella-related hospitalization in children under the age of 15 years in Turkey was $856,190 to $1,407,006. According to our estimates, 882 to 1,450 children are hospitalized for varicella each year, reflecting a population-wide occurrence of 466-768 varicella cases per 100,000 children. In conclusion, this study confirms that varicella-related hospitalizations are not uncommon in children, and two thirds of these children are otherwise healthy. The annual cost of hospitalization for varicella reflects only a small part of the overall cost of this disease, as only a very few cases require hospital admission. The incidence of this disease was higher in children <1 year of age, and there are no prevention strategies for these children other ...

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Section: Incidence Of Varicella Related Hospitalization (Per 100000 supporting

confidence: 77%

The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the pre-vaccine era (VARICOMP study)

Dinleyici¹,

Kurugöl²,

Türel³

et al. 2011

Eur J Pediatr

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“…The estimates range from 0.82 to 29.2 per 100 000 (Lin & Hadler, 2000;Tseng et al, 2000;Carapetis et al, 2004;Bonhoeffer et al, 2005;Almuneef et al, 2006;Theodoridou et al, 2006;Cameron et al, 2007;Dubos et al, 2007;Grimprel et al, 2007;Liese et al, 2008;Lopez et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Burden of varicella in Italy, 2001–2010: analysis of data from multiple sources and assessment of universal vaccination impact in three pilot regions

Trucchi

Gabutti

Rota

et al. 2015

Journal of Medical Microbiology

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“…Complications of varicella requiring hospitalization in children are becoming more frequent in recent years than previously thought. Almuneef et al (2006) considered that the predominance of uncomplicated cases confounds the morbidity and mortality associated with severe varicella.…”

Section: Discussionmentioning

confidence: 99%

Complications of Varicella – Report of Case with Hemorrhagic-Necrotic Rash and Cerebellar Ataxia

Gancheva¹,

Doichinova²,

Lukanov³

2014

JMED

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Varicella is usually self-limiting but occasionally severe infectious disease (with 2 to 6% of cases resulting in complications). The aim was to report a case with hemorrhagic-necrotic rash, discrete cerebellar ataxia and immune suppression. A two-year-and-seven-month-old boy with fever, tonsillitis and rose-colored-spots rash was treated with Amoxiclav and antihistamines followed by improvement. Eight days after treatment, fever, vesiculous rash (consequently hemorrhagicnecrotic) and enlarged lymph nodes appeared. On admission, the child was in severe condition, with generalized polymorph rash (vesicles with bloody content on necrotic surface, few crusts), generalized enlarged and painful lymph nodes, increased breath and heart rates, hepatosplenomegaly, depressed patellar and Achilles reflexes, positive Babinski sign; without signs of meningeal irritation. Ataxia had observed and Romberg was positive. Laboratory investigations revealed anemia, thrombocytopenia and normal humoral immunity. Lymphopenia (12.28%), decreased total Т-lymphocytes, normal CD4+/ CD8+ T-lymphocytes ratio at normal CD4+ and decreased CD8+ Т cells, increased В-lymphocytes were found by flow-cytometry. Serological investigations (ELISA) revealed significant titers of specific IgM antibodies against three different herpesviruses (HSV-1, HSV-2 and Varicella zoster virus). Complex etiologic and supportive treatment was administered. The child had improved after sixth day and was discharged on eleventh day. Hemorrhagic-necrotic form of varicella is rare. It occurs mainly in immunocompromised patients, but immunocompetent individuals also could be affected. This requires the use of broad diagnostic panel for precise etiological diagnosis, which will facilitate the proper treatment and favorable outcome.

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Chickenpox complications in Saudi Arabia: Is it time for routine varicella vaccination?

Abstract: These data provide a baseline for morbidity and mortality from chickenpox, and further support the inclusion of varicella vaccine in the routine childhood immunization program in Saudi Arabia.

Cited by 38 publications

References 30 publications

The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the pre-vaccine era (VARICOMP study)

The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the pre-vaccine era (VARICOMP study)

Burden of varicella in Italy, 2001–2010: analysis of data from multiple sources and assessment of universal vaccination impact in three pilot regions

Complications of Varicella – Report of Case with Hemorrhagic-Necrotic Rash and Cerebellar Ataxia

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