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

Gowin, Ewelina; Wysocki, Jacek; Michalak, Michał

doi:10.1016/j.ijid.2012.11.024

Cited by 32 publications

(41 citation statements)

References 23 publications

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“…The most common types of complications reported in our study in Hungary included keratoconjunctivitis, dehydration, skin and soft tissue infection, bronchitis, pneumonia, facial paresis, severe pain and cerebellitis. These findings are consistent with the commonly reported complications in other studies conducted in European countries [36–44]. No deaths were reported in our study; however, this was expected due to the low sample size and the varicella case-fatality rate which has been estimated at 1 death per 100,000 children [45–47].…”

Section: Discussionsupporting

confidence: 93%

Economic burden of varicella in children 1–12 Years of age in Hungary, 2011–2015

et al. 2017

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BackgroundAlthough live-attenuated varicella-zoster virus (VZV) vaccines have been proven to be safe and effective in preventing varicella and real-word evidence shows routine childhood immunization programs are effective in dramatically reducing varicella associated morbidity and mortality, varicella vaccine is not included in the National Immunization Program (NIP) in Hungary. The purpose of this study was to evaluate the clinical and economic burden associated with varicella in Hungary.MethodsThis was a multicenter, retrospective, chart review study of patients aged 1–12 years with a primary varicella diagnosis between 2011 and 2015. Healthcare resource utilization (HCRU) associated with varicella, unit costs, and work loss were used to estimate direct and indirect costs. All costs are presented in 2015 HUF / Euros (€).Results156 children with varicella were included (75 outpatients, 81 inpatients), with a mean age of 4.4 (SD: 2.0) and 3.7 (SD: 2.1) years, respectively. One or more complications were reported by 12.0% of outpatients and 92.6% of inpatients, the most common being dehydration, skin and soft tissue infections, pneumonia, keratoconjunctivitis, and cerebellitis. HCRU estimates included use of over-the-counter (OTC) medications (96.0% outpatients, 53.1% inpatients), prescription medications (9.3% outpatients, 70.4% inpatients), tests/procedures (4.0% outpatients, 97.5% inpatients), and consultation with allied health professionals (2.7% outpatients, 30.9% inpatients). The average duration of hospital stay (inpatients) was 3.6 (95% CI: 3.2, 4.1) days. The total combined direct and indirect cost per varicella case was 228,146.7 Hungarian Forint (HUF)/€ 736.0 for inpatients and 49,790.6 HUF/€ 106.6 for outpatients. The overall annual cost of varicella in Hungary for children aged <15 years in 2015 was estimated at 1,903,332,524.3 HUF/ € 6,139,980.4.ConclusionVaricella is associated with substantial clinical burden in Hungary, resulting in the utilization of a significant amount of healthcare resources. These results support the need for routine vaccination of all healthy children to reduce the varicella-associated disease burden.

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Section: Discussionsupporting

confidence: 93%

Economic burden of varicella in children 1–12 Years of age in Hungary, 2011–2015

et al. 2017

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“…Neurological complications were encountered more often in the age groups 2-5 and 6-9 years old; the clinical spectrum was consistent with findings described in the literature. [7][8][9][10][11] Skin and soft tissue infections came in the fourth place, probably because these are commonly managed on an outpatient basis.…”

Section: Discussionmentioning

confidence: 99%

Complications of Varicella in Unvaccinated Children From Romania, 2002–2013

Popescu

Ceauşu

Florescu³

et al. 2016

Pediatric Infectious Disease Journal

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“…Although varicella usually have a benign and self-limiting course, complications as skin and soft tissue secondary bacterial infections, respiratory tract infections and neurological complications can occur, especially in immunocompromised children (3,4,5,6,7,8). However, most hospitalizations for varicella are of previously healthy children (7).…”

Section: Introductionmentioning

confidence: 99%

Varicella complications in children one-site Polish population – a 19- year long survey

Smok

Franczak²,

Domagalski

et al. 2018

Przegl Epidemiol

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OBJECTIVES. The aim of this study was to describe the epidemiology of chickenpox complications in children, based on a 19-year long survey. METHODS. This publication constitutes a review of medical records of 761 patients under the age of 18 who were hospitalized at the T. Browicz Provincial Hospital for Infectious Diseases in Bydgoszcz, Poland from the 1st of January 1999 to the 31st of December 2017. RESULTS. Over the study period, 761 children diagnosed with varicella complications were hospitalized. The mean number of hospitalizations in each year amounted to 40. The median age of admitted patients was 4 years. The median length of hospitalization was 5 days (ranged from 1 to 30 days). The most frequent varicella complications included respiratory tract infections – 229/761 (30.1%), bacterial skin infections – 189/761 (24.8%) and gastrointestinal tract disorders – 142/761 (18.6%). Pneumonia, bronchitis and gastrointestinal tract disturbances, were reported most often in children under 2 years of age, while neurological complications occurred most frequently in children at 3-6 years of age. No significant differences in the number of varicella complications between immunocompromised and immunocompetent children were reported. CONCLUSIONS. Varicella complications mainly affect the youngest immunocompetent children. Population-wide vaccination and herd immunity appears to be the best way to reduce the incidence of chickenpox and the rate of varicella complications. This study gives support for inclusion of universal varicella vaccine in the National Immunization Program in Poland.

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

Cited by 32 publications

References 23 publications

Economic burden of varicella in children 1–12 Years of age in Hungary, 2011–2015

Economic burden of varicella in children 1–12 Years of age in Hungary, 2011–2015

Complications of Varicella in Unvaccinated Children From Romania, 2002–2013

Varicella complications in children one-site Polish population – a 19- year long survey

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