Varicella paediatric hospitalisations in Belgium: a 1-year national survey

Abstract

BackgroundVaricella universal vaccination (UV) has been implemented in many countries for several years. Nevertheless, varicella UV remains debated in Europe and few data are available on the real burden of infection. We assessed the burden of varicella in Belgium through analysis of hospitalised cases during a 1-year period.MethodsData on children admitted to hospital with varicella were collected through a national network from November 2011 to October 2012. Inclusion criteria were either acute varicella or related complications up to 3 weeks after the rash.ResultsParticipation of 101 hospitals was obtained, covering 97.7% of the total paediatric beds in Belgium. 552 children were included with a median age of 2.1 years. Incidence of paediatric varicella hospitalisations reached 29.5/105 person-years, with the highest impact among those 0–4 years old (global incidence and odds of hospitalisation: 79/105 person-years and 1.6/100 varicella cases, respectively). Only 14% (79/552) of the cohort had an underlying chronic condition. 65% (357/552) of children had ≥1 complication justifying their admission, 49% were bacterial superinfections and 10% neurological disorders. Only a quarter of children (141/552) received acyclovir. Incidence of complicated hospitalised cases was 19/105 person-years. Paediatric intensive care unit admission and surgery were required in 4% and 3% of hospitalised cases, respectively. Mortality among Belgian paediatric population was 0.5/106 and fatality ratio 0.2% among our cohort.ConclusionsVaricella demonstrated a substantial burden of disease in Belgian children, especially among the youngest. Our thorough nationwide study, run in a country without varicella UV, offers data to support varicella UV in Belgium.

Specific Varicella-Related Complications and Their Decrease in Hospitalized Children after the Introduction of General Varicella Vaccination: Results from a Multicenter Pediatric Hospital Surveillance Study in Bavaria (Germany)

“…Clinical data were available for 1263 children with VRH, including 954 (75.5%) children with specific VRC. This proportion of children with VRC was similar to other studies in European countries [20][21][22][23][24]. Descriptions of specific VRC types in hospitalized children are available from many countries, but were often limited by the monocentric design and low patient numbers, whereas our multicenter study provided solid data from 22 to 29 pediatric hospitals.…”

Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization

“…Varicella community incidence was estimated from 43 seroprevalence data sources from 16 countries [17–27, 29–41, 44–47, 49–54, 57–62, 64, 65, 68], primary care incidence from 17 PCI data sources from 8 countries [23, 74, 76, 79, 80, 99, 101, 102, 104–106, 109, 110, 112, 114, 124, 126], hospitalisation incidence from 18 HI data sources from 10 countries [23, 69–73, 75, 76, 79–81, 84, 87, 90, 91, 94, 102, 103], and one data source was used to estimate mortality in 31 countries [11] (Table 2). Data on all four outcomes was only available for six countries (Belgium, France, Italy, the Netherlands, Spain and the UK).…”

The burden of hospitalisation for varicella and herpes zoster in England from 2004 to 2013

“…Both diseases are usually selflimiting, but may result in complications which lead to hospitalisation and even death. 2,3 Vaccines containing live attenuated varicella-zoster virus (VZV) are available for both disease presentations for use in immunocompetent individuals. Varicella vaccine is licensed in the UK for individuals from one year of age upwards and zoster vaccine from age 50 upwards.…”