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Complications of varicella in a defined central European population
A Jaeggi1, R P Zurbruegg, C Aebi
1Department of Pediatrics, University of Bern, Inselspital, Switzerland.
Insights
Hospitalization rates for varicella complications in children were lower than previously reported, except for central nervous system issues. This highlights regional variability in varicella complications, informing immunization strategies.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Varicella (chickenpox) can lead to serious complications requiring hospitalization.
- Understanding regional variations in varicella complication rates is crucial for public health planning.
Purpose of the Study:
- To document varicella-related hospitalizations and their complications in children within the canton of Bern, Switzerland.
- To compare these hospitalization rates with previously published international data.
Main Methods:
- A retrospective analysis of hospital records for patients under 16 years old admitted for varicella complications between 1986 and 1996.
- Calculation of hospitalization rates based on birth and varicella antibody prevalence data.
Main Results:
- 113 cases of varicella complications were identified, with younger siblings being overrepresented.
- Central nervous system (CNS) complications occurred in 23% of cases, predominantly in previously healthy children.
- Hospitalization rates for primary varicella, skin infections, and pneumonia were lower than reported elsewhere, but the CNS complication rate was notably high.
Conclusions:
- Significant regional variability exists in varicella complication rates, as evidenced by lower overall hospitalization rates compared to international studies.
- These findings underscore the importance of considering local epidemiological data when developing varicella immunization strategies.
Aims:
To describe complications of varicella requiring hospitalisation in a defined population (canton of Bern) and to compare the hospitalisation rates for varicella with published data.
Methods:
Retrospective analysis of hospital records of patients less than 16 years of age admitted with complications of varicella to the hospitals serving this population (University Children's Hospital of Bern and the Wildermeth Children's Hospital of Biel, Switzerland), and calculation of hospitalisation rates for varicella and its complications based on birth rates and varicella antibody prevalence rates.
Results:
From 1986 to 1996, 113 cases (median age, 5.6 years) were identified. Younger siblings were overrepresented (odds ratio (OR), 1.42; 95% confidence interval (CI), 1.09 to 1.84). Central nervous system (CNS) complications (26 patients; 23%) were found predominantly in previously healthy children (relative risk, 7.1; 95% CI, 1.01 to 49.86). Group A beta haemolytic streptococci were recovered from only one of 35 patients with bacterial complications. The hospitalisation rates for primary varicella (9.2/10(4) cases; 95% CI, 7.4 to 11/10(4), skin infections (2.0/10(4) cases; 95% CI, 1.2 to 2.9/10(4), and pneumonia (0.8/10(4) cases; 95% CI, 0.3 to 1.3/10(4)) were significantly lower than reported previously. The CNS complication rate (2.2/10(4) cases; 95% CI, 1.3 to 3.1/10(4) was among the highest rates reported.
Conclusions:
The low hospitalisation rate in comparison with studies from elsewhere indicates that there is a large regional variability in complications associated with varicella. Such data should be taken into consideration when local varicella immunisation strategies are developed.