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A 15-year experience with varicella infections in a pediatric burn unit
R L Sheridan1, J M Weber, M M Pasternak
1Shriners Burns Hospital, Boston, MA 02114, USA. sheridan.robert@mgh.harvard.edu
Insights
Varicella infection poses risks for burned children due to immunosuppression. Prompt isolation of cases in pediatric burn units effectively prevents cross-infection, safeguarding vulnerable young patients.
Area of Science:
- Pediatric infectious diseases
- Burn care and management
- Immunocompromised patient care
Background:
- Varicella (chickenpox) infection presents significant risks for pediatric patients with burns due to their compromised immune systems.
- Preventing varicella cross-infection in pediatric burn units is crucial for patient safety and outcomes.
- A 15-year review of varicella cases in a pediatric burn unit was conducted to assess morbidity and prevention strategies.
Purpose of the Study:
- To evaluate the morbidity associated with varicella infection in acutely burned children.
- To identify effective measures for preventing varicella cross-infection within a pediatric burn unit.
- To emphasize the importance of isolation strategies in managing varicella in this high-risk population.
Main Methods:
- Retrospective analysis of varicella cases over a 15-year period in a dedicated pediatric burn unit.
- Assessment of clinical presentation, complications (morbidity), and outcomes.
- Evaluation of the effectiveness of implemented infection control protocols, particularly index case identification and isolation.
Main Results:
- Varicella infection in burned children was primarily associated with pneumonitis, with minimal wound-related complications.
- Prompt identification and isolation of initial varicella cases resulted in a very low incidence of secondary infections.
- The long incubation period of varicella necessitates vigilant monitoring and rapid response.
Conclusions:
- Varicella infection poses a significant threat to hospitalized children with burns, mainly causing pneumonitis.
- Effective prevention of varicella cross-infection in pediatric burn units relies on a well-planned and executed strategy for isolating index cases.
- Continued vigilance and isolation protocols are essential until widespread varicella vaccination achieves herd immunity.
Abstract:
Because of their well described global immunosuppression, varicella infection may be hazardous in burned children. It is therefore important to prevent cross-infections within pediatric burn units. We describe a 15-year experience with varicella in a pediatric burn unit, focusing on the morbidity associated with the infection and measures that have been effective in the prevention of cross-infection. We found that varicella infection in acutely burned children is associated with pneumonitis, but little wound related morbidity. Despite the deceptively long incubation period, prompt identification and isolation of index cases was associated with an extremely low incidence of cross-infection. Until widespread administration of varicella vaccine confers herd immunity, varicella remains a threat to hospitalized young children, highlighting the importance of a well planned and executed index case isolation strategy.