Varicella zoster in children attending day care centers
Ricardo Marcitelli1, Lucia Ferro Bricks
1Pediatrics Department, University of Taubaté, Taubaté, SP, Brazil.
Insights
Varicella (chickenpox) caused significant illness in young children attending daycare, with complications in over 5% and lasting effects in 0.7%. Vaccination for children over one year could prevent transmission to infants, protecting vulnerable populations.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Varicella (chickenpox) is a common childhood illness.
- Children in daycare settings are at high risk of transmission.
- Understanding varicella-related morbidity in this population is crucial for public health interventions.
Purpose of the Study:
- To describe the morbidity associated with varicella infection in children attending day care centers.
- To identify risk factors and complications of varicella in this specific demographic.
- To inform public health strategies regarding varicella prevention and management.
Main Methods:
- A descriptive study was conducted using parent inquiries.
- Data were collected from 664 children diagnosed with varicella after attending day care centers in Taubaté, São Paulo.
- The study analyzed symptoms, medical visits, medication use, complications, hospitalizations, and sequelae.
Main Results:
- The median age of affected children was 36 months; 8.4% contracted varicella before age one.
- Common symptoms included exanthema (100%), fever (85.4%), anorexia (39.6%), and headache (15.3%).
- Complications occurred in 5.7% of children, with hospitalization in 1.2% and sequelae in 0.7%; younger children (<1 year) had higher complication and hospitalization rates.
Conclusions:
- Varicella poses significant morbidity risks to children in daycare, particularly those under one year old.
- The study highlights the overuse of nonsteroidal anti-inflammatory drugs and antibiotics.
- Varicella vaccination for children over one year is recommended to achieve herd immunity and protect infants, urging public health authorities to consider vaccine programs for daycare attendees.
Objective:
To describe morbidity associated to varicella in children attending day care centers.
Methods:
Descriptive study carried out through inquiries with parents of 664 children who acquired varicella after admission to day care centers in Taubaté (population: 244,165, census of 2004), a prosperous city in the State of São Paulo.
Results:
The median age was 36 months (range 6 to 80 months); 8.4% of the children had varicella before 1 year of age. The main symptoms were: exanthema (100.0%), fever (85.4%) anorexia (39.6%), and headache (15.3%). 517 children (77.9%) had at least 1 medical visit, and 80.6% received at least 1 medication; 73 (11.0%) received nonsteroidal antiinflammatory drugs, and 52 (7.8%) received antibiotics. Complications occurred in 38 children (5.7%; 95% confidence interval: 3% - 8%); 8 (1.2%) were hospitalized, and 5 (0.7%) had sequelae. Complications and hospitalizations rates were 3 times more frequent in children with less than 1 year of age than in older children. More than half of the children and of the working parents were absent from their regular activities for more than a week.
Conclusions:
Varicella was associated with significant morbidity, affected younger children, was complicated in more than 5%, and left sequelae in 0.7% of children. More than 10% of the children received nonsteroidal antiinflammatory drugs, highlighting the need to warn the population about the risks of these drugs. Although varicella vaccination is not recommended for children younger than 12 months, vaccination of the children older than a year could avoid by herd immunity the transmission to babies. Brazilian public health authorities should be alerted to this issue and offer varicella vaccine to children attending day care centers.
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