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Neurologic varicella complications before routine immunization in Germany

Anita L Rack1, Veit Grote, Andrea Streng

  • 1Dr. von Haunersches Kinderspital, University Children's Hospital Munich, Munich, Germany.

Pediatric Neurology
|December 17, 2009
PubMed

Insights

Neurologic complications frequently hospitalized children with varicella, most commonly acute cerebellar ataxia and febrile convulsions. These complications impacted immunocompetent children more often than immunocompromised ones.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Neurology

Background:

  • Varicella (chickenpox) is a common, highly infectious childhood illness.
  • Neurologic complications can arise from varicella infection.
  • Understanding the incidence and types of these complications is crucial for pediatric care.

Purpose of the Study:

  • To determine the incidence and types of neurologic complications in children hospitalized with varicella.
  • To identify risk factors and outcomes associated with these complications.

Main Methods:

  • Prospective nationwide surveillance of hospitalized varicella cases in Germany (2003-2004).
  • Data collected through the German Pediatric Surveillance Unit for Rare Diseases.
  • Analysis of demographic, clinical, and outcome data for children up to 16 years old.

Main Results:

  • Neurologic complications occurred in 25.4% of hospitalized children, being the most frequent reason for admission.
  • Acute cerebellar ataxia (31.0%) and febrile convulsions (29.7%) were the most common diagnoses.
  • Complications were more frequent in immunocompetent (32%) versus immunocompromised (4%) children.
  • Sequelae were observed in 12% of affected children, with 3 deaths.

Conclusions:

  • Neurologic complications are a significant cause of hospitalization for children with varicella.
  • Cerebellar ataxia and convulsions are the primary neurologic manifestations.
  • Immunocompetent children are at higher risk for these complications.

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