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Deaths from varicella in infants
Pediatric Infectious Disease
|September 1, 1985
Summary
Maternal varicella exposure before birth can severely affect newborns. However, most infant varicella deaths result from postnatal infection, not in utero exposure, making routine immunoglobulin unlikely to be warranted for all infants.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Maternal varicella infection near delivery poses severe risks to newborns.
- Routine varicella-zoster immunoglobulin is recommended for infants exposed in utero.
- Data on infant deaths from postnatal varicella infection are limited.
Purpose of the Study:
- To determine the proportion of infant varicella deaths attributable to intrauterine exposure.
- To assess the risk of death from postnatal varicella infection in infants.
- To evaluate the necessity of routine postexposure varicella-zoster immunoglobulin for all infants.
Main Methods:
- Analysis of 92 varicella-related deaths in children under 1 year old.
- Data sourced from the National Center for Health Statistics (1968-1978).
- Categorization of deaths based on age at death and presumed exposure (intrauterine vs. postnatal).
Main Results:
- Only five deaths occurred in newborns (0-19 days old), indicating intrauterine infection causes few infant varicella deaths.
- The majority of varicella deaths in infants under 1 year old were linked to postnatal infection.
- Infants under 1 year have a 4-fold higher death rate from varicella compared to children aged 1-14 years.
Conclusions:
- Intrauterine varicella exposure accounts for a small fraction of infant varicella deaths.
- Postnatal varicella infection is the primary driver of increased mortality risk in infants.
- Routine postexposure varicella-zoster immunoglobulin for all infants under 1 year is not currently justified due to low annual deaths and relative risk.
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