Ethnic differences in the severity of varicella in adults in northern Saudi Arabia

The severity of varicella infection in 124 expatriates from the Asian continent was compared to that in 120 Saudi nationals, seen in Arar Central Hospital, Arar, Saudi Arabia, between January 1992 and December 1994. Persistent fever (defined as a raised body temperature more than 37.4 degrees C lasting more than 5 days), extensive skin eruptions (defined as extensive, when more than 50% of the body surface was affected) and transient elevation of hepatic enzymes (aspartate transaminases > 37 U/L and alanine transaminases > 40 U/L) after excluding other possible causes, occurred significantly more in expatriates than in Saudis. The mean duration of the illness in expatriates was 15.9 +/- 3.41 days as compared to a mean duration of 13.1 +/- 3.52 days in Saudis. This difference was statistically significant (p < 0.01 Student's t-test). The findings in this study suggest that varicella infection runs a more severe course in expatriates from the Asian continent as compared to the Saudis. Treatment with the antiviral agent acyclovir may be indicated in this group of expatriates with varicella infection.