VARICELLA HOSPITALISATION
Abstract
Background. The purpose of the retrospective study was to analyse hospitalisation for varicella.
Methods. All patients with varicella who were admitted to the Department of Infectious Diseases, University Medical Centre Ljubljana, between January 1, 1995, and December 31, 1998, were included in the study.
Results. The percentage of hospitalised varicella patients was 0.69% of all notified cases in Ljubljana health region. The hospitalisation rate for children younger or equal to 15 years old was 51/10,000 estimated cases of varicella in Ljubljana health region. Varicella complications were the most frequent cause for admission. In children the most common complications were skin and soft tissue complications (35.5%), followed by CNS (17.4%) complications, lower respiratory tract (14.5%), gastrointestinal (11.6%) and others. Primary pneumonia was the most common complication in the patients older than 15 years. The median hospital stay was 6 days (2–39 days). Sequelae were recorded in four patients while two patients died. Specific mortality was 1:30,000 notified cases of varicella.
Conclusions. Varicella is a common benign and self-limited infectious disease. For majority of patients home care is adequate while hospitalisation is rarely indicated. Severe complications can occur which may be also fatal.
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References
Preblud SR, Orenstein WA, Bart KJ. Varicella: clinical manifestations, epidemiology and health impact in children. Pediatr Infect Dis J 1984; 3: 505–9.
Kraigher A, Hočevar-Grom A, Klaus I et al. Epidemiološko spremljanje nalezljivih bolezni v Sloveniji v letu 1998. Zdrav Var 1999; 38: Suppl 4: 3–80.
Preblud SR. Varicella: complications and costs. Pediatrics 1986; 78: Suppl 4: 728–35.
White CJ. Varicella-zoster virus vaccine. Clin Infect Dis 1997; 24: 753–63.
Fornaro P, Gandini P, Marin M et al. Epidemiology and cost analysis of varicella in Italy: results of a sentinel study in the pediatric practice. Pediatr Infect Dis J 1999; 18: 414–9.
Law B, Fitzsimon C, Ford Jones L, McCormick J, Riviere M. Cost of chickenpox in Canada: part 2. Cost of complicated cases and total economic impact. Pediatrics 1999; 104: 7–14.
Coudeville L, Paree F, Lebrun T, Sailly JC. The value of varicella vaccination in healthy children: cost-benefit analysis of the situation in France. Vaccine 1999; 17: 142–51.
Preblud SR. Age specific risks of varicella complications. Pediatrics 1981; 68: 14–8.
Enders G, Miller E, Cradock Watson J, Bolley I, Ridehalgh M. Consequences of varicella and herpes zoster in pregnancy: prospective study of 1739 cases. Lancet 1994; 343: 1548–51.
Oxman MN. Varicella. In: Braude AI, Davis CE, Fierer J eds. Infectious diseases and medical microbiology. Philadelphia: Saunders, 1986: 1392–406.
Brunell PA. Varicella-zoster infections. In: Feigin RD, Cherry JD eds. Textbook of pediatric infectious diseases. Philadelphia: Saunders, 1997: 1587–91.
Kidney DD, Watson JB, Nisar N. Varicella gangrenosa. Arch Dis Child 1988; 63: 444–5.
Bovill BA, Weir WRC. Staphylococcal infections. Br J Hosp Med 1994; 51: 589–93.
Drwal Klein LA, Odonovan CA. Varicella in pediatric patients. Ann Pharmacother 1993; 27: 938–49.
Arvin AM. Varicella-zoster virus. In: Nelson WE, Behrman RE, Kliegman RM, Arvin AM. Textbook of pediatrics. Philadelphia: Saunders, 1996: 892–5.
Friedman HD, Dracker RA. Cold agglutinin disease after chickenpox. Am J Clin Pathol 1992; 97: 92–6.
Whitley RJ. Varicella-zoster virus. In: Mandell GL, Bennett JE, Dolin R eds. Principles and practice of infectious diseases. New York: Churchill Livingstone, 1995: 1345–51.
Fairley CK, Miller E. Varicella-zoster epidemiology – a changing scene? J Infec Dis 1996; 174: Suppl 3: 314–9.
The working group on severe streptococcal infections. Defining the group A streptococcal toxic shock syndrome. JAMA 1993; 269: 390–1.
Jaeggi A, Zurbruegg RP, Aebi C. Complications of varicella in a defined central European population. Arch Dis Child 1998; 79: 472–7.
Bovill B, Bannister B. Review of 26 vears hospital admissions for chickenpox in north London. J Infect 1998; 36: Suppl 1: 17–23.
Maharshak N, Somekh E. Hospitalization for varicella in central Israel. Acta Paediatr 1999; 88: 1279–83.
Sočan M, Kraigher A, Pahor L. Epidemiologija noric v Sloveniji v dvajsetletnem obdobju. Zdrav Vestn 2000; 69: 253–6.
Jackson MA, Burry VF, Olson LC. Complications of varicella requiring hospitalization in previously healthy children. Pediatr Infect Dis J 1992; 11: 441–5.
Peterson CL, Mascola L, Chao SM et al. Children hospitalized for varicella: a prevaccine review. J Pediatr 1996; 129: 529–36.
Kelšin N, Medved M, Markelc M. Analiza bolnišničnega zdravljenja otrok in mladostnikov v Sloveniji. Zdrav Var 1998; 37: 345–54.
Guess HA, Broughton DD, Melton LJ, Kurland LT. Chickenpox hospitalizations among residents of Olmsted County, Minnesota, 1962 through 1981. Am J Dis Child 1984; 138: 1055–7.
Choo PW, Donahue JG, Manson JA, Platt R. The epidemiology of varicella and its complications. J Infect Dis 1995; 172: 706–12.
Huse DM, Meissner HC, Lacey MJ, Oster G. Childhood vaccination against chickenpox: an analysis of benefits and costs. J Pediatr 1994; 124: 869–74.
Yawn BP, Yawn RA, Lydick E. Community impact of childhood varicella infection. J Pediatr 1997; 130: 759–65.
Fleisher G, Henry W, Mcsorley M, Arbeter A, Plotkin S. Life threatening complications of varicella. Am J Dis Child 1981; 135: 896–9.
Joseph CA, Noah ND. Epidemiology of chickenpox in England and Wales 1967–85. Br Med J 1988; 296: 673–6.
Ziebold C, Kries R, Lang R, Weigl J, Schmitt HJ. Severe complications of varicella in previously healthy children in Germany. Pediatrics 2001; 108: e79.
Abzug MJ, Cotton MF. Severe chickenpox after intranasal use of corticosteroids. J Pediatr 1993; 123: 577–9.
Kasper WJ, Howe PM. Fatal varicella after a single course of corticosteroids. Pediatr Infect Dis J 1990; 9: 729–32.
Domingo JD, Ridao M, Latour J, Ballester A, Morant A. A cost-benefit analysis of routine varicella vaccination in Spain. Vaccine 1999; 17: 1306–11.
American Academy of Pediatrics. Active and passive immunization. In: Peter G ed. 1997 Red Book: report of the commettee of infectious disease. Elk Grove Village, IL: American Academy of Pediatrics, 1997: 50–9.
Burnett I. Immunoglobulin should be given if steroid dosage was > 0,15 mg/ kg/day in preceding three months. BMJ 1995; 310: 327.
Gogos CA, Bassaris HP, Vagenakis AG. Varicella pneumonia in adults. A review of pulmonary manifestations, risk factors and treatment. Respiration 1992; 59: 339–43.
Bachli E, Kagi MK, Krause M. Viszerale und neurologische Komplikationen bei varizellen Infektionen des Erwachsenen. Schweiz Med Wochenschr 1996; 126: 440–6.
Aebi C, Ahmed A, Ramilo O. Bacterial complications of primary varicella in children. Clin Infect Dis 1996; 23: 698–705.
Cowan MR, Primm PA, Scott SM, Abramo TJ, Wiebe RA. Serious group A betahemolytic streptococcal infections complicating varicella. Ann Emerg Med 1994; 23: 818–22.
Pleterski Rigler D, Rojc-Pečnik V. Bakterijske okužbe pri otrocih z noricami. In: Čižman M, Strle F eds. Infektološki simpozij 1996. Ljubljana: Med Razgl 1996; 35: Suppl 1: 119–28.
Hull D, Johnston DI. Essential paediatrics. New York: Churchill Livingstone, 1987: 164–5.
Rivera P, Canelles P, Quiles P, Orti E, Cuquerella J, Medina E. Gastrointestinal involvement in infections caused by varicella virus. Endoscopy 1998; 30: S9.
Feldman S, Crout JD, Andrew ME. Incidence and natural history of chemically defined varicella-zoster virus hepatitis in children and adolescents. Scand J Infect Dis 1997; 29: 33–6.
Pitel PA, McCormick KL, Fitzgerald E, Orson JM. Subclinical hepatic changes in varicella infection. Pediatrics 1980; 65: 631–3.
Winiarski J. Platelet antigens in varicella associated thrombocytopenia. Arch Dis Child 1990; 65: 137–9.
Hollenstein U, Thalhammer F, Burgmann H. Disseminated intravascular coagulation and rhabdomyolysis in fulminant varicella infection. Infection 1998; 26: 306–8.
Quinterodelrio AI, Fink CW. Varicella arthritis in childhood. Pediatr Infect Dis J 1997; 16: 241–3.
Gershon AA, Takahashi M, White CJ. Varicella vaccine. In: Plotkin SA, Orenstein WA. Vaccines. Philadelphia: Saunders, 1999: 475–507.
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