The hospitalization because of varicella in a tertiary care pediatric hospital during 10 year study period

L. Bertoluzzo, E. Castagnola, G. Losurdo, E. Bondi, F. Canale, Raffaella Giacchino

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction. Varicella is one of the most widespread childhood viral infectious diseases and typically shows an endemic and epidemic trend. It has usually a benign clinical course even if it can present severe complications. We conducted a retrospective study to evaluate hospitalizations due to varicella or its complications in a tertiary care pediatric hospital in Italy, in absence of a nation-wide program for varicella immunization. Methods. A retrospective cohort study was designed and medical records of patients discharged from "G. Gaslini" Children's Hospital, Genoa, Italy, from January 1995 to December 2004 with a diagnosis of varicella (ICD-9 and ICD-9CM codes) were identified from Hospital database. For each case reporting presence of complications, the clinical report form was extracted and the complications recorded. Results. During a 10 year study period, 346 (0.16%) of hospital discharges presented one of the varicella identify codes, concerning a total of 313 patients for a total of 3,010 days of hospitalization. 276 (80%) discharges were in absence of any complication with a mean hospital stay of 7.9 days; 14 (4%) cases dischaged with "not detailed complications, for a mean of 7.1 days of hospitalization. In 56 (16%) clinical report forms the presence of detailed complications was recorded, with a mean of 13 days of hospitalization for each case. Cerebellar ataxia, encephalitis or cerebrovascular disease, were observed in 13 patients, six of them had more than one hospital admission because of severe sequelae due to CNS complications of varicella. Other 7 patients presented severe skin bacterial superinfections, 3 had pneumonia and one severe, self limiting thrombocytopenia. In the other 17 episodes, clinical reports described other symptoms (e.g. severe cephalalgia or abdominal pain, dehydration, high fever) without specific organ involvement, as varicella-related complications. No deaths were observed. Conclusion. This study provides an epidemiological analysis of the rate of hospitalization of children with varicella or its complications in a tertiary care pediatric hospital in absence of a nation-wide program for varicella vaccination. Central nervous system disease represented the most frequently observed severe complication, followed by skin superinfection and pneumonia. Hospitalizations due to varicella or due to treatment of its sequelae accounted for a total of 3,010 days of admission. This represents a high economic cost, that is further increased if indirect costs, as work by parents and medical and social costs for treatment of severe central nervous system sequelae, are considered. The recently marketed varicella vaccines have been shown to be safe and effective, with an estimated 84-86% of cases prevented and 100% prevention of severe disease. The routine vaccination program against varicella disease is the first attempt to decrease the complications and the costs of ubiquitous varicella infection. The success of the program will largely depend on the vaccination coverage achieved and on the long-term immunity conferred by the vaccine.

Original languageEnglish
Pages (from-to)169-172
Number of pages4
JournalJournal of Preventive Medicine and Hygiene
Volume46
Issue number4
Publication statusPublished - Dec 2005

Keywords

  • Hospitalization
  • Varicella
  • Varicella/complications

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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