Skip to main content

Advertisement

SpringerLink
Log in

Prospective surveillance of hospitalisations associated with varicella-zoster virus infections in children and adolescents

  • Original Paper
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Our goal was to determine the epidemiology of severe varicella-zoster virus (VZV) infections in hospitalised paediatric patients. Admissions associated with VZV infection of patients aged 0–16 years were reported by all 38 paediatric units in Switzerland to the Swiss Paediatric Surveillance Unit (SPSU) during 3 consecutive years (4/2000–3/2003). We verified completeness of reporting by capture-recapture analysis with patient records identified by ICD-10 codes. Outcome of illness was assessed 6 months after hospitalisation. A total of 335 cases (235 identified by SPSU reports, 100 by ICD-10 code) were included in this study. Mean age of patients was 4.1 years (median 3.5 years, range 0–16 years); 54% were male. Some 293 (87%) patients presented with chickenpox, 42 (13%) with herpes zoster and 291 (87%) patients were not immunocompromised. A total of 319 complications occurred in 237 (71%) patients: secondary bacterial infections (n =109); central nervous system involvement (n =76); VZV pneumonitis (n =7); others (n =127). Eleven (3%) patients required intensive care and three died. On follow-up, 303 (96%) of 315 patients had completely recovered; sequelae were present in 12 (4%) patients. The calculated hospitalisation rate was 13 per 104 cases. Conclusion:This study describes a sizeable hospitalisation and complication rate of varicella-zoster virus infections and provides a solid basis for future immunisation recommendations in Switzerland.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

SPSU :

Swiss Paediatric Surveillance Unit

VZV :

varicella-zoster virus

References

  1. Aebi C, Fischer K, Gorgievski M, Matter L, Mühlemann K (2001) Age-specific seroprevalence to varicella-zoster virus: study in Swiss children and analysis of European data. Vaccine 19: 3097–3103

    Google Scholar 

  2. Banz K, Wagenpfeil S, Neiss A, Goertz A, Staginnus U, Vollmar J, Wutzler P (2003) The cost-effectiveness of routine childhood varicella vaccination in Germany. Vaccine 21: 1256–1267

    Article  CAS  PubMed  Google Scholar 

  3. Choo PW, Donahue JG, Manson JE, Platt R (1995) The epidemiology of varicella and its complications. J Infect Dis 172: 706–712

    Google Scholar 

  4. Galil K, Brown C, Lin F, Seward J (2002) Hospitalisations for varicella in the United States, 1988 to 1999. Pediatr Infect Dis J 21: 931–935

    Article  PubMed  Google Scholar 

  5. Gil A, Oyaguez I, Carrasco P, Gonzalez A (2001) Epidemiology of primary varicella hospitalisations in Spain. Vaccine 20: 295–298

    Google Scholar 

  6. Guess H, Broughton D, Melton L, Kurland LT (1986) Population based studies of varicella complications. Pediatrics 78[Suppl]: 723–727

  7. Hook EB, Regal RR (1995) Capture-recapture methods in epidemiology: methods and limitations. Epidemiol Rev 17: 243–264

    Google Scholar 

  8. Huse DM, Meissner HC, Lacey MJ, Oster G (1994) Childhood vaccination against chickenpox: an analysis of benefits and costs. J Pediatr 124: 869–874

    Google Scholar 

  9. Iff T, Donati F, Vassella F, Schaad UB, Bianchetti MG (1998) Acute encephalitis in Swiss children: aetiology and outcome. Eur J Paediatr Neurol 2: 233–237

    Google Scholar 

  10. Jackson MA, Burry VF, Olson LC (1992) Complications of varicella requiring hospitalisation in previously healthy children. Pediatr Infect Dis J 11: 441–445

    Google Scholar 

  11. Jaeggi A, Zurbruegg R, Aebi C (1998) Complications of varicella in a defined central European population. Arch Dis Child 79: 472–477

    Google Scholar 

  12. Law B, MacDonald N, Halperin S, Scheifele D, Dery P, Jadavji T, Lebel MH, Mills E, Morris R, Vaudry W, Gold R, Marchessault V, Duclos P (2000) The Immunization Monitoring Program Active (IMPACT) prospective five year study of Canadian children hospitalised for chickenpox or an associated complication. Pediatr Infect Dis J 19: 1053–1059

    Google Scholar 

  13. Lieu TA, Cochi SL, Black SB, Halloran ME, Shinefield HR, Holmes SJ, Wharton M, Washington AE (1994) Cost-effectiveness of a routine varicella vaccination program for US children. JAMA 271: 375–381

    Google Scholar 

  14. Lin F, Hadler JL (2000) Epidemiology of primary varicella and herpes zoster hospitalisations: the pre-varicella vaccine era. J Infect Dis 181: 1897–1905

    Google Scholar 

  15. Linder N, Waintraub I, Smetana Z, Barzilai A, Lubin D, Mendelson E, Sirota L (2000) Placental transfer and decay of varicella-zoster virus antibodies in preterm infants. J Pediatr 137: 85–89

    Google Scholar 

  16. Manfredi R, Chiodo F, Titone L, Vierucci A, Catania S, Ghirardini G, Assanta N, Caramia G, Marcucci F, Loizzo B, Muscolino F (1997) Chickenpox complications among immunocompetent hospitalised children in Italy. Pediatr Med Chir 19: 99–104

    Google Scholar 

  17. Peterson CL, Mascola L, Chao SM, Lieberman JM, Arcinue EL, Blumberg DA, Kim KS, Kovacs A, Wong VK, Brunell PA (1996) Children hospitalised for varicella: a prevaccine review. J Pediatr 129: 529–536

    Google Scholar 

  18. Preblud SR (1981) Age-specific risks of varicella complications. Pediatrics 68: 14–17

    Google Scholar 

  19. Preblud SR, Orenstein WA, Bart KJ (1984) Varicella: clinical manifestations, epidemiology and health impact in children. Pediatr Infect Dis 3: 505–509

    Google Scholar 

  20. Swiss Ministry of Statistics. Statistics of population structure and development (2002) Available athttp://www.statistik.admin.ch

  21. Travaglini M, Gubler J, Buhlmann U, Goetschel P (2001) Varicella zoster virus infection complicated by Neisseria meningitidis bacteraemia in two children. Eur J Pediatr 160: 399

    Google Scholar 

  22. Varughese PW (1988) Chickenpox in Canada, 1924–87. Can Med Assoc J 138: 133–134

    Google Scholar 

  23. WHO Vaccines, Immunizations and Biologicals. Country profiles. Available at:http://www-nt.who.int/vaccines/globalsummary/Immunization/

  24. Yawn B, Yawn R, Lydick E (1997) Community impact of childhood varicella infection. J Pediatr 130: 759–765

    Google Scholar 

  25. Ziebold C, von Kries R, Lang R, Weigl J, Schmitt HJ (2001) Severe complications of varicella in previously healthy children in Germany: a 1-year survey. Pediatrics 108: E79

    Google Scholar 

Download references

Acknowledgements

A research grant was provided by GlaxoSmithKline, Switzerland.

We would like to thank Daniela Beeli, SPSU secretariat, for coordinating the report forms; Esther Schilling, study secretariat, for keeping track of reports and managing follow-up. We also would like to particularly thank the SPSU representatives of the respective paediatric units in Switzerland: A. Blumberg, J-L. Micheli, C. Aebi, E. Antonelli, P. Baeckert, W. Bär, J. P. Berclaz, J. P. Bossi, H-U. Bucher, L. Buetti, U. Bühlmann, E. Bussmann, O. Carrel, P. O. Cattin, J-M. Choffat, A. Corboz, G. Délèze, P. Diebold, P. Dolivo, F. Farron, M. Gehri, C. A. Haenggeli, J. Hentschel, P. S. Hüppi, P. Imahorn, C. Kind, B. Knöpfli, S. König, O. Lapaire, B. Laubscher, C. Le Coultre, M. Maherzi, A. Malzacher, W. Pezzoli, G. P. Ramelli, B. M. Regazzoni, F. Renevey, P. Rimensberger, C. Rudin, C. Stüssi, A. Superti-Furga, R. Tabin, J. Wisser, M. Wopmann, G. Zeilinger, and U. Zimmermann for their continuous and invaluable support as well as all the dedicated paediatricians taking care of the patients and helping us to complete the questionnaires.

Author information

Authors and Affiliations

  1. Division of Paediatric Infectious Diseases, University Children’s Hospital, P.O. Box, 4005 , Basel, Switzerland

    Jan Bonhoeffer, Gurli Baer, Beda Muehleisen, Urs B. Schaad & Ulrich Heininger

  2. Division of Paediatric Infectious Diseases, University Children’s Hospital, Bern, Switzerland

    Christoph Aebi

  3. Division of Paediatric Infectious Diseases, University Children’s Hospital, Zurich, Switzerland

    David Nadal

Authors
  1. Jan Bonhoeffer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gurli Baer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Beda Muehleisen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christoph Aebi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. David Nadal
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Urs B. Schaad
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ulrich Heininger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ulrich Heininger.

Additional information

This study was presented in part at the 42nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), San Diego, September 27th–30th, 2002

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bonhoeffer, J., Baer, G., Muehleisen, B. et al. Prospective surveillance of hospitalisations associated with varicella-zoster virus infections in children and adolescents. Eur J Pediatr 164, 366–370 (2005). https://doi.org/10.1007/s00431-005-1637-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-005-1637-8

Keywords

Search

Navigation