Neurologic Varicella Complications Before Routine Immunization in Germany

Rack, Anita; Grote, Veit; Streng, Andrea; Belohradsky, Bernd H.; Heinen, Florian; Kries, Rüdiger von; Liese, Johannes G.

doi:10.1016/j.pediatrneurol.2009.07.012

Cited by 47 publications

(50 citation statements)

References 37 publications

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“…The overall incidence of VZV-associated encephalitis in children is estimated at 0.2 per 100 000 children [22] and the average age is 5.4-6.4 years [20,23]. Mortality is reported to be zero in two larger studies [20,23], while, in another three of 17 children with an unknown immune status suffering from VZV encephalitis died [9].…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

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Varicella-zoster virus infections of the central nervous system – Prognosis, diagnostics and treatment

Grahn

Studahl

2015

Journal of Infection

155

118

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Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

“…Mortality is reported to be zero in two larger studies [20,23], while, in another three of 17 children with an unknown immune status suffering from VZV encephalitis died [9].…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

Varicella-zoster virus infections of the central nervous system – Prognosis, diagnostics and treatment

Grahn

Studahl

2015

Journal of Infection

155

118

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“…The most frequently described complications of VZI in these patients are interstitial or necrotizing pneumonia, hepatitis with acute liver failure, bacterial super infections, and post-infectious inflammatory sequelae (e.g., cerebellar ataxia, hematological abnormalities, and glomerulonephritis encephalitis) [3][4][5][6][7][8]. The varicella-related mortality in children receiving chemotherapy was around 7%-10% before the era of antiviral therapy, with 32% having visceral dissemination [5].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for complicated varicella infection in pediatric oncology patients at a tertiary health care facility in Pakistan

Alam

Qamar

Khan

et al. 2014

J Infect Dev Ctries

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Introduction: Varicella zoster infection(VZI) is well recognized as a potential cause of morbidity and mortality in immunocompromised pediatric oncology patients (POP). The purpose of this study was to describe the clinical profile and risk factors for complications and outcomes of VZI in POP treated with acyclovir. Methodology: Medical records of all POP with a discharge diagnosis of VZI over a period of seven years (2005)(2006)(2007)(2008)(2009)(2010)(2011) were reviewed. The demographic features, underlying malignancy, risk factors for VZI, complications, and outcomes were recorded. Results: Thirty-six POP with VZI were identified. Leukemia was the most common underlying malignancy (n = 20, 58.8%), followed by lymphoma (n = 7, 20.6%) and solid organ tumors (n = 7, 20.6%). Most of the cases (41%) were observed in children under five. All patients were treated with acyclovir. Varicella-related complications developed in 10 (29%) patients. The most frequent complication was bloodstream infection (n = 3, 8.8%), followed by pneumonia (n = 2, 5.9%), skin infection (n = 2, 5.9%), hepatitis, renal failure, and encephalitis. Independent risk factors associated with complications were age < five years, weight for age < fifth percentile, delay in seeking care (> seven days after onset of symptoms) and severe neutropenia (ANC < 500/cm). One child died secondary to varicella encephalitis. Conclusion: Our data suggests that young age, poor health-seeking behavior, severe neutropenia, and being underweight are the major risk factors for the development of varicella-related complications in POP in developing countries. These complications could be favorably modified through active immunization of immunocompetent children.

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“…More severe forms of the disease and complications are thought to be quite rare in healthy children. However, varicella zoster virus infection can cause severe morbidity and mortality, due to complications involving varicella pneumonia, encephalitis, neurological, hematological and invasive bacterial infections in immunologically healthy children (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Complications of Varicella in Healthy Children: Is It Increasing?

Koturoğlu¹,

Kurugöl²,

Halıcıoğlu³

et al. 2015

jpr

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ABS TRACTÖZET Aim: Varicella is a common and self-limiting disease caused by the varicella zoster. However it may cause severe morbidity and mortality, due to complications in healthy children. These complications can be prevented by vaccination. The aim of this study was to determine the type of complications of varicella in hospitalized children. Also these data were compared with the study carried out in 2005 and changes in the varicella hospitalizations were analyzed to obtain the necessary data for the study of the vaccine. Materials and Methods: A retrospective study involving 262 children hospitalized for complications due to varicella between January 2005 and December 2009 was carried out. Incidence and clinical spectrum of complications and their age and seasonal variations related distribution was analyzed. Results: We identified 262 children hospitalized for complications of varicella. Fourteen children with immune deficiency or on immunosuppressive treatment were excluded. The majority of varicella complications occurred in children under 5 years of age. The most common complications were infectious complications (41.9%). Thereafter, neurologic complications (35.6%) and hematological complications were seen (3.6%). The seasonal distribution of complications associated with varicella had a higher incidence in January (21.4%). Three patients died due to these complications. Conclusion: Complications of varicella were more frequent than previously reported. Also mortality rates were higher than those in the previous study. Varicella can be accompanied by severe complications and death in immunologically healthy children. In this study, the importance of varicella vaccination was emphasized again.

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Neurologic Varicella Complications Before Routine Immunization in Germany

Cited by 47 publications

References 37 publications

Varicella-zoster virus infections of the central nervous system – Prognosis, diagnostics and treatment

Varicella-zoster virus infections of the central nervous system – Prognosis, diagnostics and treatment

Risk factors for complicated varicella infection in pediatric oncology patients at a tertiary health care facility in Pakistan

Complications of Varicella in Healthy Children: Is It Increasing?

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