Varicella rates among unvaccinated and one-dose vaccinated healthy children in Izmir, Turkey

Kurugöl, Zafer; Halıcıoğlu, Oya; Koç, Feyza; Koturoğlu, Güldane; Akşit, Sadık

doi:10.1016/j.ijid.2011.03.016

Cited by 33 publications

(36 citation statements)

References 47 publications

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“…In Turkey, Kurugol et al [24] showed that among vaccinated children, 27.7% had breakthrough varicella and about 25% of breakthrough cases produced moderate or severe disease. Mortality from varicella is not common, but it occurs disproportionately among adolescents and adults due to pneumonitis and encephalitis [11].…”

Section: Incidence Of Varicella Related Hospitalization (Per 100000mentioning

confidence: 99%

The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the pre-vaccine era (VARICOMP study)

Dinleyici¹,

Kurugöl²,

Türel³

et al. 2011

Eur J Pediatr

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Varicella can cause complications that are potentially serious and require hospitalization. Our current understanding of the causes and incidence of varicella-related hospitalization in Turkey is limited and sufficiently accurate epidemiological and economical information is lacking. The aim of this study was to estimate the annual incidence of varicella-related hospitalizations, describe the complications, and estimate the annual mortality and cost of varicella in children. VARICOMP is a multi-center study that was performed to provide epidemiological and economic data on hospitalization for varicella in children between 0 and 15 years of age from October 2008 to September 2010 in Turkey. According to medical records from 27 health care centers in 14 cities (representing 49.3% of the childhood population in Turkey), 824 children (73% previously healthy) were hospitalized for varicella over the 2-year period. Most cases occurred in the spring and early summer months. Most cases were in children under 5 years of age, and 29.5% were in children under 1 year of age. The estimated incidence of varicella-related hospitalization was 5.29-6.89 per 100,000 in all children between 0-15 years of age in Turkey, 21.7 to 28 per 100,000 children under 1 year of age, 9.8-13.8 per 100,000 children under 5 years of age, 3.96-6.52 per 100,000 children between 5 and 10 years of age and 0.42 to 0.71 per 100,000 children between 10 and 15 years of age. Among the 824 children, 212 (25.7%) were hospitalized because of primary varicella infection. The most common complications in children were secondary bacterial infection (23%), neurological (19.1%), and respiratory (17.5%) complications. Secondary bacterial infections (p < 0.001) and neurological complications (p < 0.001) were significantly more common in previously healthy children, whereas hematological complications (p < 0.001) were more commonly observed in children with underlying conditions. The median length of the hospital stay was 6 days, and it was longer in children with underlying conditions (<0.001). The median cost of hospitalization per patient was $338 and was significantly higher in children with underlying conditions (p < 0.001). The estimated direct annual cost (not including the loss of parental work time and school absence) of varicella-related hospitalization in children under the age of 15 years in Turkey was $856,190 to $1,407,006. According to our estimates, 882 to 1,450 children are hospitalized for varicella each year, reflecting a population-wide occurrence of 466-768 varicella cases per 100,000 children. In conclusion, this study confirms that varicella-related hospitalizations are not uncommon in children, and two thirds of these children are otherwise healthy. The annual cost of hospitalization for varicella reflects only a small part of the overall cost of this disease, as only a very few cases require hospital admission. The incidence of this disease was higher in children <1 year of age, and there are no prevention strategies for these children other ...

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Section: Incidence Of Varicella Related Hospitalization (Per 100000mentioning

confidence: 99%

The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the pre-vaccine era (VARICOMP study)

Dinleyici¹,

Kurugöl²,

Türel³

et al. 2011

Eur J Pediatr

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show abstract

“…In non-outbreak situation studies, the breakthrough infection rate varies widely, ranging from 2.1% to 9.5% [6,7]. In Turkey, Kurugol et al [8] showed that 27.7% of children developed breakthrough infection from a total of 1683 vaccinated children and 24.7% of those had a moderate to severe disease course. In Taiwan, between 2000 and 2007, of more than 1 million children who received single-dose varicella vaccine, 2% had breakthrough infections and 0.016% required hospitalization and the overall vaccine effectiveness against varicella-related hospitalization was 85.4%.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is difficult to explain the outbreaks. An increased risk for breakthrough disease has been noted with decreasing age at vaccination, time elapsed since vaccination, history of asthma, corticosteroid use, vaccination with varicella vaccine within 30 days of live attenuated measles-mumps and varicella vaccine [8]. While these associations have not been consistently reproduced in all studies, primary vaccine failure is evidently common in healthy young children after a single dose of live attenuated varicella vaccine and the most plausible explanation is that some immunized children do not develop humoral immunity to the varicella virus [11].…”

Section: Discussionmentioning

confidence: 99%

“…In the 29 publications that have reported on breakthrough varicella rates with time, an increased risk of breakthrough varicella has been shown with time and this increased risk has generally been observed around 4-5 years post-vaccination [5]. A large retrospective study of over 11,000 children found that the time since vaccination is an important risk factor for breakthrough varicella, with both incidence and severity increasing over a 10-year period [8]. Galil et al [12] reported that children who had been vaccinated for more than three years were at a two-fold greater risk of varicella infection than those who had been vaccinated for shorter periods of time.…”

Section: Discussionmentioning

confidence: 99%

“…The annual rate of breakthrough varicella significantly increased with the time since vaccination, from 1.6 cases per 1000 person-years within 1 year after vaccination to 9.0 per 1000 person-years at 5 years and 58.2 per 1000 person-years at 9 years. In Turkey, Kurugol et al [8] reported that the median age at vaccination was 13 months and the median time elapsed since vaccination was 72 months for breakthrough infection. The frequency of breakthrough infection was significantly higher (3.7-fold higher risk for breakthrough infection) in children vaccinated more than 5 years previously than in children who had been vaccinated <5 years and the rate of breakthrough infection was 29.6% at 8 years after vaccination and 63% at 10 years after vaccination.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Children with breakthrough varicella infection requiring hospitalization in Turkey (VARICOMP Study 2008–2013)

Dinleyici

Kurugöl

Kara

et al. 2015

Vaccine

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Explore the optimal timing for administering the second dose of the varicella vaccine in China

Sun,

Wang,

Zhang

et al. 2023

Journal of Medical Virology

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The prevalence of varicella in China has been increasing annually, with a relatively high incidence rate of breakthrough cases. Administering two doses of the varicella vaccine (Varv) proves to be the most effective measure. The objective of this study is to assess the immunogenicity of two doses of the Varv at varying intervals and explore the optimal timing for administering the second dose of the Varv. Utilizing a prospective cohort study design, the quantification of varicella immunoglobulin G (IgG) antibodies' geometric mean concentrations (GMC) is conducted through glycoprotein‐based enzyme‐linked immunosorbent assay (gpELISA). A total of 903 infants were included in the per‐protocol population. After completing the first dose of the Varv, the GMC of antibody after 1 month (Group A) was 463.8 (447.6−480.1) mIU/mL. There was a statistically significant difference in GMC and seroconversion rates among the groups (B/C/D) that received the second dose of the Varv (p < 0.05). Multiple comparisons revealed that the group with a 3‐year interval between the two vaccine doses had a higher GMC of 665.2 (622.6−707.8) mIU/mL compared to the group with a 1‐year interval of 611.1 (577.1−645.3) mIU/mL and the group with a 5‐year interval of 564.7 (540.1−589.4) mIU/mL. To effectively prevent and control the varicella epidemic in Jiangsu Province, two dose Varv vaccination is recommended, the optimal time point for the second dose Varv is 3 years after the first vaccination.

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Varicella rates among unvaccinated and one-dose vaccinated healthy children in Izmir, Turkey

Cited by 33 publications

References 47 publications

The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the pre-vaccine era (VARICOMP study)

The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the pre-vaccine era (VARICOMP study)

Children with breakthrough varicella infection requiring hospitalization in Turkey (VARICOMP Study 2008–2013)

Explore the optimal timing for administering the second dose of the varicella vaccine in China

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