Epidemiology and Outcome of Necrotizing Fasciitis in Children

An Active Surveillance Study of the Canadian Paediatric Surveillance Program

Ihuoma Eneli, Herbert Dele Davies

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Objective: To describe the epidemiology, management, and outcome of pediatric necrotizing fasciitis (NF) in Canada before full implementation of varicella immunization programs. Study design: This was a prospective cohort study of all children under age 16 years identified by the Canadian Paediatric Surveillance Program (CPSP). Results: Between November 1, 2001 and October 31, 2003, 36 NF cases were identified (mean age, 5.9 ± 5 years). Group A streptococcus (GAS)-related and non-GAS-related NF accounted for 2.12 and 0.81 cases per million children, respectively. The annual incidence was substantially higher in children under age 5 years (5.9 vs 1.8 per million; P = .0002). Males over age 1 year had the highest disease burden, with 12 cases per million, versus 3.2 cases per million for females under age 1 year (P < .0001). Most (15/26; 58%) GAS-related cases were associated with varicella. Complications occurred in 29 children (78%), and 2 children (5.4%) died. Conclusion: In the prevaccine era, NF occurred most commonly in Canadian children under age 5 years, with a peak incidence in males under age 1 year. There is substantial associated morbidity and about 5% mortality. The data provide baseline incidence of disease and a surveillance mechanism for NF after the implementation of publicly funded varicella immunization programs in Canada.

Original languageEnglish (US)
JournalJournal of Pediatrics
Volume151
Issue number1
DOIs
StatePublished - Jan 1 2007

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Necrotizing Fasciitis
Epidemiology
Pediatrics
Chickenpox
Streptococcus
Immunization Programs
Canada
Incidence
Cohort Studies
Prospective Studies
Morbidity
Mortality

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

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title = "Epidemiology and Outcome of Necrotizing Fasciitis in Children: An Active Surveillance Study of the Canadian Paediatric Surveillance Program",
abstract = "Objective: To describe the epidemiology, management, and outcome of pediatric necrotizing fasciitis (NF) in Canada before full implementation of varicella immunization programs. Study design: This was a prospective cohort study of all children under age 16 years identified by the Canadian Paediatric Surveillance Program (CPSP). Results: Between November 1, 2001 and October 31, 2003, 36 NF cases were identified (mean age, 5.9 ± 5 years). Group A streptococcus (GAS)-related and non-GAS-related NF accounted for 2.12 and 0.81 cases per million children, respectively. The annual incidence was substantially higher in children under age 5 years (5.9 vs 1.8 per million; P = .0002). Males over age 1 year had the highest disease burden, with 12 cases per million, versus 3.2 cases per million for females under age 1 year (P < .0001). Most (15/26; 58{\%}) GAS-related cases were associated with varicella. Complications occurred in 29 children (78{\%}), and 2 children (5.4{\%}) died. Conclusion: In the prevaccine era, NF occurred most commonly in Canadian children under age 5 years, with a peak incidence in males under age 1 year. There is substantial associated morbidity and about 5{\%} mortality. The data provide baseline incidence of disease and a surveillance mechanism for NF after the implementation of publicly funded varicella immunization programs in Canada.",
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AB - Objective: To describe the epidemiology, management, and outcome of pediatric necrotizing fasciitis (NF) in Canada before full implementation of varicella immunization programs. Study design: This was a prospective cohort study of all children under age 16 years identified by the Canadian Paediatric Surveillance Program (CPSP). Results: Between November 1, 2001 and October 31, 2003, 36 NF cases were identified (mean age, 5.9 ± 5 years). Group A streptococcus (GAS)-related and non-GAS-related NF accounted for 2.12 and 0.81 cases per million children, respectively. The annual incidence was substantially higher in children under age 5 years (5.9 vs 1.8 per million; P = .0002). Males over age 1 year had the highest disease burden, with 12 cases per million, versus 3.2 cases per million for females under age 1 year (P < .0001). Most (15/26; 58%) GAS-related cases were associated with varicella. Complications occurred in 29 children (78%), and 2 children (5.4%) died. Conclusion: In the prevaccine era, NF occurred most commonly in Canadian children under age 5 years, with a peak incidence in males under age 1 year. There is substantial associated morbidity and about 5% mortality. The data provide baseline incidence of disease and a surveillance mechanism for NF after the implementation of publicly funded varicella immunization programs in Canada.

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