Varicella zoster virus infections in Canadian children in the prevaccine era

A hospital-based study

Susan Kuhn, Herbert Dele Davies, Taj Jadavji

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

OBJECTIVE: To describe the clinical course of children admitted for varicella zoster virus (VZV) infections to a pediatric hospital before the release of VZV vaccine in Canada. DESIGN: Retrospective case series. SETTING: Tertiary pediatric hospital. Population studied was children aged 18 years or younger admitted to hospital between 1983 and 1992 who were discharged with a diagnosis of varicella or zoster. Of the 201 children who were identified, 36 were excluded, leaving 165 for analysis. RESULTS: There was a male:female ratio of 1.5:1 and a median age of 5.3 years (range two weeks to 18 years). The group included those who were previously healthy (70, 42.4%), immunocompromised (60, 36.4%), and those with non-immunocompromising conditions (35, 21.2%). Comparison of immunocompetent and immunocompromised children revealed that complication of VZV infection was a more common reason for admission among the former (86 of 105, 81.9%, P<0.001), whereas treatment with acyclovir to limit dissemination was the most common reason in the latter (53 of 60, 88.3%, P<0.001). Skin and soft tissue infections were the most common complications in immunocompetent children (36 of 98) and those younger than five years (26 of 53), whereas pulmonary complications predominated among immunocompromised patients (eight of 98) and neurological complications in five- to 10-year-olds (16 of 36). Only one death (0.6%) occurred in an immunocompetent patient. Group A beta-hemolytic streptococci and Staphylococcus aureus caused equal numbers of secondary infections (92% of all isolates). CONCLUSIONS: Complications of VZV infections and secondary prophylactic antiviral treatment of immunocompromised children explain the majority of hospitalizations in this institution, and can be monitored after VZV vaccine introduction. Complications vary significantly with underlying healthy status and age.

Original languageEnglish (US)
Pages (from-to)323-328
Number of pages6
JournalCanadian Journal of Infectious Diseases
Volume8
Issue number6
DOIs
StatePublished - Jan 1 1997
Externally publishedYes

Fingerprint

Human Herpesvirus 3
Virus Diseases
Herpes Zoster Vaccine
Chickenpox Vaccine
Pediatric Hospitals
Soft Tissue Infections
Acyclovir
Chickenpox
Herpes Zoster
Immunocompromised Host
Streptococcus
Coinfection
Tertiary Care Centers
Canada
Antiviral Agents
Staphylococcus aureus
Hospitalization
Lung
Skin
Therapeutics

Keywords

  • Childhood
  • Complications
  • Varicella zoster infections

ASJC Scopus subject areas

  • Microbiology (medical)

Cite this

Varicella zoster virus infections in Canadian children in the prevaccine era : A hospital-based study. / Kuhn, Susan; Davies, Herbert Dele; Jadavji, Taj.

In: Canadian Journal of Infectious Diseases, Vol. 8, No. 6, 01.01.1997, p. 323-328.

Research output: Contribution to journalArticle

@article{bbb331599a8248978e297ace6ff3e6e5,
title = "Varicella zoster virus infections in Canadian children in the prevaccine era: A hospital-based study",
abstract = "OBJECTIVE: To describe the clinical course of children admitted for varicella zoster virus (VZV) infections to a pediatric hospital before the release of VZV vaccine in Canada. DESIGN: Retrospective case series. SETTING: Tertiary pediatric hospital. Population studied was children aged 18 years or younger admitted to hospital between 1983 and 1992 who were discharged with a diagnosis of varicella or zoster. Of the 201 children who were identified, 36 were excluded, leaving 165 for analysis. RESULTS: There was a male:female ratio of 1.5:1 and a median age of 5.3 years (range two weeks to 18 years). The group included those who were previously healthy (70, 42.4{\%}), immunocompromised (60, 36.4{\%}), and those with non-immunocompromising conditions (35, 21.2{\%}). Comparison of immunocompetent and immunocompromised children revealed that complication of VZV infection was a more common reason for admission among the former (86 of 105, 81.9{\%}, P<0.001), whereas treatment with acyclovir to limit dissemination was the most common reason in the latter (53 of 60, 88.3{\%}, P<0.001). Skin and soft tissue infections were the most common complications in immunocompetent children (36 of 98) and those younger than five years (26 of 53), whereas pulmonary complications predominated among immunocompromised patients (eight of 98) and neurological complications in five- to 10-year-olds (16 of 36). Only one death (0.6{\%}) occurred in an immunocompetent patient. Group A beta-hemolytic streptococci and Staphylococcus aureus caused equal numbers of secondary infections (92{\%} of all isolates). CONCLUSIONS: Complications of VZV infections and secondary prophylactic antiviral treatment of immunocompromised children explain the majority of hospitalizations in this institution, and can be monitored after VZV vaccine introduction. Complications vary significantly with underlying healthy status and age.",
keywords = "Childhood, Complications, Varicella zoster infections",
author = "Susan Kuhn and Davies, {Herbert Dele} and Taj Jadavji",
year = "1997",
month = "1",
day = "1",
doi = "10.1155/1997/742365",
language = "English (US)",
volume = "8",
pages = "323--328",
journal = "Canadian Journal of Infectious Diseases and Medical Microbiology",
issn = "1712-9532",
publisher = "Pulsus Group Inc.",
number = "6",

}

TY - JOUR

T1 - Varicella zoster virus infections in Canadian children in the prevaccine era

T2 - A hospital-based study

AU - Kuhn, Susan

AU - Davies, Herbert Dele

AU - Jadavji, Taj

PY - 1997/1/1

Y1 - 1997/1/1

N2 - OBJECTIVE: To describe the clinical course of children admitted for varicella zoster virus (VZV) infections to a pediatric hospital before the release of VZV vaccine in Canada. DESIGN: Retrospective case series. SETTING: Tertiary pediatric hospital. Population studied was children aged 18 years or younger admitted to hospital between 1983 and 1992 who were discharged with a diagnosis of varicella or zoster. Of the 201 children who were identified, 36 were excluded, leaving 165 for analysis. RESULTS: There was a male:female ratio of 1.5:1 and a median age of 5.3 years (range two weeks to 18 years). The group included those who were previously healthy (70, 42.4%), immunocompromised (60, 36.4%), and those with non-immunocompromising conditions (35, 21.2%). Comparison of immunocompetent and immunocompromised children revealed that complication of VZV infection was a more common reason for admission among the former (86 of 105, 81.9%, P<0.001), whereas treatment with acyclovir to limit dissemination was the most common reason in the latter (53 of 60, 88.3%, P<0.001). Skin and soft tissue infections were the most common complications in immunocompetent children (36 of 98) and those younger than five years (26 of 53), whereas pulmonary complications predominated among immunocompromised patients (eight of 98) and neurological complications in five- to 10-year-olds (16 of 36). Only one death (0.6%) occurred in an immunocompetent patient. Group A beta-hemolytic streptococci and Staphylococcus aureus caused equal numbers of secondary infections (92% of all isolates). CONCLUSIONS: Complications of VZV infections and secondary prophylactic antiviral treatment of immunocompromised children explain the majority of hospitalizations in this institution, and can be monitored after VZV vaccine introduction. Complications vary significantly with underlying healthy status and age.

AB - OBJECTIVE: To describe the clinical course of children admitted for varicella zoster virus (VZV) infections to a pediatric hospital before the release of VZV vaccine in Canada. DESIGN: Retrospective case series. SETTING: Tertiary pediatric hospital. Population studied was children aged 18 years or younger admitted to hospital between 1983 and 1992 who were discharged with a diagnosis of varicella or zoster. Of the 201 children who were identified, 36 were excluded, leaving 165 for analysis. RESULTS: There was a male:female ratio of 1.5:1 and a median age of 5.3 years (range two weeks to 18 years). The group included those who were previously healthy (70, 42.4%), immunocompromised (60, 36.4%), and those with non-immunocompromising conditions (35, 21.2%). Comparison of immunocompetent and immunocompromised children revealed that complication of VZV infection was a more common reason for admission among the former (86 of 105, 81.9%, P<0.001), whereas treatment with acyclovir to limit dissemination was the most common reason in the latter (53 of 60, 88.3%, P<0.001). Skin and soft tissue infections were the most common complications in immunocompetent children (36 of 98) and those younger than five years (26 of 53), whereas pulmonary complications predominated among immunocompromised patients (eight of 98) and neurological complications in five- to 10-year-olds (16 of 36). Only one death (0.6%) occurred in an immunocompetent patient. Group A beta-hemolytic streptococci and Staphylococcus aureus caused equal numbers of secondary infections (92% of all isolates). CONCLUSIONS: Complications of VZV infections and secondary prophylactic antiviral treatment of immunocompromised children explain the majority of hospitalizations in this institution, and can be monitored after VZV vaccine introduction. Complications vary significantly with underlying healthy status and age.

KW - Childhood

KW - Complications

KW - Varicella zoster infections

UR - http://www.scopus.com/inward/record.url?scp=0031458896&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031458896&partnerID=8YFLogxK

U2 - 10.1155/1997/742365

DO - 10.1155/1997/742365

M3 - Article

VL - 8

SP - 323

EP - 328

JO - Canadian Journal of Infectious Diseases and Medical Microbiology

JF - Canadian Journal of Infectious Diseases and Medical Microbiology

SN - 1712-9532

IS - 6

ER -