The only realistic way of preventing deaths and severe complications arising from chickenpox is to routinely vaccinate children against the disease, concludes research published ahead of print in Archives of Disease in Childhood.
At present, only healthcare workers and others likely to be at risk of contracting or passing on the infection, are routinely immunised in the UK. But vaccination programmes for children have been introduced in several other countries, including the USA, Canada, Australia, and Finland.
The authors base their conclusions on active monitoring by paediatricians in the UK and Ireland of children up to the age of 16 admitted to hospital with severe complications resulting from chickenpox infection.
During the monitoring period, which ran for 13 months between 2002 and 2003, 188 cases were reported to the British Paediatric Surveillance Unit.
Of these, 112 children met the criteria, giving a case rate of 0.82 per 100,000. Their average age was 3 years.
The complications included septic shock, pneumonia, and encephalitis, as well as uncoordinated movement (ataxia), toxic shock syndrome, and "flesh eating" bacterial infection (necrotising fasciitis).
Almost half the children (46%) had additional bacterial infections.
Six children died. One child died in the womb. Although four of the five other children, who were aged between 2 and 14 years, already had a pre-existing medical condition, these were not groups currently targeted for immunisation.
After discharge, 4 out of 10 children had ongoing problems as a result of their infection, including, most commonly, ataxia or skin scarring.
Their average length of hospital stay was seven days, but ranged from one to 68.
Most of these children were healthy before they contracted the virus, say the authors. Universal immunisation could have prevented their complications, as they were mostly old enough to have rece
|Contact: Emma Dickinson|
BMJ-British Medical Journal