Children hospitalized for varicella: A prevaccine review

C. L. Peterson, L. Mascola, S. M. Chao, J. M. Lieberman, E. L. Arcinue, Dean A Blumberg, Sik Kim Kwang Sik Kim, A. Kovacs, V. K. Wong, P. A. Brunell

Research output: Contribution to journalArticle

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Abstract

Objectives: To describe varicella complications in healthy and previously ill children hospitalized for varicella and to explore trends in group A β-hemolytic streptococcus complications of varicella. Methods: A retrospective record review of children hospitalized for varicella between January 1, 1990, and March 31, 1994, was conducted in nine large acute care hospitals in Los Angeles County, California. Results: We identified 574 children hospitalized for varicella in study hospitals during the 4.25-year study period (estimated risk of hospitalization, approximately 1 in 550 cases of varicella); 53% of the children were healthy before the onset of varicella and 47% were previously ill with underlying cancers or other chronic illnesses. Children were hospitalized for treatment of complications (n = 427, 74%) or for prophylactic antiviral therapy or observation (n = 147, 26%). Systems involved in complications included skin/soft tissue (45%), neurologic (18%), respiratory (14%), gastrointestinal (10%), and hematologic, renal, or hepatic (8% or less). The mean age of children with skin/soft tissue infections was 2.7 years (range < 1 to 16 years) compared with 4.7 years (< 1 to 18 years) for other complications. Children with skin/soft tissue and neurologic complications were more often previously healthy (p <0.05), whereas those with respiratory complications were more often previously ill (p <0.001). Hospitalizations for skin/soft tissue infections increased during the study period. The proportion of complications as a result of group A β-hemolytic streptococcus infection increased from 4.7% before 1993 to 12.2% for the remainder of the study period (p = 0.02). Conclusions: Prior health status was predictive of the type of complications experienced by children with varicella requiring hospitalization. Our data suggest a recent increase in skin/soft tissue complications of varicella requiring hospitalization and an increase in the proportion of complications related to group A β-hemolytic streptococcus. Wide-scale vaccine use should reverse this trend and reduce the overall impact of varicella on both healthy and previously ill children.

Original languageEnglish (US)
Pages (from-to)529-536
Number of pages8
JournalJournal of Pediatrics
Volume129
Issue number4
DOIs
StatePublished - 1996
Externally publishedYes

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Hospitalized Child
Chickenpox
Hospitalization
Skin
Streptococcus
Soft Tissue Infections
Nervous System
Los Angeles
Health Status
Antiviral Agents
Chronic Disease
Vaccines
Observation
Kidney

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Peterson, C. L., Mascola, L., Chao, S. M., Lieberman, J. M., Arcinue, E. L., Blumberg, D. A., ... Brunell, P. A. (1996). Children hospitalized for varicella: A prevaccine review. Journal of Pediatrics, 129(4), 529-536. https://doi.org/10.1016/S0022-3476(96)70117-8

Children hospitalized for varicella : A prevaccine review. / Peterson, C. L.; Mascola, L.; Chao, S. M.; Lieberman, J. M.; Arcinue, E. L.; Blumberg, Dean A; Kwang Sik Kim, Sik Kim; Kovacs, A.; Wong, V. K.; Brunell, P. A.

In: Journal of Pediatrics, Vol. 129, No. 4, 1996, p. 529-536.

Research output: Contribution to journalArticle

Peterson, CL, Mascola, L, Chao, SM, Lieberman, JM, Arcinue, EL, Blumberg, DA, Kwang Sik Kim, SK, Kovacs, A, Wong, VK & Brunell, PA 1996, 'Children hospitalized for varicella: A prevaccine review', Journal of Pediatrics, vol. 129, no. 4, pp. 529-536. https://doi.org/10.1016/S0022-3476(96)70117-8
Peterson CL, Mascola L, Chao SM, Lieberman JM, Arcinue EL, Blumberg DA et al. Children hospitalized for varicella: A prevaccine review. Journal of Pediatrics. 1996;129(4):529-536. https://doi.org/10.1016/S0022-3476(96)70117-8
Peterson, C. L. ; Mascola, L. ; Chao, S. M. ; Lieberman, J. M. ; Arcinue, E. L. ; Blumberg, Dean A ; Kwang Sik Kim, Sik Kim ; Kovacs, A. ; Wong, V. K. ; Brunell, P. A. / Children hospitalized for varicella : A prevaccine review. In: Journal of Pediatrics. 1996 ; Vol. 129, No. 4. pp. 529-536.
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title = "Children hospitalized for varicella: A prevaccine review",
abstract = "Objectives: To describe varicella complications in healthy and previously ill children hospitalized for varicella and to explore trends in group A β-hemolytic streptococcus complications of varicella. Methods: A retrospective record review of children hospitalized for varicella between January 1, 1990, and March 31, 1994, was conducted in nine large acute care hospitals in Los Angeles County, California. Results: We identified 574 children hospitalized for varicella in study hospitals during the 4.25-year study period (estimated risk of hospitalization, approximately 1 in 550 cases of varicella); 53{\%} of the children were healthy before the onset of varicella and 47{\%} were previously ill with underlying cancers or other chronic illnesses. Children were hospitalized for treatment of complications (n = 427, 74{\%}) or for prophylactic antiviral therapy or observation (n = 147, 26{\%}). Systems involved in complications included skin/soft tissue (45{\%}), neurologic (18{\%}), respiratory (14{\%}), gastrointestinal (10{\%}), and hematologic, renal, or hepatic (8{\%} or less). The mean age of children with skin/soft tissue infections was 2.7 years (range < 1 to 16 years) compared with 4.7 years (< 1 to 18 years) for other complications. Children with skin/soft tissue and neurologic complications were more often previously healthy (p <0.05), whereas those with respiratory complications were more often previously ill (p <0.001). Hospitalizations for skin/soft tissue infections increased during the study period. The proportion of complications as a result of group A β-hemolytic streptococcus infection increased from 4.7{\%} before 1993 to 12.2{\%} for the remainder of the study period (p = 0.02). Conclusions: Prior health status was predictive of the type of complications experienced by children with varicella requiring hospitalization. Our data suggest a recent increase in skin/soft tissue complications of varicella requiring hospitalization and an increase in the proportion of complications related to group A β-hemolytic streptococcus. Wide-scale vaccine use should reverse this trend and reduce the overall impact of varicella on both healthy and previously ill children.",
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T1 - Children hospitalized for varicella

T2 - A prevaccine review

AU - Peterson, C. L.

AU - Mascola, L.

AU - Chao, S. M.

AU - Lieberman, J. M.

AU - Arcinue, E. L.

AU - Blumberg, Dean A

AU - Kwang Sik Kim, Sik Kim

AU - Kovacs, A.

AU - Wong, V. K.

AU - Brunell, P. A.

PY - 1996

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N2 - Objectives: To describe varicella complications in healthy and previously ill children hospitalized for varicella and to explore trends in group A β-hemolytic streptococcus complications of varicella. Methods: A retrospective record review of children hospitalized for varicella between January 1, 1990, and March 31, 1994, was conducted in nine large acute care hospitals in Los Angeles County, California. Results: We identified 574 children hospitalized for varicella in study hospitals during the 4.25-year study period (estimated risk of hospitalization, approximately 1 in 550 cases of varicella); 53% of the children were healthy before the onset of varicella and 47% were previously ill with underlying cancers or other chronic illnesses. Children were hospitalized for treatment of complications (n = 427, 74%) or for prophylactic antiviral therapy or observation (n = 147, 26%). Systems involved in complications included skin/soft tissue (45%), neurologic (18%), respiratory (14%), gastrointestinal (10%), and hematologic, renal, or hepatic (8% or less). The mean age of children with skin/soft tissue infections was 2.7 years (range < 1 to 16 years) compared with 4.7 years (< 1 to 18 years) for other complications. Children with skin/soft tissue and neurologic complications were more often previously healthy (p <0.05), whereas those with respiratory complications were more often previously ill (p <0.001). Hospitalizations for skin/soft tissue infections increased during the study period. The proportion of complications as a result of group A β-hemolytic streptococcus infection increased from 4.7% before 1993 to 12.2% for the remainder of the study period (p = 0.02). Conclusions: Prior health status was predictive of the type of complications experienced by children with varicella requiring hospitalization. Our data suggest a recent increase in skin/soft tissue complications of varicella requiring hospitalization and an increase in the proportion of complications related to group A β-hemolytic streptococcus. Wide-scale vaccine use should reverse this trend and reduce the overall impact of varicella on both healthy and previously ill children.

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