Law B, MacDonald N, Halperin S, Scheifele D, Déry P, Jadavji T, Lebel M H, Mills E, Morris R, Vaudry W, Gold R, Marchessault V, Duclos P
Department of Medical Microbiology, Winnipeg, Manitoba, Canada.
Pediatr Infect Dis J. 2000 Nov;19(11):1053-9. doi: 10.1097/00006454-200011000-00005.
Varicella vaccine was approved for use in Canada in 1998. A major goal of universal varicella vaccine programs is to reduce severe infection and associated complications. Baseline data are essential against which to judge the effectiveness of routine childhood immunization.
To describe morbidity and mortality among children hospitalized for chickenpox. Methods. From January 1, 1991, to March 31, 1996, chickenpox admissions to 11 pediatric referral centers were actively identified. Patient and illness characteristics were compared for 3 subgroups defined by prior health: healthy; unhealthy but immunocompetent; immunocompromised.
Of 861 cases 488 (56.7%) were healthy, 75(8.7%) were unhealthy and 298 (34.6%) were immunocompromised. The immunocompromised children differed from healthy/unhealthy cases in mean age (6.4 vs. 4.0/4.6 years, respectively, P < 0.0001); median interval from rash onset to admission (2 vs. 5/5 days, P < 0.0001); complication rate (20% vs. 90%/79%; P = 0.001); and rate of acyclovir therapy (98% vs. 24%/39%; P = 0.001). Unhealthy vs. healthy cases had a higher frequency (P < 0.01) of intensive care (13.3% vs. 4.7%), ventilation (9.3% vs. 2.0%) and death (4% vs. 0.2%).
These data provide a baseline for morbidity/mortality resulting from chickenpox before varicella vaccine use in Canada.
水痘疫苗于1998年在加拿大获批使用。普遍接种水痘疫苗项目的一个主要目标是减少严重感染及相关并发症。基线数据对于判断儿童常规免疫的有效性至关重要。
描述因水痘住院儿童的发病率和死亡率。方法：1991年1月1日至1996年3月31日期间，积极确定了11家儿科转诊中心的水痘住院病例。比较了根据既往健康状况定义的3个亚组的患者和疾病特征：健康；不健康但免疫功能正常；免疫功能低下。
861例病例中，488例（56.7%）健康，75例（8.7%）不健康，298例（34.6%）免疫功能低下。免疫功能低下儿童与健康/不健康病例在平均年龄（分别为6.4岁与4.0/4.6岁，P<0.0001）、皮疹出现至入院的中位间隔时间（2天与5/5天，P<0.0001）、并发症发生率（20%与90%/79%；P=0.001）以及阿昔洛韦治疗率（98%与24%/39%；P=0.001）方面存在差异。不健康病例与健康病例相比，重症监护（13.3%对4.7%）、通气（9.3%对2.0%）和死亡（4%对0.2%）的频率更高（P<0.01）。
这些数据为加拿大使用水痘疫苗前水痘导致的发病率/死亡率提供了基线。
