Grote Veit, von Kries Rüdiger, Springer Wolfgang, Hammersen Gerhard, Kreth Hans Wolfgang, Liese Johannes
Institute of Social Pediatrics and Adolescent Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.
Acta Paediatr. 2008 Feb;97(2):187-92. doi: 10.1111/j.1651-2227.2007.00595.x. Epub 2007 Dec 10.
Although varicella is acknowledged as a rare cause of death in children, there are few comprehensive data with respect to the clinical course leading to death.
A nationwide, active surveillance was carried out in Germany for children up to age 17 years who were admitted to a paediatric hospital for varicella or associated complications, including deaths.
A total of 10 children with varicella-associated death were reported over period of 2 years, yielding a mortality rate of 0.4/1 000 000 children per year. Three deaths occurred in children diagnosed with acute lymphocytic leukaemia and disseminated varicella, two shortly after diagnosis of leukaemia and therefore not preventable, and one during remission with an untypical presentation. Two children died with a congenital varicella syndrome. There was no death in children with neonatal varicella. Four other cases were related to varicella pneumonia or septicaemia and one to myocarditis.
In a population with no general varicella vaccination programme, varicella accounted for a small but not negligible risk for death in immunocompetent and immunocompromised children. Together these data point to the importance of a thoroughly implemented, general varicella vaccination programme.
尽管水痘被认为是儿童罕见的死亡原因，但关于导致死亡的临床病程的综合数据很少。
在德国对17岁以下因水痘或相关并发症（包括死亡）入住儿科医院的儿童进行了全国性的主动监测。
在2年期间共报告了10例水痘相关死亡病例，每年的死亡率为0.4/1 000 000儿童。3例死亡发生在诊断为急性淋巴细胞白血病并伴有播散性水痘的儿童中，2例在白血病诊断后不久死亡，因此无法预防，1例在缓解期，表现不典型。2例儿童死于先天性水痘综合征。新生儿水痘患儿无死亡病例。其他4例与水痘肺炎或败血症有关，1例与心肌炎有关。
在没有普遍水痘疫苗接种计划的人群中，水痘在免疫功能正常和免疫功能低下的儿童中导致死亡的风险虽小但不可忽视。这些数据共同表明全面实施普遍水痘疫苗接种计划的重要性。
