Egeskov-Cavling Amanda Marie, Johannesen Caroline Klint, Rezahosseini Omid, Eiberg Mads Frederik, Poulsen Anja, Folke Fredrik, Fischer Thea K
Department of Clinical Research, Copenhagen University Hospital, North Zealand Hospital, Dyrehavevej 29, 3400, Hilleroed, Denmark.
Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital, North Zealand, Hilleroed, Denmark.
Infect Dis Ther. 2025 Sep 13. doi: 10.1007/s40121-025-01233-z.
In the absence of a national varicella vaccine program, it is assumed that the annual proportion of children in Denmark acquiring a varicella infection (chickenpox) corresponds to the birth cohort size, approximately 60,000 per year. Varicella infections impose a burden on families and increase healthcare utilization. Previous studies have estimated the disease burden of severe varicella cases requiring hospitalization. However, information about the burden of mild-to-moderate varicella cases is scarce. We aim to provide insights into the burden of mild-to-moderate varicella cases at the community level.
We utilized data from the non-emergency medical helpline (1813 helpline) and national hospital admission register to provide adjusted estimates of the burden of moderate varicella cases at the community level among children (< 18 years) in Denmark from 2015 to 2023, applying time series regression analysis to counteract underreporting in the 1813 helpline.
We estimated that 20,439 (95% CI 17,378-23,501) calls to the 1813 helpline were attributed to varicella infections (VZV-associated calls), a 103.1% additional proportion to the 10,068 calls documented in the call notes. The average yearly number of VZV-associated calls was 2271 calls. When correcting for irregular patterns of infection during the COVID-19 pandemic, the average yearly estimated number of VZV-associated calls was 2561. In the first 6 months of 2023, we estimated 2552 calls (95% CI 2170-2934). The overall incidence of VZV-associated calls is 623 per 100,000 person-years (95% CI 529.49-716.06), with annual incidence ranging from 291 in 2021 to 910 in 2017.
The 1813 helpline calls attributed to varicella were double the numbers reported previously in the call notes, indicating a larger impact of mild-to-moderate cases on healthcare services than initially thought. This highlights the importance of addressing challenges with varicella infection burden estimates and adds considerably to the burden of mild-to-moderate cases of varicella on a community level.
在丹麦没有全国性水痘疫苗接种计划的情况下，据推测，丹麦每年感染水痘（带状疱疹）的儿童比例与出生队列规模相对应，每年约60,000例。水痘感染给家庭带来负担，并增加了医疗保健的使用。先前的研究已经估计了需要住院治疗的严重水痘病例的疾病负担。然而，关于轻度至中度水痘病例负担的信息却很少。我们旨在深入了解社区层面轻度至中度水痘病例的负担情况。
我们利用非紧急医疗求助热线（1813热线）的数据和国家医院入院登记数据，通过时间序列回归分析来抵消1813热线中报告不足的情况，从而对2015年至2023年丹麦18岁以下儿童社区层面中度水痘病例的负担进行调整后的估计。
我们估计，拨打1813热线的20,439次（95%置信区间17,378 - 23,501）电话归因于水痘感染（与水痘带状疱疹病毒相关的电话），这比通话记录中记录的10,068次电话多出103.1%。与水痘带状疱疹病毒相关的电话的年平均数量为2271次。在纠正了新冠疫情期间感染模式的不规则性后，与水痘带状疱疹病毒相关的电话的年平均估计数量为2561次。在2023年的前6个月，我们估计有2552次电话（95%置信区间2170 - 2934）。与水痘带状疱疹病毒相关的电话的总体发病率为每10万人年623次（95%置信区间529.49 - 716.06），年发病率范围从2021年的291次到2017年的910次。
归因于水痘的1813热线电话数量是之前通话记录中报告数量的两倍，这表明轻度至中度病例对医疗服务的影响比最初认为的更大。这凸显了应对水痘感染负担估计挑战的重要性，并在社区层面大大增加了轻度至中度水痘病例的负担。
