the epidemiology of varicella-related hospitalizations

the epidemiology of varicella-related hospitalizations

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THE EPIDEMIOLOGY OF VARICELLA-RELATED HOSPITALIZATIONS IN TURKEY FROM 2008 TO
2012: A NATIONWIDE SURVEY DURING THE PRE-VACCINE ERA (VARICOMP STUDY)
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E.C. Dinleyici , Z. Kurugol , N. Bayram , I. Devrim , O. Turel , O. Yasa , H. Tezer , E. Alhan , N.
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Dalgic , N. Uygur-Kulcu , H. Ozdemir
, M. Emiroglu , G. Sensoy , E. Ciftci , C. Nuhoglu , M.A.
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Tas , O. Metin-Timur , M. Elevli , M. Kondolot , A. Kara , S. Celebi , A. Tapisiz , D. Aygun , M.
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Ozen , E. Guler , A. Somer , S. Velipasalioglu , S. Oncel , M. Ceyhan , H. Apa , C. Kuzdan , N.
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Hatipoglu , M. Erguven , E. Kocabas , A. Kanik , B. Gulhan , A. Say , N. Belet , E. Ince , C. Sag , T.
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Tas , G. Tanir , M. Bahar , M. Ozturk , M. Celik , M. Hacimustafaoglu , S. Akarsu , A. Elmas , E.S.
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Arisoy , D. Odabas , B. Bilac , G. Akca , F. Akin , A.R. Namli , A. Parlakay , C. Kocaoglu , B.
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Caliskan , S. Incesoy-Ozdemir , Z.A. Yargic , U. Celik
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Department of Pediatric Infectious Disease and Pediatric Intensive Care Unit, Eskisehir Osmangazi
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University Faculty of Medicine, Eskisehir, Ege University, Faculty of Medicine, Dr Behcet Uz Children's
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Training and Research Hospital, Tepecik Training and Research Hospital, Izmir, Kanuni Sultan Suleyman
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Training and Research Hospital, Medeniyet University Goztepe Training and Research Hospital, Istanbul,
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Ankara Diskapi Children's Training and Research Hospital, Gazi University Faculty of Medicine, Ankara,
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Cukurova University Faculty of Medicine, Adana, Sisli Etfal Training and Research Hospital, Zeynep
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Kamil Maternity and Childrens' Diseases Training and Research Hospital, Istanbul, Konya Training and
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Research Hospital, Konya, Ankara University Faculty of Medicine, Ankara, Necmettin Erbakan University
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Meram Faculty of Medicine, Konya, Ondokuz Mayis University Hospital, Samsun, Haydarpasa Numune
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Training and Research Hospital, Istanbul, Dicle University Faculty of Medicine, Diyarbakir, Dr. Sami Ulus
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Maternity and Children Hospital, Ankara, Haseki Educational and Research Hospital, Istanbul, Erciyes
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University Faculty of Medicine, Kayseri, Hacettepe University Faculty of Medicine, Ankara, Uludag
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University Medical Faculty, Bursa, Firat University Faculty of Medicine, Elazig, Suleyman Demirel
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University Faculty of Medicine, Isparta, Sutcu Imam University Faculty of Medicine, Kahramanmaras,
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Istanbul University Istanbul Medical Faculty, Istanbul, Akdeniz University Faculty of Medicine, Antalya,
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Kocaeli University Faculty of Medicine, Kocaeli, Eskisehir Osmangazi University Faculty of Medicine,
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Eskisehir, Adana Numune Education and Research Hospital, Adana, Turkey
Background: Although it is usually self-limiting, varicella can cause complications that are potentially
serious and require hospitalization. The aim of VARICOMP study was to evaluate pediatric varicella-related
hospitalizations in children before vaccine introduction.
Methods: Medical records of children requiring hospitalization due to varicella from 28 health care centers in
14 cities (representing 50% of the childhood population in Turkey) from 2008-2012, have been evaluated.
Results: 1936 children (69.2% previously healthy) were hospitalized for varicella over the 4-year period.
Most cases occurred in January-March and May-July. The median age was 3 years, and boys outnumbered
girls. Most cases were in children under 5 years of age, and 28.1% were < 1 year of age. Among the 1936
children, most common complication is neurological (18.6%). Secondary bacterial infections are reported in
17.8%, respiratory complications in 15.6%, hematological complications in 4.9%. 17.6% out of children have
been hospitalized due to underlying disease, 9.6% due to severe varicella, 6.7% due to fever, 8.5% due to
feeding difficulties. The median length of the hospital stay was 6 days and the mortality rate was 0.36%.
Conclusion: This study confirms that varicella-related hospitalizations are common, especially in previously
healthy children. The incidence of this disease was higher in children < 1 year of age. Varicella vaccine was
introduced to the National Immunization Program in January 2013 and we plan to evaluate vaccine
effectiveness in the next 4 year period in same geographical area and to evaluate potential need for the
second dose at preschool period.