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Varicella in a P aediatric I ntensive C are U nit: 10‐year review from S tarship C hildren's H ospital, N ew Z ealand
Author(s) -
Wen Sophie ChienHui,
Miles Fiona,
McSharry Brent,
Wilson Elizabeth
Publication year - 2014
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12473
Subject(s) - medicine , pediatric intensive care unit , pediatrics , chickenpox , varicella vaccine , sepsis , paediatric intensive care unit , intensive care , mechanical ventilation , intensive care unit , septic shock , intensive care medicine , emergency medicine , immunology , immunization , virus , immune system
Aims Varicella is now a vaccine‐preventable disease but is generally considered benign, making it a low priority for a funded universal immunisation scheme. We aimed to increase the knowledge of the severity, morbidity and mortality caused by varicella, by a review of cases requiring paediatric intensive care in N ew Z ealand where vaccine is available but not funded. Methods This is a retrospective chart review of children admitted to the paediatric intensive care unit ( PICU ) over a 10‐year period ( J uly 2001– J uly 2011) identified from the PICU database with a primary or secondary code for varicella. Results Thirty‐four cases were identified and 26 cases were included. Of the 26 cases, 84.6% were M aori or P acific I sland ethnicity, 54% had no preceding medical condition and 23% were immunocompromised. Main PICU admission reasons were neurologic (38.5%), secondary bacterial sepsis or shock (26.9%), respiratory (15.4%), disseminated varicella (11.5%), or other causes (7.7%). Fifty per cent of children required inotropic support and 81% invasive ventilation. Four children died (15%), three of whom were immunocompromised. A further eight children (31%) had ongoing disability at hospital discharge. Conclusion Varicella, or its secondary complications, requiring paediatric intensive care, carries high mortality, particularly for immunocompromised patients, and long‐term morbidities, mostly affecting previously healthy children.