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Varicella paediatric hospitalisations in Belgium : a 1-year national survey

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Abstract
Background: Varicella universal vaccination (UV) has been implemented in many countries for several years. Nevertheless, varicella UV remains debated in Europe and few data are available on the real burden of infection. We assessed the burden of varicella in Belgium through analysis of hospitalised cases during a 1-year period. Methods: Data on children admitted to hospital with varicella were collected through a national network from November 2011 to October 2012. Inclusion criteria were either acute varicella or related complications up to 3 weeks after the rash. Results: Participation of 101 hospitals was obtained, covering 97.7% of the total paediatric beds in Belgium. 552 children were included with a median age of 2.1 years. Incidence of paediatric varicella hospitalisations reached 29.5/105 person-years, with the highest impact among those 0-4 years old (global incidence and odds of hospitalisation: 79/105 person-years and 1.6/100 varicella cases, respectively). Only 14% (79/552) of the cohort had an underlying chronic condition. 65% (357/552) of children had >= 1 complication justifying their admission, 49% were bacterial superinfections and 10% neurological disorders. Only a quarter of children (141/ 552) received acyclovir. Incidence of complicated hospitalised cases was 19/10(5) person-years. Paediatric intensive care unit admission and surgery were required in 4% and 3% of hospitalised cases, respectively. Mortality among Belgian paediatric population was 0.5/106 and fatality ratio 0.2% among our cohort. Conclusions: Varicella demonstrated a substantial burden of disease in Belgian children, especially among the youngest. Our thorough nationwide study, run in a country without varicella UV, offers data to support varicella UV in Belgium.
Keywords
PREVIOUSLY HEALTHY-CHILDREN, UNITED-STATES, VACCINATION PROGRAM, HERPES-ZOSTER, SEVERE COMPLICATIONS, LONG-TERM, IMPACT, EPIDEMIOLOGY, GERMANY, IMPLEMENTATION

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Chicago
Blumental, Sophie, Martine Sabbe, Philippe Lepage, the Belgian Group for Varicella, and Petra Schelstraete. 2016. “Varicella Paediatric Hospitalisations in Belgium : a 1-year National Survey.” Archives of Disease in Childhood 101 (1): 16–22.
APA
Blumental, S., Sabbe, M., Lepage, P., Belgian Group for Varicella, the, & Schelstraete, P. (2016). Varicella paediatric hospitalisations in Belgium : a 1-year national survey. ARCHIVES OF DISEASE IN CHILDHOOD, 101(1), 16–22.
Vancouver
1.
Blumental S, Sabbe M, Lepage P, Belgian Group for Varicella the, Schelstraete P. Varicella paediatric hospitalisations in Belgium : a 1-year national survey. ARCHIVES OF DISEASE IN CHILDHOOD. 2016;101(1):16–22.
MLA
Blumental, Sophie, Martine Sabbe, Philippe Lepage, et al. “Varicella Paediatric Hospitalisations in Belgium : a 1-year National Survey.” ARCHIVES OF DISEASE IN CHILDHOOD 101.1 (2016): 16–22. Print.
@article{7104141,
  abstract     = {Background: Varicella universal vaccination (UV) has been implemented in many countries for several years. Nevertheless, varicella UV remains debated in Europe and few data are available on the real burden of infection. We assessed the burden of varicella in Belgium through analysis of hospitalised cases during a 1-year period. 
Methods: Data on children admitted to hospital with varicella were collected through a national network from November 2011 to October 2012. Inclusion criteria were either acute varicella or related complications up to 3 weeks after the rash. 
Results: Participation of 101 hospitals was obtained, covering 97.7\% of the total paediatric beds in Belgium. 552 children were included with a median age of 2.1 years. Incidence of paediatric varicella hospitalisations reached 29.5/105 person-years, with the highest impact among those 0-4 years old (global incidence and odds of hospitalisation: 79/105 person-years and 1.6/100 varicella cases, respectively). Only 14\% (79/552) of the cohort had an underlying chronic condition. 65\% (357/552) of children had {\textrangle}= 1 complication justifying their admission, 49\% were bacterial superinfections and 10\% neurological disorders. Only a quarter of children (141/ 552) received acyclovir. Incidence of complicated hospitalised cases was 19/10(5) person-years. Paediatric intensive care unit admission and surgery were required in 4\% and 3\% of hospitalised cases, respectively. Mortality among Belgian paediatric population was 0.5/106 and fatality ratio 0.2\% among our cohort. 
Conclusions: Varicella demonstrated a substantial burden of disease in Belgian children, especially among the youngest. Our thorough nationwide study, run in a country without varicella UV, offers data to support varicella UV in Belgium.},
  author       = {Blumental, Sophie and Sabbe, Martine and Lepage, Philippe and Belgian Group for Varicella, the and Schelstraete, Petra},
  issn         = {0003-9888},
  journal      = {ARCHIVES OF DISEASE IN CHILDHOOD},
  keyword      = {PREVIOUSLY HEALTHY-CHILDREN,UNITED-STATES,VACCINATION PROGRAM,HERPES-ZOSTER,SEVERE COMPLICATIONS,LONG-TERM,IMPACT,EPIDEMIOLOGY,GERMANY,IMPLEMENTATION},
  language     = {eng},
  number       = {1},
  pages        = {16--22},
  title        = {Varicella paediatric hospitalisations in Belgium : a 1-year national survey},
  url          = {http://dx.doi.org/10.1136/archdischild-2015-308283},
  volume       = {101},
  year         = {2016},
}

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