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1.
Rev. argent. salud publica ; 13: 1-8, 5/02/2021.
Article in Spanish | LILACS, BINACIS, ARGMSAL | ID: biblio-1348620

ABSTRACT

INTRODUCTION: Varicella is a vaccine-preventable disease with marked seasonality. Few studies incorporate climatic variables to understand the epidemiological characteristics of this disease. The aim was to evaluate the relationship between varicella incidence and climatic variables in Tucumán (a province with temperate subtropical climate) during 2005-2019. METHODS: The relationship in pre- (2005-2014) and post-vaccination (2015-2019) periods was analyzed, identifying the associated climatic variables and the cut-off point where the risk of transmission increased. An observational ecological study was carried out with secondary data sources. R software was used. The information was split into three time series: 2005-2009, 2010-2014 and 2015-2019. For each period, a description of the time series was performed and generalized additive models (GAMs) were built using a negative binomial distribution. RESULTS: A seasonal behavior was observed, with peak incidence during spring in all periods. In the post-vaccination period, the peak occurred later (epidemiological week [EW] 46) than in the pre-vaccination periods (EW 43 and 42). Maximum temperature and relative humidity were associated during the first two periods, while minimum temperature, wind and thermal amplitude were associated in the third one. DISCUSSION: This study helped establish the relationship between climatic variables and varicella in Tucumán.


Subject(s)
Argentina , Chickenpox , Epidemiology , Climate
2.
Evid. actual. práct. ambul ; 24(4): e002147, 2021.
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1361868

ABSTRACT

A partir de 2022, a la dosis de vacuna contra la varicela contemplada a los 15 meses de edad en el Calendario Nacional de Vacunación de Argentina, se suma una segunda dosis al ingreso escolar. En este artículo se repasan los aspectos clave para la implementación de esta práctica de inmunización universal, gratuita y obligatoria. (AU)


Starting in 2022, a second dose of the varicella vaccine will be added to the 15-month-old dose included in Argentina's National Vaccination Schedule at school entry. This article reviews the key aspects for the implementation of this universal, free and mandatory immunization practice. (AU)


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Chickenpox/prevention & control , Immunization Schedule , Chickenpox Vaccine/administration & dosage , Argentina , Chickenpox/immunology
3.
Rev. fac. cienc. méd. (Impr.) ; 17(2): 17-24, jul.-dic. 2020. graf., tab.
Article in Spanish | LILACS, BIMENA | ID: biblio-1291850

ABSTRACT

Se estima que más del 90 % de la población mundial susceptible ha padecido varicela antes de los 15 años. En Honduras son escasos los estudios realizados sobre esta enfermedad. Objetivo: establecer las características clínico-epidemiológicas de varicela en población afectada de la Región Sanitaria Metropolitana del Distrito Central, del 1 de enero al 31 de diciembre 2016. Material y Métodos: estudio transversal; universo de 2 885 casos reportados a la unidad de vigilancia de la Región Sanitaria Metropolitana del Distrito Central. Se estudiaron 343 casos, los cuales se seleccionaron proporcionalmente según el número de casos por establecimientos de salud de procedencia. Se creó una ficha y una base de datos en MS Excel, el análisis se hizo usando Epi Info. Resultados: la mayoría de los casos tenían menos de 12 años de edad, los grupos más afectados fueron los de 0 a 5 años, 153(44.9%) y los de 6 a 12 años, 113(33.1%), la media de edad fue de 9.2 años ± 10 años 1DE. Un tercio fue atendido a nivel hospitalario; en el Instituto Hondureño de Seguridad Social 109(31.8%), 4(1.2%) en el Hospital San Felipe y 2(0.6%) en el Hospital Escuela Universitario. La media de duración de la fiebre sin complicaciones fue 2.1 días ± 1.2 días. Uno de cada 10 casos presentó alguna complicación, entre éstas, las enfermedades respiratorias superiores (6.4%) y lesiones de piel (1.5%) y los menores de 6 años tendieron a sufrir complicaciones. 74% recibió antipiréticos/antiinflamatorios, 47.6% antihistamínicos y 25.1% antibióticos. La prescripción de antibióticos fue significativamente mayor para casos con complicaciones (OR=17.9, IC95% 7.3-44.0), al igual que analgésicos y antipiréticos (OR=2.8, IC95% 1-8.3). Conclusiones: la población más afectada fueron los niños menores de 12 años y las complicaciones se observaron en niños menores de 6 años. El uso de antibióticos y analgésicos fue mayor en casos con complicaciones. Los hallazgos del estudio apoyan la importancia de considerar la inclusión de la vacuna contra varicela en el esquema nacional de inmunizaciones...(AU)


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Physicians' Offices , Chickenpox/epidemiology , Varicellovirus , State Health Surveillance Centers
4.
Medwave ; 20(6): e7983, 31-07-2020.
Article in English, Spanish | LILACS | ID: biblio-1119734

ABSTRACT

INTRODUCCIÓN: La varicela es una enfermedad infectocontagiosa producida por el virus varicela-zóster. Para su prevención, convencionalmente se utiliza la vacuna varicela, cuya administración busca disminuir la aparición de enfermedad y sus complicaciones. Sin embargo, aún existe controversia sobre la efectividad. MÉTODOS: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Se identificaron dos revisiones sistemáticas que en conjunto incluyeron 16 estudios primarios, de los cuales, tres corresponden a ensayos aleatorizados. Concluimos que la vacunación contra la varicela disminuye el riesgo de contraer la enfermedad a largo plazo en pacientes sanos sin exposición previa y que probablemente disminuye el riesgo de contraer la enfermedad a corto plazo. Sin embargo, aumenta la reacción local 48 horas posterior a su administración y probablemente aumenta la aparición de fiebre y varicela-like rash.


INTRODUCTION: Chickenpox is an infectious disease caused by varicella-zoster virus. Varicella vaccine is conventionally used for its prevention, and its administration seeks to reduce the onset of the disease and complications associated. However, there is still controversy about its effectiveness. METHODS: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified two systematic reviews including 16 studies overall, of which three were randomized trials. We concluded that the varicella vaccine decreases the risk of contracting the disease in the long term and probably reduces the risk of developing the disease in the short term in healthy unexposed patients. Nevertheless, the vaccination increases the occurrence of local reactions 48 hours after its administration and probably increases the presence of fever and chickenpox-like rash.


Subject(s)
Humans , Chickenpox/prevention & control , Chickenpox Vaccine/administration & dosage , Randomized Controlled Trials as Topic , Databases, Factual , Chickenpox Vaccine/adverse effects
6.
Cad. Saúde Pública (Online) ; 36(1): e00149119, 2020. tab
Article in English | LILACS | ID: biblio-1055626

ABSTRACT

Abstract: Varicella in adults and immunocompromised patients can be severe. The clinical diagnosis of varicella has high accuracy and the history of disease has a high positive predictive value for protection. A significant portion of adults, however, cannot remember if they have had varicella, especially older individuals. We conducted a cross-sectional study to determine the seroprevalence of varicella protective antibodies titers in adults with no clinical history of disease, attended at a Reference Center for Special Immunobiologicals and Travel Medicine in Rio de Janeiro (Brazil). Titration of immunoglobulin G (IgG) antibodies to varicella-zoster was determined by chemiluminescence immunoassay. Among 140 adults without history of varicella, 92% had protective antibody titers. We concluded that seroprevalence of varicella-zoster protection was very high in adults with negative history of disease and the use of serology before vaccination reduced significantly unnecessary vaccine and immunoglobulin use.


Resumo: A varicela é uma doença potencialmente grave em adultos e em pacientes imunocomprometidos. O diagnóstico clínico da varicela apresenta alta acurácia, e o relato da doença na história individual tem alto valor preditivo positivo para a proteção. Entretanto, uma proporção significativa de adultos, principalmente os mais idosos, não se lembra se já teve a doença. Realizamos um estudo transversal para determinar a soroprevalência de títulos protetores de anticorpos contra a varicela em adultos sem história clínica da doença, atendidos em um Centro de Referência para Imunobiológicos Especiais e Medicina de Viagem no Rio de Janeiro, Brasil. Os títulos da imunoglobulina G (IgG) contra varicela-zoster foram determinados por quimiluminescência. Entre 140 adultos sem história de varicela, 92% apresentaram títulos protetores de anticorpos. Concluímos que a soroprevalência de proteção contra varicela-zoster é muito alta em adultos sem história da doença, e que o uso de teste sorológico antes da vacinação reduziria significativamente a vacinação desnecessária e o uso de imunoglobulina.


Resumen: La varicela en adultos y pacientes inmunocomprometidos puede ser grave. El diagnóstico clínico de la varicela tiene una gran precisión y la historia de la enfermedad cuenta con un alto valor predictivo positivo para la protección contra ella. Sin embargo, un porcentaje significativo de adultos, no puede recordar si tuvieron varicela, especialmente las personas más viejas. Realizamos un estudio transversal para determinar la seroprevalencia de las concentraciones de anticuerpos protectores frente a la varicela, en adultos sin historia clínica de la enfermedad, que se llevó a cabo en un Centro de Referencia para Inmunobiología Especial y Medicina del Viajero en Río de Janeiro (Brasil). Se determinó la valoración de los anticuerpos de inmunoglobulina G (IgG) a la varicela-zoster mediante un ensayo inmunológico quimioluminiscente. Entre 140 adultos sin historial de varicela, un 92% tuvieron concentraciones de anticuerpos protectores. Concluimos que la seroprevalencia de la protección a la varicela-zoster fue muy alta en adultos con un historial negativo de la enfermedad y la utilización de la serología antes de la vacunación redujo de manera significativa la vacunación innecesaria y el uso de la inmunoglobulina.


Subject(s)
Humans , Adult , Immunoglobulin G/blood , Chickenpox/epidemiology , Herpesvirus 3, Human/immunology , Measurements, Methods and Theories , Brazil/epidemiology , Chickenpox/prevention & control , Chickenpox/blood , Prevalence , Cross-Sectional Studies , Chickenpox Vaccine , Luminescent Measurements , Antibodies, Viral/blood
7.
Cienc. tecnol. salud ; 7(2): 265-272, 2020. il 27 c
Article in Spanish | LILACS, LIGCSA, DIGIUSAC | ID: biblio-1348243

ABSTRACT

Se determinó la frecuencia de anticuerpos IgG para Toxoplasma gondii y los virus de paperas, sarampión, rubéola, varicela y hepatitis B en 90 estudiantes de la carrera de Química Biológica de la Facultad de CCQQ y Farmacia. La mayor frecuencia se encontró para rubéola y sarampión, 98.9% para cada prueba y la menor frecuencia fue para T. gondii con 23.3%. No se encontró asociación significativa entre la positividad y el género, entre la positividad a paperas, sarampión, varicela y el haber sufrido la infección o haber estado en contacto con personas infectadas y entre la positividad a T. gondii y el consumir carne roja y/o comida callejera (p > .05). Únicamente en el caso de la hepatitis B se encontró una asociación significativa entre la positividad y la edad (p = < .001), el hecho de estar vacunado (p < .001) y el ser sexualmente activo (p = .004). Los porcentajes de vacunación en la población en estudio fue alta únicamente para hepatitis B (80%), mientras que para las otras infecciones fue 35.6% para rubéola y sarampión, 22.2% para varicela y 10% para paperas. Más de 82% de los estudiantes presentaron protección a los seis agentes estudiados y se recomienda realizar encuestas sero-epidemiológicas constantes, evaluar los programas de inmunización, identificar los grupos a riesgo y que las personas que no presenten anticuerpos se vacunen.


The frequency of IgG antibodies for Toxoplasma gondii and the mumps, measles, rubella, varicella and hepa-titis B viruses was determined in 90 students of the Biological Chemistry career of the Faculty of CCQQ and Pharmacy. The highest frequency was found for Rubella and Measles, 98.9% each, and the lowest frequency was for T. gondii with 23.3%. No significant difference was found between positivity and gender, between positivity to mumps, measles, chicken pox and having suffered infection or having been in contact with infected persons and between positivity to T. gondii and consuming red meat and / or street food (p > .05). Only in the case of Hepatitis B a significant difference between positivity and age (p = .001), the fact of being vaccinated (p = .001) and being sexually active (p = .004 was found. The percentage of vaccination in the study population was high only for He-patitis B (80%), while for the other infections it was 35.6% for rubella and measles, 22.2% for varicella and 10% for mumps. More than 82% of the students presented protection to the six agents studied and it is recommended to carry out constant sero-epidemiological surveys, to evaluate the immunization programs, to identify the risk groups and that people who do not present antibodies get vaccinated.


Subject(s)
Humans , Male , Female , Adult , Students, Pharmacy , Immunoglobulin G/immunology , Rubella/immunology , Toxoplasma/immunology , Immunoglobulin G/analysis , Chickenpox/immunology , Mass Vaccination , Guatemala/epidemiology , Hepatitis B/immunology , Measles/immunology , Mumps/immunology
8.
Article in Spanish | LILACS, BINACIS, ARGMSAL | ID: biblio-1117063

ABSTRACT

La varicela es una de las enfermedades inmunoprevenibles más comunes. En 1998 la Organización Mundial de la Salud recomendó incorporar la vacuna a los programas nacionales de vacunación. Argentina lo hizo en 2015. El objetivo de este trabajo fue analizar la serie temporal de varicela durante 2005-2019 y evaluar el impacto de la vacuna sobre su incidencia en Tucumán tras la implementación. MÉTODOS: Se llevó a cabo un estudio observacional de tipo ecológico con fuentes de datos secundarias. Los casos de varicela fueron los consignados por el Sistema Nacional de Vigilancia de Salud. Se describió la serie temporal de casos notificados de varicela para Tucumán y se construyeron modelos aditivos generalizados (GAM) utilizando una distribución binomial negativa. Se verificó el impacto de la vacuna tomando el período 2005-2014, se construyó un modelo GAM y se pronosticó el comportamiento más probable luego de la implementación. Se evaluó el impacto comparando las tasas con sus intervalos de confianza entre lo pronosticado y lo observado. RESULTADOS: Tucumán notificó 82 810 casos durante 2005-2019. La tasa anual varió entre 1,66 por 1000 habitantes (2019) y 6,04 por 1000 habitantes (2007). La serie presentó estacionalidad y en los últimos años una tendencia decreciente. Se observó una disminución significativa de la tasa de incidencia tras la implementación de la vacuna. DISCUSIÓN: El presente trabajo evidenció el impacto de una política pública como la vacuna


Subject(s)
Public Policy , Chickenpox , Time Series Studies , Chickenpox Vaccine
9.
Biociencias ; 15(1): 79-89, jun.2020.
Article in Spanish | LILACS, COLNAL | ID: biblio-1122960

ABSTRACT

La varicela es una enfermedad infecto-contagiosa, producida por el virus varicela-zoster (VVZ); es un virus alfaherpes que se relaciona más estrechamente con el virus del herpes simple, se presenta cuando el virus entra en contacto con la mucosa del tracto respiratorio superior o la conjuntiva de una persona susceptible, la transmisión de persona a persona se puede presentar por contacto directo con lesiones de VZV o por propagación en el aire. La reinfección con VZV es rara. El período de incubación es de 10 a 21 días; los síntomas que generalmente se presentan son fiebre, malestar general, anorexia, dolor de cabeza y posteriormente vesículas claras, pruriginosas en las primeras etapas, llenas de líquido que evolucionan a costras. La complicación más común de la varicela es la sobreinfección bacteriana de las lesiones cutáneas causadas con mayor frecuencia por Staphylococcus aureus y Streptococcus del grupo A, pero también es posible encontrar linfadenitis y abscesos subcutáneos. Cuando la varicela se presenta durante los últimos días de gestación (<5 días) o 2 días después del parto, existe un riesgo aproximado de 20% de presentar varicela neonatal.


The Varicela is an infectious-contagious disease, caused by the varicella-zoster virus (VZV); It is an alphaherpes virus that is more closely related to the herpes simplex virus, it occurs when the virus comes into contact with the mucosa of the upper respiratory tract or the conjunctiva of a suscep-tible person, transmission from person to person can occur by contact Direct with VZV or airborne injuries. Reinfection with VZV is rare. The incubation period is from 10 to 21 days; The symptoms that generally appear are fever, general malaise, anorexia, headache and later clear, itchy vesicles in the early stages, filled with fluid that evolve to crusts. The most common complication of varicela is bacterial superinfection of the cutaneous lesions most frequently caused by group A Staphylococcus aureus and Streptococcus, but it is also possible to find lymphadenitis and subcutaneous abscesses. When chickenpox occurs during the last days of gestation (<5 days) or 2 days after delivery, there is an approximate 20% risk of developing neonatal varicela


Subject(s)
Humans , Herpesvirus 3, Human , Population Characteristics , Chickenpox , Herpes Zoster
10.
Cad. Saúde Pública (Online) ; 36(supl.2): e00008520, 2020.
Article in Portuguese | SES-SP, LILACS, SES-SP | ID: biblio-1132881

ABSTRACT

Resumo: A vacinação é uma das maiores intervenções em saúde pública pela segurança e efetividade, porém nem sempre vacinar significa imunizar. Inúmeros aspectos relacionados tanto ao indivíduo que recebe a vacina, quanto à especificidade de cada imunobiológico administrado compõem o processo para a obtenção de uma adequada imunização, sendo essencial que sejam observados para não culminar em falhas vacinais. A análise dos estudos de imunogenicidade e efetividade para as vacinas sarampo, varicela e caxumba apontam para a necessidade da incorporação de duas doses aos calendários básicos de vacinação para o controle das referidas doenças. Estudos epidemiológicos que analisaram surtos dessas doenças identificaram casos em indivíduos que receberam duas doses da vacina, o que pode apontar provável falha secundária. Para a vacina febre amarela, a discussão atual reside no número de doses ideal para a proteção individual. A Organização Mundial da Saúde recomenda dose única para toda a vida. Apesar dos poucos relatos em literatura a respeito das falhas vacinais, os estudos de imunogenicidade demonstram perda de proteção ao longo dos anos, principalmente na faixa etária pediátrica. Num cenário atual de eliminação e controle de doenças, associado à diminuição da circulação de vírus selvagens, o papel da vigilância epidemiológica é fundamental para aprofundar o conhecimento a respeito dos múltiplos fatores envolvidos, que culminam com falhas vacinais e surgimento de surtos. A ocorrência de surtos de doenças imunopreveníveis impacta negativamente a credibilidade dos programas de imunização, acarretando baixas coberturas vacinais e interferindo no êxito da vacinação.


Resumen: La vacunación es una de las mayores intervenciones en salud pública, por su seguridad y efectividad, sin embargo, no siempre vacunar significa inmunizar. Innumerables aspectos relacionados tanto con el individuo que recibe la vacuna, como con la especificidad de cada inmunobiológico administrado, componen el proceso para conseguir una adecuada inmunización, siendo esencial que sean observados para no acabar con fallos en las vacunas. El análisis de los estudios de inmunogenicidad y efectividad para las vacunas sarampión, varicela y parotiditis, apuntan hacia la necesidad de la incorporación de dos dosis a los calendarios básicos de vacunación para el control de las mencionadas enfermedades. Estudios epidemiológicos que analizaron brotes de esas enfermedades identificaron casos en individuos que recibieron dos dosis de la vacuna, lo que puede apuntar un probable fallo secundario. Para la vacuna de fiebre amarilla la discusión actual reside en el número de dosis ideal para protección individual. La Organización Mundial de la Salud recomienda una dosis única para toda la vida. A pesar de los pocos relatos en la literatura, respecto a los fallos en las vacunas, los estudios de inmunogenicidad demuestran una pérdida de protección a lo largo de los años, principalmente en la franja de etaria pediátrica. En un escenario actual de eliminación y control de enfermedades, asociado a la disminución de la circulación de virus salvajes, el papel de la vigilancia epidemiológica es fundamental para profundizar el conocimiento respecto a los múltiples factores implicados, que culminan con fallos en las vacunas y surgimiento de brotes. La ocurrencia de brotes de enfermedades inmunoprevenibles impacta negativamente en la credibilidad de los programas de inmunización, acarreando bajas coberturas de vacunación e interfiriendo en el éxito de la vacunación.


Abstract: Vaccination is one of the greatest public health interventions, based on its safety and effectiveness, but vaccination does not always mean immunization. Numerous aspects related both to the individual that receives the vaccine and the specificity of each vaccine administered are part of the process of obtaining adequate immunization, and it is essential to observe the aspects in order to avoid vaccine failures. The analysis of immunogenicity and effectiveness studies for the measles, varicella, and mumps vaccines point to the need to incorporate two doses into the basic vaccination calendars in order to control these diseases. Epidemiological studies that analyzed outbreaks of these diseases identified cases in individuals that received two doses of the vaccine, which may indicate likely secondary failure. For the yellow fever vaccine, the current discussion lies in the ideal number of doses for individual protection. The World Health Organization recommends a single dose for life. Despite the few reports in the literature concerning vaccine failures, immunogenicity studies demonstrate waning protection over the years, mainly in the pediatric age bracket. In the current scenario of elimination and control of diseases, associated with the decrease in the circulation of the wild-type viruses, the role of epidemiological surveillance is crucial for expanding knowledge on the multiple factors involved, culminating in vaccine failures and the emergence of outbreaks. Outbreaks of vaccine-preventable diseases negatively impact the credibility of immunization programs, leading to low vaccination coverage rates and interfering in vaccination's success.


Subject(s)
Humans , Infant , Child , Rubella , Yellow Fever/prevention & control , Yellow Fever/epidemiology , Chickenpox , Measles/prevention & control , Measles/epidemiology , Mumps/prevention & control , Mumps/epidemiology , Brazil , Immunization Schedule , Vaccination , Vaccines, Combined , Chickenpox Vaccine/adverse effects , Measles-Mumps-Rubella Vaccine
11.
Article in Korean | WPRIM | ID: wpr-811288

ABSTRACT

An increase in the number of patients with infectious diseases in Korea, can be attributed to various factors, such as the prevalence of new infectious diseases of the 21st century, the re-emergence of past infectious diseases, an increase in the number of elderly individuals, patients with chronic diseases, immune deficiency, and globalization. In this context, vaccination becomes vital for the adult population. Although, the guidelines for adult immunization are currently being updated, the rate of adult vaccination remains lower than that of infant vaccination. At present, the major challenges for increasing the rate of adult immunization include negative views on the need for some immunizations and a lack of understanding of group immunity among the youth. Consequently, a successful immunization program will be required to direct efforts towards educating patients and spreading awareness. Based on the current guidelines and practical applications, varicella zoster; Japanese encephalitis; tetanus, diphtheria, and pertussis; pneumococcus; measles, mumps, and rubella; and hepatitis A vaccines could effectively be considered for adult vaccination.


Subject(s)
Adolescent , Adult , Aged , Chickenpox , Chronic Disease , Communicable Diseases , Diphtheria , Encephalitis, Japanese , Hepatitis A Vaccines , Herpes Zoster , Humans , Immunization Programs , Immunization , Infant , Internationality , Korea , Measles , Mumps , Pneumococcal Vaccines , Prevalence , Rubella , Streptococcus pneumoniae , Tetanus , Vaccination , Whooping Cough
12.
Article in English | WPRIM | ID: wpr-882006

ABSTRACT

@#INTRODUCTION: Varicella or commonly known as chicken pox is caused by varicella-zoster virus (VZV) that is usually seen as a vesicular eruption in children. It is a highly contagious infection and is the result of exogenous primary infection of a susceptible individual. Immunocompromised individuals have impaired cell-mediated immunity and are prone to develop severe disease. They may have atypical presentations and lesions may sometimes appear hemorrhagic. CASE REPORT: We report two separate cases of HIV-AIDS patients presenting with erythematous umbilicated papules in which the initial clinical impression was molluscum contagiosum. Skin punch biopsy was done and revealed hemorrhagic varicella. Patients were started on intravenous acyclovir with noted remarkable improvement. CONCLUSION: This case report highlights the clinical and histopathologic features of hemorrhagic varicella. A skin biopsy is mandatory to establish the correct diagnosis and to initiate proper treatment.


Subject(s)
Chickenpox , Acyclovir , Acquired Immunodeficiency Syndrome , Herpesvirus 3, Human
13.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(4): 510-515, Oct.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1041364

ABSTRACT

ABSTRACT Objective: To report a case of varicella complicated by acute osteomyelitis in order to remind of a rare and potentially serious complication of a very common pediatric disease. Case description: A previously healthy 3-month-old female infant with 10-day history of varicella was admitted to the hospital for fever, groan and prostration. The initial laboratorial evaluation was compatible with bacterial sepsis. By the third day after admission, a swelling of the seventh left rib had developed. The ultrasound and scintigraphy evaluation suggested rib osteomyelitis. Blood cultures were negative. The patient completed six weeks of antibiotics with favorable clinical, laboratorial and imaging evolution. Comments: Varicella is one of the most frequent exanthematic diseases of childhood and it is usually self-limited. The most frequent complication is bacterial infection of cutaneous lesions. Osteoarticular complications are rare, and rib osteomyelitis is described in less than 1% of cases. The main route of dissemination is hematogenic, and the most frequent etiological agent is Staphylococcus aureus. The prognosis is generally good and depends on early detection and antibiotic initiation.


RESUMO Objetivo: Descrever um caso de varicela complicada de osteomielite aguda a fim de alertar para a complicação rara e potencialmente grave de uma doença muito frequente em idade pediátrica. Descrição do caso: Lactente de três meses, previamente saudável, internada por um quadro de febre, prostração e gemido, num contexto de varicela com cerca de dez dias de evolução, com avaliação inicial compatível com sepse de etiologia bacteriana. No terceiro dia de internação, observou-se uma tumefação na sétima costela esquerda. A avaliação ecográfica e cintilográfica mostraram alterações sugestivas de osteomielite de arco costal. As hemoculturas foram negativas. Recebeu antibioticoterapia por seis semanas e evoluiu favoravelmente do ponto de vista clínico, laboratorial e ecográfico. Comentários: A varicela é uma das doenças exantemáticas mais frequentes da infância, sendo habitualmente autolimitada. A complicação mais frequente é a infecção bacteriana secundária das lesões cutâneas, sendo raras as complicações osteoarticulares. O arcabouço costal é uma localização excepcional de osteomielite, descrita em menos de 1% dos casos. A principal via de disseminação é a hematogênica, e o agente mais frequente, o Staphylococcus aureus. O prognóstico é geralmente bom, quando a antibioticoterapia se institui precocemente.


Subject(s)
Humans , Female , Infant , Osteomyelitis/diagnosis , Osteomyelitis/virology , Chickenpox/complications , Ribs
14.
Rev. méd. hered ; 30(2): 76-86, abr. 2019. graf, tab
Article in Spanish | LIPECS, LILACS, LIPECS | ID: biblio-1058672

ABSTRACT

Objetivo: Describir las complicaciones más frecuentes y la carga económica asociada con la varicela en el Perú. Material y métodos: Estudio multicéntrico de revisión de historias clínicas de pacientes de 1 a 14 años con diagnóstico de varicela entre 2011 y 2016. El uso de recursos de atención médica (URAM) asociados con la varicela, los costos unitarios y la pérdida de trabajo se utilizaron para estimar los costos directos e indirectos, presentados en USD ($). Los datos de costos y URAM se combinaron con estimaciones de carga de enfermedad para calcular el costo total anual de la varicela en el Perú. Resultados: Se incluyeron un total de 179 niños con varicela (101 ambulatorios, 78 hospitalizados). Entre los pacientes ambulatorios, el 5,9 % presentó una o más complicaciones, en comparación con 96,2 % de pacientes hospitalizados. El URAM incluyó el uso de medicamentos de venta libre (72,3 % frente a 89,7 % de pacientes ambulatorios y hospitalizados, respectivamente), medicamentos con receta (30,7 % frente a 94,9 %) y análisis y procedimientos (0,0 % frente a 80,8 %). Los costos directos e indirectos por caso ambulatorio fueron $36 y $62 respectivamente y por caso hospitalizado fueron $548 y $222. El costo anual total asociado con la varicela se estimó en $13 907 146. Conclusión: La varicela está asociada con complicaciones clínicas importantes y elevado URAM en Perú, lo que respalda la necesidad de implementación de un plan de vacunación universal. (AU)


Objective: The purpose of this study was to evaluate the clinical and economic burden associated with varicella in Peru. Methods: This was a multicenter, retrospective chart review study of patients aged 1-14 years with a varicella diagnosis between 2011 and 2016. Healthcare resource utilization (HCRU) associated with varicella, unit costs, and work loss were used to estimate direct and indirect costs, presented in USD ($). The cost and HCRU data was combined with estimates of varicella disease burden to estimate the overall annual costs of management of varicella in Peru. Results: A total of 179 children with varicella (101 outpatients, 78 inpatients) were included. Among outpatients, 5.9% experienced ≥1 complication, compared with 96.2% of inpatients. HCRU estimates included use of over-the-counter (OTC) medications (72.3% vs. 89.7% of outpatient and inpatients, respectively), prescription medications (30.7% vs. 94.9%), tests/procedures (0.0% vs. 80.8%). Among outpatients, direct and indirect costs per case were $36 and $62, respectively; among inpatients, respective costs were $548 and $222. The total annual cost associated with varicella was estimated at $ 13 907 146. Conclusion: Varicella is associated with substantial clinical complications and high HCRU in Peru, supporting the need for implementation of a routine childhood varicella vaccination plan. (AU)


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Peru , Chickenpox/economics , Health Care Costs , Health Expenditures , Immunization Programs , Costs and Cost Analysis , Retrospective Studies , Multicenter Studies as Topic , Observational Studies as Topic
15.
Arch. argent. pediatr ; 117(1): 12-18, feb. 2019. graf, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-983771

ABSTRACT

Introducción. En Argentina, se estiman 400 000 casos anuales de varicela. Dado el subregistro de casos existentes, la carga de enfermedad real se desconoce. Objetivo. Evaluar la carga de enfermedad por varicela antes de la introducción de la vacuna al Calendario Nacional. Materiales y métodos. Estudio retrospectivo, analítico, observacional, realizado en tres centros asistenciales del país. Revisión de los registros de consultas ambulatorias a los Servicios de Urgencias y de las historias clínicas de las internaciones por varicela en pacientes < 18 años. Período: 1/2011-12/2013. Resultados. Fueron asistidas un total de 382782 consultas ambulatorias; 3367 (0,88 %) correspondieron a consultas por varicela; el 57,6 %, < 4 años. Requirieron internación 164 (4,9 %) con una tasa de hospitalización global de 65,3/10000 hospitalizados/año (IC 95 %: 55,4-76,5); tasa de hospitalización en niños sanos: 57,2/10 000 (IC 95 %: 67,7-48,0); mediana de edad: 31,5 meses. Las causas de internación más frecuentes fueron infecciones de piel y/o partes blandas (61,1 %) y respiratorias (10,1 %). El 54,3 % recibió tratamiento con aciclovir, y el 73,1 %, con antibióticos. Presentaron bacteriemia 5/67 (7,5 %), todas por cocos Gram(+) y en inmunocompetentes. De los 19 pacientes inmunocomprometidos, el 36,8 % tuvo complicaciones (5 infecciones de piel y/o partes blandas y 2 neumonías). La mediana de días de internación fue 4, significativamente más prolongada en pacientes inmunocomprometidos. Un paciente requirió cuidados intensivos. No hubo fallecidos. Conclusión. La carga de enfermedad registrada fue significativa, con impacto considerable en pacientes sin patología de base.


Introduction. In Argentina, an estimated 400 000 varicella cases occur annually. Given the under-recording of existing cases, the actual burden of disease is unknown. Objective. To assess the burden of varicella before the introduction of the varicella vaccine in the national immunization schedule. Materials and methods. Retrospective, analytical, observational study carried out in three hospitals of Argentina. Review of medical records from outpatient visits to the Emergency Department and from patients younger than 18 years hospitalized for varicella. Period: 1/2011-12/2013. Results. A total of 382 782 outpatients were seen; 3367(0.88%) corresponded to visits due to varicella; 57.6 % were < 4 years old. A total of 164 (4.9 %) patients required hospitalization, with an overall hospitalization rate of 65.3/10 000 hospitalized patients/year (95 % confidence interval -#91;CI-#93;: 55.4-76.5); hospitalization rate in healthy children: 57.2/10 000 (95 % CI: 67.7-48.0); median age: 31.5 months. The most common causes of hospitalization were skin and/or soft tissue infections (61.1 %) and respiratory infections (10.1 %). Also, 54.3 % were treated with acyclovir and 73.1 %, with antibiotics. Bacteremia developed in 5/67 patients (7.5 %), all cases were caused by Gram-positive cocci and occurred in immunocompetent patients. Out of 19 immunocompromised patients, 36.8 % had complications (5 skin and/or soft tissue infection and 2 pneumonia cases). The median length of stay was 4 days, which is significantly more prolonged in immunocompromised patients. One patient required intensive care. No patient died. Conclusion. The burden of disease was significant, with a considerable impact in patients without an underlying disease.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Chickenpox/epidemiology , Cost of Illness , Argentina/epidemiology , Chickenpox/diagnosis , Chickenpox/drug therapy , Retrospective Studies , Ambulatory Care , Hospitalization
16.
Rev. Soc. Bras. Med. Trop ; 52: e20190149, 2019. tab, graf
Article in English | LILACS | ID: biblio-1057243

ABSTRACT

Abstract INTRODUCTION: This study aimed to analyze cases of complicated varicella and the impact of varicella vaccination in Minas Gerais, Brazil. METHODS: This was a time series study of a territorial basis using data on varicella cases from 2010 to 2016, which was provided by the State Health Department of Minas Gerais on . Descriptive statistics were used for the analysis, and the generalized linear regression model proposed by Prais-Winsten was used for the time tendency, adopting a significance level of 5% and the integrated autoregressive modeling of moving averages. RESULTS: There were 1,635 cases of varicella; out of which cellulitis (44%) was the predominant complication. The home-acquired cases were 38.9% and 464 cases (40.6%) were not previously vaccinated. There was a significant decrease in the incidence coefficient when comparing the pre- and post- immunization periods, from 1.95 cases/100,000 inhabitants in 2010 to 0.24 cases/100.000 inhabitants in 2016 (p<0.05). There was a higher incidence of cases recorded among males, with higher prevalence in the age group of 1-4 years (54.7%). Lethality was higher between 5-9 years of age (44%). Mortality was higher in the age group of 0-4 years and among females (2.58/100,000 inhabitants/year). The overall trend of the incidence coefficient was a decreasing one, with an annual percentage variation. CONCLUSIONS: The number of complicated varicella cases notified decreased, coincidentally, in the post-immunization period. However, the immunization coverage period was restricted for the assessment of the correlation between immunization coverage and incidence.


Subject(s)
Humans , Male , Female , Pregnancy , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Aged, 80 and over , Chickenpox/epidemiology , Vaccination/statistics & numerical data , Hospitalization/statistics & numerical data , Seasons , Socioeconomic Factors , Brazil/epidemiology , Chickenpox/prevention & control , Incidence , Spatio-Temporal Analysis , Middle Aged
17.
Article in English | WPRIM | ID: wpr-763369

ABSTRACT

PURPOSE: There are limited population-based data regarding herpes zoster in children. Thus we conducted a multi-institutional epidemiological analysis of herpes zoster in children and comparative analysis according to their immune status. MATERIALS AND METHODS: The study included 126 children under the age of 18 years who were hospitalized for herpes zoster at 8 hospitals in South Korea, between July 2009 and June 2015. The subjects were divided into 2 groups according to their immune status, and medical records were reviewed. RESULTS: There were 61 cases (48.4%) in the immunocompetent group and 65 cases (51.6%) in the immunocompromised group. Median age was older in immunocompromised group (11.4 vs. 8.6) (p<0.001). The mean duration of hospitalization was longer in immunocompromised group (11.0 vs. 6.6) (p<0.001). Patients were treated with oral or intravenous antiviral agents. A total of 12 in immunocompetent group were cured only by oral acyclovir. No treatment failure was found in both groups. Six immunocompromised patients had postherpetic neuralgia and 1 case was in immunocompetent group. In immunocompetent children, herpes zoster was likely caused by early varicella infection. There was no increase in progression of severity in both groups due to appropriate treatment. CONCLUSION: Early initiation of therapy is necessary for those in immunocompromised conditions. And inactivated herpes zoster vaccination may be considered in immunocompromised adolescents in the future.


Subject(s)
Acyclovir , Adolescent , Antiviral Agents , Chickenpox , Child , Child, Hospitalized , Herpes Zoster , Hospitalization , Humans , Immunocompromised Host , Korea , Medical Records , Neuralgia, Postherpetic , Treatment Failure , Vaccination
18.
Article in English | WPRIM | ID: wpr-765158

ABSTRACT

The number of reported varicella cases is continuously increasing in Korea; however, associated medical utilization is declining. The ratio between varicella insurance claims and reports of passive infectious disease surveillance has gradually increased to > 80% since the second half of 2017. The recent increase in reported varicella cases is influenced by improved reporting. We calculated the varicella incidence and cumulative incidence in each birth cohort according to age. The cumulative incidence rate among children aged < 6 years in the birth cohort born after the National Immunization Program introduced the varicella vaccine was about 60% lower than among children born before


Subject(s)
Chickenpox Vaccine , Chickenpox , Child , Cohort Studies , Communicable Diseases , Humans , Immunization Programs , Immunization , Incidence , Insurance , Korea , Parturition
19.
Article in English | WPRIM | ID: wpr-764924

ABSTRACT

BACKGROUND: In Korea, the incidence of varicella has increased despite the introduction of a universal one-dose vaccination for children aged 12–15 months in 2005. A previous study demonstrated that the vaccine effectiveness was insufficient to prevent against varicella. We assessed the effect of the varicella vaccination on disease severity. METHODS: Epidemiologic investigation of varicella cases in Seoul metropolitan area from 2015 to 2017 were used. Varicella-related symptoms such as rash were determined by the clinical practitioners. Disease severity of patients was assessed by the number of skin lesions and divided into mild (≤ 50) and moderate (51–249) to severe (≥ 250). Unconditional logistic regression analysis was performed and age was controlled. RESULTS: Among a total of 1,008 varicella cases reported, 869 cases were breakthrough cases and 139 were unvaccinated cases. The risk for occurrence of moderate-to-severe disease in the breakthrough group was 0.57 times less than that of the unvaccinated group. CONCLUSION: These data suggest that national varicella vaccination may have a significant effect on attenuation of disease severity in children.


Subject(s)
Chickenpox , Child , Disease Outbreaks , Exanthema , Humans , Incidence , Korea , Logistic Models , Seoul , Skin , Vaccination
20.
Article in English | WPRIM | ID: wpr-764921

ABSTRACT

No abstract available.


Subject(s)
Chickenpox
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