Abstract
BackgroundIn the Netherlands, incidence of physician's consultations and hospitalizations for varicella is low compared to other countries. Better knowledge about the severity of varicella among Dutch hospitalized patients is needed. Therefore, a medical record research was conducted among hospitalized patients with diagnosis varicella.MethodsHospital admissions due to varicella in 2003-2006 were obtained from the National Medical Register. Retrospectively, additional data were retrieved from the medical record of patients hospitalized with varicella in 23 Dutch hospitals using a standardized form. Analyses were performed using descriptive statistics.ResultsThe study population (N = 296) was representative for all varicella admissions in the Netherlands (N = 1,658) regarding age, sex, duration of admission and type of diagnosis. Complications were recorded in 76% of the patients (37% had at least one relatively severe complication). Bacterial super infections of skin lesions (28%), (imminent) dehydration (19%), febrile convulsions (7%), pneumonia (7%) and gastroenteritis (7%) were most frequently reported. No varicella-related death occurred within the study population and 3% of the patients had serious rest symptoms.ConclusionsIt is not likely that the severity of varicella among hospitalized patients in the Netherlands differs from other countries. A considerable part of the varicella complications among hospitalized patients was rather moderate and can be treated effectively, although in a third of the hospitalized cases with complications, severe complications occurred. These data are relevant in the decision-making process regarding whether or not to introduce routine varicella vaccination in the Netherlands.
Highlights
In the Netherlands, incidence of physician’s consultations and hospitalizations for varicella is low compared to other countries
Patient characteristics In the 23 hospitals that consented in participation, 359 admissions with main and/or side diagnosis varicella were registered in the National Medical Register in the period 2003-2006
There was no significant difference in median age, sex, median duration of admission, type of diagnoses and ICD-9 codes between the study population and all Dutch hospitalized patients in the National Medical Register in 2003-2006 (Table 1)
Summary
In the Netherlands, incidence of physician’s consultations and hospitalizations for varicella is low compared to other countries. A medical record research was conducted among hospitalized patients with diagnosis varicella. Childhood varicella usually results in mild to moderate illness but serious complications like central nervous system involvement, pneumonia, secondary invasive bacterial infections and death may occur [1]. The United States was the first country that introduced universal childhood varicella vaccination. (vaccine coverage among children aged 19 to 35 months increased nationally from 27% in 1997 to 89% in 2006) and has reduced overall disease incidence by 57% to 90%, hospitalizations by 75% to 88%, deaths by >74%, and direct inpatient and outpatient medical expenditures by 74% [2]. In some other European countries like Austria, Belgium, Cyprus, France, Italy, Poland, Spain, Sweden and Switzerland, routine childhood vaccination is only offered in some regions, only in the private sector or only to high risk groups and/or susceptible adolescents [3,4]
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