Characteristics of chickenpox in children and adults at a tertiary health center in Sarajevo, Bosnia-Herzegovina

Year 2012, Volume: 2 Issue: 02, 64 - 67, 01.06.2012

Rusmir Baljic Sajma Dautovic-krkic Nada Koluder-cimic Mirsada Hukic Amir Hadzic Mensura Seremet Selma Hasimbegovic-ıbrahimovic

https://doi.org/10.5799/ahinjs.02.2012.02.0044

Abstract

Introduction: Chickenpox is very contagious childhood disease, which occurs due to varicella-zoster virus (VZV) primary infection. Disease in healthy children resolves usually without complications, but risk of complication is much higher in adults and immunocompromised hosts. The goal of this study was to determine different clinical and epidemiological characteristics, laboratory features, clinical course, and outcome of chickenpox in children and adults. Material and methods: The descriptive study was conducted at the Department of Infectious Diseases, Clinical Center in Sarajevo, Bosnia-Herzegovina. The study included 120 patients chosen randomly. We compared their clinical and epidemiological characteristics, laboratory investigations, complications and the outcome of the disease. Results: Age of patients was in range from one to 48 years. Male patients prevailed in both groups (65% in adults, 52% in children). Hospitalization rate was 10.7/100,000 inhabitants. Positive contact with chickenpox was confirmed in 80% adults and 82% children. Dominating symptoms were fever, rash and muscle aches. Levels of C-reactive protein, erythrocyte sedimentation rates (ESR) and fibrinogen levels were elevated in both groups, while thrombocytopenia was presented in 33% of adults and 3% of children. Adults had complications in 83.3% and their hospitalization rate was longer compared to children (11.5 days vs. 9.5 days, p<0.001). Conclusions: Chickenpox is a potentially severe illness in adult patients. Introduction of active immunization in Bosnia-Herzegovina should be considered to prevent severe forms of chickenpox.

Keywords

-

Characteristics of chickenpox in children and adults at a tertiary health center in Sarajevo, Bosnia-Herzegovina

Abstract

Keywords

-

References

• 1. Mohsen AH, McKendrick M.Varicella pneumonia in adults. Eur Respir J 2003; 21:886-891.
• 2. Ulrich H, Jane FS. Varicella. Lancet 2006; 368:1365-1376. 3. Meyer PA, Seward JF, Jumaan AO, Wharton M. Varicella mortality: trends before vaccine licensure in the United States, 1970-1994. J Infect Dis 2000; 182: 383-390.
• 4. Deguen S, Chau NP, Flahault A. Epidemiology of chickenpox in France (1991-1995). J Epidemiol Community Health 1998; 52:46-49.
• 5. Chiner E, Ballester I, Betlloch I, et al. Varicella-zoster virus pneumonia in an adult population:Has mortality decreased? Scand J Infect Dis 2010; 42: 215-221.
• 6. Galil K, Brown C, Lin F, Seward J. Hospitalizations for varicella in the United States, 1988 to 1999. Pediatr Infect Dis J 2002; 21: 931-935.
• 7. Girija AS, Rafeeque M, Abdurehman KP. Neurological complications of chickenpox. Ann Indian Acad Neurol 2007; 10:240-6
• 8. Huong Q, Nguyen MPH, Aisha O, et al. Decline in mortality due to Varicella after implementation of Varicella vaccination in the United States. N Engl J Med 2005; 352:450-458.
• 9. Davis MM, Patel MS, Gebremariam A. Decline in varicellarelated hospitalizations and expenditures for children and adults after introduction of varicella vaccine in the United States. Pediatrics 2004;114:786-792.
• 10. Bonanni P, Breuer J, Gershon A, et al. Varicella vaccination in Europe - taking the practical approach. BMC Med 2009; 28:26.
• 11. Paul E, Thiel T. Epidemiology of varicella zoster infection. Results of a prospective study in the Ansbach area. Hautarzt 1996; 47:604-609.
• 12. Gila A, San-Martin M, Carrascoa, Gonzalez A. Epidemiology of severe varicella-zoster virus infection in Spain. Vaccine 2004; 22:3947-3951.
• 13. Alanezi M. Varicella pneumonia in adults: 13 years’ experience with review of literature. Ann Thoracic Med 2007;2:163- 165.
• 14. Arvin AM, Gershon A. Varicella-Zoster Virus: Virology and Clinical Management. Cambridge University Press. 2000.
• 15. Myers MG, Seward JF, LaRussa PS. Varicella-zoster virus. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF. Nelson Textbook of Pediatrics. 18th ed. Philadelphia. Saunders Elsevier, 2007: chap 250.
• 16. Whitley RJ. Varicella zoster virus. In: Mandell GC, Bennett JE, Dolin R. Principles and practice of infectious diseases. 5th edn. Philadelphia, Churchill Livingstone, 2000:1580-5.
• 17. Ali N, Anwar M, Majeed I, Tariq WU. Chickenpox associated thrombocytopenia in adults. J Coll Physicians Surg Pak 2006; 16: 270-272.
• 18. Dulovic O, Gvozdenovic E, Nikolic J, Spurnic AR, Katanic N, Kovarevic-Pavicevic D. Varicella complications: is it time to consider a routine varicella vaccination? Vojnosanit Pregl 2010; 67:523-529.
• 19. Molligoda P, Suriyarachchi C. Necrotizing fasciitis following chicken pox in a child with dermatomyositis. Sri Lanka J Child Health 2009; 38: 40-42
• 20. Mason LW,Carpenter EC, Morris E, Davies J. Varicella Zoster Associated Osteomyelitis. Internet J Orthop Surg 2009;11: 23
• 21. Liese JG, Grote V, Rosenfeld E, Fisher R, Belohradsky BH, Kries R. ESPED Varicella Study Group. The burden of varicella complications before the introduction of routine varicella vaccination in Germany. Pediatr Infect Dis J 2008; 27:119-124.
• 22. Dass R, Singh S, Kumar V, et al. Varicella glomerulonephritis mimiking microscopic polyangitis. Rheumatol Int 2004; 24: 362-364.
• 23. Hockberger RS, Rothstein RJ. Varicella pneumonia in adults spectrum of disease. Ann Emerg Med 1986;15:931-934.
• 24. Almuneef M, Memish Z, Blakhy HH, Alotaibi B, Helmy M. Chickenpox complications in Saudi Arabia: is it time for routine vaccination? Int J Infect Dis 2006; 10: 156-61. 25. Cameron JC, Allan G, Johnston F, Finn A, Heath PT, Booy R. Severe complications of chickenpox in hospitalised children in the UK and Ireland. Arch Dis Child 2007; 92: 1062-1066.
• 26. Koturoglu G, Kurugöl Z, Cetin N, Hizarcioglu M, Vardar F, Helvaci M, Capar Z, Ozkinay F, Ozkinay C. Complications of varicella in healthy children in Izmir, Turkey. Pediatr Int 2005; 47:296-269.
• 27. Piqueras AI, Otero RMC, Perez-Tamarit D, Asensi BF, Diosdado ON, Santos DM. Hospitalizations for varicella in the Hospital Infantil La Fe, Valencia, Spain, 2001-2004. An Pediatr 2005;63(2):120-124.
• 28. Abro AJ, Ustadi AM, Das K, Saleh Abdou AM. Chickenpox: presentation and complications in adults. J Pak Med Assoc 2009: 59: 828-831.
• 29. Ejaz A, Raza N, Sohail M. Outcome of chicken pox in adult immunocompetent patients. J Pakistan Assoc Dermatologists 2006; 16:141-146.
• 30. Varicella-related deaths in Florida, 1998. MMWR Morb Mortal Wkly Rep 1999; 48:379-381.
• 31. Marin M, Zhang JX, Seward JF. Near elimination of varicella deaths in the US after implementation of the vaccination program. Pediatrics 2011; 1