Abstract
Amaç: Varisella, özellikle küçük çocuklarda potansiyel olarak ciddi komplikasyonları olan oldukça bulaşıcı bir hastalıktır. Türkiye’de su çiçeği aşısı, 2013 yılında 12 aylık bebekleri hedef alan Ulusal Suçiçeği Aşısı programına entegre edildi. Resmi olarak rapor edilen su çiçeği vakaları son yirmi yılda önemli ölçüde azalmış olsa da, eksik raporlama hala bir sorun olmaya devam ediyor. Bu çalışmada üçüncü basamak bir merkezde suçiçeği seropozitifliğinin araştırılması amaçlanmıştır.
Gereç ve Yöntemler: Kalitatif bir immünolojik test olan enzim bağlantılı immünosorbent testi (ELISA), anti-varisella antikorlarını tespit etmek için kullanılmıştır. Türkiye’de ikamet eden 4-18 yaş arası bireylerden serum örnekleri toplandı. Aşı kayıtları, su çiçeği geçmişi ve hastalık bildirimine ilişkin bilgiler de toplanmıştır.
Bulgular: Toplam 90 çocuğun su çiçeği IgG antikoru kayıtlarına erişildi. Çalışma popülasyonunda pozitif su çiçeği antikorlarının genel prevalansı %58.0 (n=47)’di. Seropozitiflik oranları 4-6 yaş grubunda %67.2, 7-12 yaş grubunda ise %30 olarak belirlendi. Özellikle 4-6 yaş grubu seropozitiflik ile yaş arasında anlamlı bir ilişki gösterdi [p=0.005; OR=4.85; 95%CI (1.614-14.569)].
Sonuç: Suçiçeği için %58’lik seropozitiflik oranı endişe vericidir. Bunun ışığında daha kapsamlı çalışmaların yapılması değerli bir yol gösterici olacaktır. 4-6 yaş aralığında ek doz su çiçeği aşısı yapılması düşünülebilir. Böyle bir aşılama stratejisinin uygulanmasının potansiyel faydalarını ve fizibilitesini değerlendirmek için daha fazla araştırma yapılması gerekmektedir.
Keywords
Project Number
ka23/244
References
- Steiner I, Kennedy PG, Pachner AR. The neurotropic herpes viruses: herpes simplex and varicella-zoster. Lancet Neurol 2007;6:1015–28.
- Riera-Montes M, Bollaerts K, Heininger U, Hens N, Gabutti G, Gil A, et al. Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization. BMC Infect Dis 2017;17:353.
- Wiese-Posselt M, Siedler A, Mankertz A, Sauerbrei A, Hengel H, Wichmann O, Poethko-Müller C. Varicella-zoster virus seroprevalence in children and adolescents in the pre-varicella vaccine era, Germany. BMC Infec Dis 2017;17:356.
- Seward JF, Watson BM, Peterson CL, Mascola L, Pelosi JW, Zhang JX, Wharton M. Varicella disease after introduction of varicella vaccine in the United States, 1995-2000. JAMA 2002;287:606-11.
- Guris D, Jumaan AO, Mascola L, Watson BM, Zhang JX, Chaves SS, Gargiullo P et al. Changing varicella epidemiology in active surveillance sites—United States, 1995–2005. J Infec Dis 2008;197Suppl:S71-S75.
- Hu P, Yang F, Li X, Wang Y, Xiao T, Li H, et al. Effectiveness of one-dose versus two-dose varicella vaccine in children in Qingdao, China: a matched case-control study. Hum Vaccin Immunother 2021;17:5311-5.
- Marin M, Seward JF, Gershon AA. 25 Years of Varicella Vaccination in the United States. J Infect Dis 2022;226 (suppl 4): S375-9.
- Almis H, Hakan Bucak I, Emre Kilic F, Kayak D, Geyik M, Tekin M, et al. The evaluation of chickenpox in the post-vaccination period in Turkey. Ann Med Res 2021;26: 833–6.
- Zhang Z, Zhang Y, Yu J, Dong C, Zhang J, Liu N, et al. Seroprevalence rates in children aged 3-6 years after implementing a two-dose varicella vaccination: A observational study. Hum Vaccin Immunother 2023;19:2211465.
- Modderman SC, de Kleijn ED, Hartwig NG. Serious complications of chickenpox: Healthy children are at risk as well. Ned Tijdschr Geneeskund 2021;165:D5422.
- Bollaerts K, Riera-Montes M, Heininger U, Hens N, Souverain A, Verstraeten T, et al. A systematic review of varicella seroprevalence in European countries before universal childhood immunization: deriving incidence from seroprevalence data. Epidemiol Infect 2017;145: 2666-77.
- Saç R, Taşar MA, Yalaki Z, Güneylioğlu MM, Özsoy G, Karadağlı S, et al. Hepatitis A, hepatitis B, measles, mumps, rubella and varicella seroprevalence in Turkish adolescent nursing students. Nobel Med 2019;15:33–40.
- Gabutti G, Grassi T, Bagordo F, Savio M, Rota MC, Castiglia P, Baldovin T, et al. Sero-Epidemiological Study of Varicella in the Italian General Population. Vaccines 2023;11: 306.
- Luan L, Shen X, Qiu J, Jing Y, Zhang J, Wang J, et al. Seroprevalence and molecular characteristics of varicella-zoster virus infection in Chinese children. BMC Infect Dis 2019;19:643.
Abstract
Objective: Varicella is a highly contagious illness with potentially severe complications, especially in young children. In Turkey, the varicella vaccine was integrated into the Universal Varicella Vaccination program in 2013, targeting 12-month-old infants. While officially reported varicella cases have decreased considerably in the past two decades, underreporting remains a challenge. This study aimed to investigate varicella seropositivity in a tertiary center.
Material and Methods: A qualitative immunoassay, the enzyme-linked immunosorbent assay (ELISA), was employed to detect anti-varicella antibodies. Serum samples were collected from individuals aged 4 to 18 residing in Turkey. Information on vaccination records, varicella history, and disease notification was also collected.
Results: The varicella IgG antibody records were accessed for a total of 90 children. The overall prevalence of positive varicella antibodies was 58.0% (n=47) in the study population. Seropositivity rates were 67.2% for the 4-6 age group and 30% for the 7-12 age group. Notably, the 4-6 age group showed a significant association between seropositivity and age [p=0.005; OR=4.85; 95%CI (1.614-14.569)].
Conclusion: The seropositivity rate of 58% for chickenpox is concerning. In light of this, conducting more extensive studies will provide valuable guidance. It may be worth considering the administration of an additional dose of the varicella vaccine within the age range of 4-6 years. Further research is necessary to assess the potential benefits and feasibility of implementing such a vaccination strategy.
Keywords
Ethical Statement
Anabilim Dalınızda görev yapmakta olan Öğr. Gör. Dr. Betül Orhan Kılıç tarafından yürütülecek olan KA23/244 nolu "Pediatrik hastalarda suçiçeği seropozitiflik oranları: Tek merkezli bir çalışmanın bulguları" başlıklı araştırma projesi Kurulumuz tarafından uygun bulunmuştur. Projenin başlama tarihi ile çalışmanın sunulduğu kongre ve yayımlandığı dergi konusunda Kurulumuza bilgi verilmesini rica ederim.
Supporting Institution
başkent üniversitesi
Project Number
ka23/244
Thanks
katılım sağlayan tüm hastalarıma teşekkür ederim
References
- Steiner I, Kennedy PG, Pachner AR. The neurotropic herpes viruses: herpes simplex and varicella-zoster. Lancet Neurol 2007;6:1015–28.
- Riera-Montes M, Bollaerts K, Heininger U, Hens N, Gabutti G, Gil A, et al. Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization. BMC Infect Dis 2017;17:353.
- Wiese-Posselt M, Siedler A, Mankertz A, Sauerbrei A, Hengel H, Wichmann O, Poethko-Müller C. Varicella-zoster virus seroprevalence in children and adolescents in the pre-varicella vaccine era, Germany. BMC Infec Dis 2017;17:356.
- Seward JF, Watson BM, Peterson CL, Mascola L, Pelosi JW, Zhang JX, Wharton M. Varicella disease after introduction of varicella vaccine in the United States, 1995-2000. JAMA 2002;287:606-11.
- Guris D, Jumaan AO, Mascola L, Watson BM, Zhang JX, Chaves SS, Gargiullo P et al. Changing varicella epidemiology in active surveillance sites—United States, 1995–2005. J Infec Dis 2008;197Suppl:S71-S75.
- Hu P, Yang F, Li X, Wang Y, Xiao T, Li H, et al. Effectiveness of one-dose versus two-dose varicella vaccine in children in Qingdao, China: a matched case-control study. Hum Vaccin Immunother 2021;17:5311-5.
- Marin M, Seward JF, Gershon AA. 25 Years of Varicella Vaccination in the United States. J Infect Dis 2022;226 (suppl 4): S375-9.
- Almis H, Hakan Bucak I, Emre Kilic F, Kayak D, Geyik M, Tekin M, et al. The evaluation of chickenpox in the post-vaccination period in Turkey. Ann Med Res 2021;26: 833–6.
- Zhang Z, Zhang Y, Yu J, Dong C, Zhang J, Liu N, et al. Seroprevalence rates in children aged 3-6 years after implementing a two-dose varicella vaccination: A observational study. Hum Vaccin Immunother 2023;19:2211465.
- Modderman SC, de Kleijn ED, Hartwig NG. Serious complications of chickenpox: Healthy children are at risk as well. Ned Tijdschr Geneeskund 2021;165:D5422.
- Bollaerts K, Riera-Montes M, Heininger U, Hens N, Souverain A, Verstraeten T, et al. A systematic review of varicella seroprevalence in European countries before universal childhood immunization: deriving incidence from seroprevalence data. Epidemiol Infect 2017;145: 2666-77.
- Saç R, Taşar MA, Yalaki Z, Güneylioğlu MM, Özsoy G, Karadağlı S, et al. Hepatitis A, hepatitis B, measles, mumps, rubella and varicella seroprevalence in Turkish adolescent nursing students. Nobel Med 2019;15:33–40.
- Gabutti G, Grassi T, Bagordo F, Savio M, Rota MC, Castiglia P, Baldovin T, et al. Sero-Epidemiological Study of Varicella in the Italian General Population. Vaccines 2023;11: 306.
- Luan L, Shen X, Qiu J, Jing Y, Zhang J, Wang J, et al. Seroprevalence and molecular characteristics of varicella-zoster virus infection in Chinese children. BMC Infect Dis 2019;19:643.
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | ORIGINAL ARTICLES |
| Authors | |
| Project Number | ka23/244 |
| Early Pub Date | April 16, 2024 |
| Publication Date | May 13, 2024 |
| Submission Date | January 10, 2024 |
| Acceptance Date | March 12, 2024 |
| Published in Issue | Year 2024 Volume: 18 Issue: 3 |
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