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|Title:||Severe and complicated varicella and associated genotypes 10 years after introduction of a one-dose varicella vaccine program|
|Citation:||Journal of Infectious Diseases, 2019; 219(3):391-399|
|Publisher:||Oxford University Press|
|Helen S. Marshall, Michelle Clarke, Christine Heath, Helen Quinn, Peter C. Richmond, Nigel Crawford, Elizabeth Elliott, Cheryl Toi, Anne Kynaston, Robert Booy, and Kristine Macartney|
|Abstract:||Background: This national, sentinel prospective study aimed to identify children with severe hospitalized varicella, despite availability of universal 1-dose vaccination since 2005, and determine associations between virus genotypes and disease severity. Methods: Children with varicella or zoster from 5 Paediatric Active Enhanced Disease Surveillance hospitals were enrolled. Lesions were swabbed for genotyping. Associations with disease severity were analyzed using multiple regression. Results: From 2007 to 2015, 327 children with confirmed varicella (n = 238) or zoster (n = 89) were enrolled. Two hundred three (62%) were immunocompetent children; including 5 of 8 children who required intensive care unit management. Eighteen percent (36 of 203) of immunocompetent children had been previously vaccinated. Vaccinated children aged >18 months were less likely to have severe disease (9%; 5 of 56) than unvaccinated children (21%; 21 of 100; P = .05). Three of 126 children who had virus genotyping (2 immunocompromised) had varicella (n = 2) or zoster (n = 2) due to the Oka/vaccine strain. European origin clades predominated and were independently associated with more severe disease (odds ratio = 3.2; 95% confidence interval, 1.1– 9.5; P = .04). Conclusions: Severe hospitalized varicella still occurs with a 1-dose varicella program, although predominantly in unvaccinated children. Most 1-dose vaccine recipients were protected against severe disease. Viral genotyping in complex hospitalized cases is important to assist in monitoring disease due to Oka-vaccine strain.|
|Keywords:||Children; herpes zoster; varicella; immunization|
|Rights:||© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: email@example.com.|
|Appears in Collections:||Aurora harvest 8|
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