Article in Japanese
Nationwide survey for severe varicella and zoster in iatrogenic immunocompromised patients
Hidetaka NAKAI1), Ken SUGATA1), Tetsushi YOSHIKAWA1), Yoshizo ASANO1,2)
Treating severe varicella and zoster in immunocompromised patients is quite expensive. This makes it important to evaluate the cost-benefit ratio for universal immunization by VZV vaccine in Japan. We began by conducting a nationwide survey to determine the incidence and clinical course of severe varicella and zoster cases in iatrogenic immunocompromised patients. A questionnaire was sent to 3357 facilities which have pediatric wards, to examine severe varicella and zoster cases in iatrogenic immunocompromised patients from January 2007 through December 2008. Facilities with severe cases were sent a second questionnaire to obtain detailed information about the patient(s). Finally, data were collected from 2408 facilities (recovery ratio 71.7%), and seven severe cases (varicella 6 cases, zoster 1 case) were reported. Mean age of the cases was 8.0 years (4-18 years), and all cases were male. The underlying diseases were malignant diseases in six cases and chronic nephritis in one case. Complications of the cases varied: encephalitis, pneumonia, hepatitis, disseminated intravascular coagulation, and deteriorated underlying disease. The sole fatal case was a patient with disseminated varicella. Although the six remaining cases recovered completely, their admission periods appeared to be long. Therefore, medical expenses in these cases are considered to be high.
1) Department of Pediatrics, Fujita Health University School of Medicine
2) Research Center for Zoonosis Control, Hokkaido University
|Received||April 26, 2010|
|Accepted||December 15, 2010|