Ener Cagri Dinleyici1, Zafer Kurugol2, Ates Kara3, Hasan Tezer4, Mehmet Ali Tas5, Ekrem Guler6, Olcay Yasa7, Ilker Devrim8, Ergin Ciftci9, Halil Ozdemir9, Ayper Somer10, Metehan Ozen11, Gulnar Sensoy12, Nazan Dalgic13, Emre Alhan14. 1. Eskisehir Osmangazi University, Faculty of Medicine, Department of Pediatrics, Eskisehir, Turkey. Electronic address: timboothtr@yahoo.com. 2. Ege University, Faculty of Medicine, Department of Pediatrics, İzmir, Turkey. 3. Hacettepe University, Faculty of Medicine, Department of Pediatrics, Ankara, Turkey. 4. Gazi University, Faculty of Medicine, Department of Pediatrics, Ankara, Turkey. 5. Dicle University, Faculty of Medicine, Department of Pediatrics, Diyarbakir, Turkey. 6. Sutcu Imam University, Faculty of Medicine, Department of Pediatrics, Kahramanmaras, Turkey. 7. Department of Pediatrics, Goztepe Training and Research Hospital, SB Istanbul Medeniyet University, Istanbul, Turkey. 8. Department of Pediatrics, Dr. Behçet Uz Children's Hospital, İzmir, Turkey. 9. Ankara University, Faculty of Medicine, Department of Pediatrics, Ankara, Turkey. 10. Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Istanbul, Turkey. 11. Acibadem University, Faculty of Medicine, Department of Pediatrics, Istanbul, Turkey. 12. 19 Mayis University, Faculty of Medicine, Department of Pediatrics, Samsun, Turkey. 13. Department of Pediatrics, Sisli Etfal Training and Research Hospital, Istanbul, Turkey. 14. Cukurova University, Faculty of Medicine, Department of Pediatrics, Adana, Turkey.
Abstract
INTRODUCTION: Varicella in previously immunized individuals, known as "breakthrough varicella". While the majority of breakthrough cases are mild, some may be severe, requiring hospitalization in previously healthy children or children with an underlying condition. METHODS: This report, as a part of the prospective national pediatric varicella hospitalizations study (including 29 centers, represent 50% of pediatric population) in Turkey, is aimed to evaluate breakthrough varicella infection requiring hospitalization before the routine use of single-dose live varicella vaccine in national program from 2008 to 2013 (<10% of the pediatric age group received a single-dose vaccine). RESULTS: In the time period, 1939 children were hospitalized due to varicella infection in Turkey; 36 children (20 boys, 16 girls, mean age 68.0+37.6 months, all received single dose live varicella vaccine) with breakthrough varicella infection. Breakthrough varicella infection might be severe in previously healthy children (61.1%) and children with immune-compromising conditions (38.9%). The time elapsed between vaccination and hospitalization was approximately 5 years, and neurological complications, mainly encephalitis and meningitis, were the most common reason for hospitalization in previously healthy children. CONCLUSION: Pediatric breakthrough varicella requiring hospitalization have been seen in Turkey, is mainly observed in previously healthy children at 5 years after a single-dose varicella vaccine. The varicella vaccine has been implemented as part of the National Immunization Program in Turkey in 2013 (a single dose at age 12 months). Further surveillance in the same settings could evaluate the effectiveness of national immunization with single-dose varicella vaccine at 12 months of age and potential need for second dose of vaccine.
INTRODUCTION: Varicella in previously immunized individuals, known as "breakthrough varicella". While the majority of breakthrough cases are mild, some may be severe, requiring hospitalization in previously healthy children or children with an underlying condition. METHODS: This report, as a part of the prospective national pediatric varicella hospitalizations study (including 29 centers, represent 50% of pediatric population) in Turkey, is aimed to evaluate breakthrough varicella infection requiring hospitalization before the routine use of single-dose live varicella vaccine in national program from 2008 to 2013 (<10% of the pediatric age group received a single-dose vaccine). RESULTS: In the time period, 1939 children were hospitalized due to varicella infection in Turkey; 36 children (20 boys, 16 girls, mean age 68.0+37.6 months, all received single dose live varicella vaccine) with breakthrough varicella infection. Breakthrough varicella infection might be severe in previously healthy children (61.1%) and children with immune-compromising conditions (38.9%). The time elapsed between vaccination and hospitalization was approximately 5 years, and neurological complications, mainly encephalitis and meningitis, were the most common reason for hospitalization in previously healthy children. CONCLUSION: Pediatric breakthrough varicella requiring hospitalization have been seen in Turkey, is mainly observed in previously healthy children at 5 years after a single-dose varicella vaccine. The varicella vaccine has been implemented as part of the National Immunization Program in Turkey in 2013 (a single dose at age 12 months). Further surveillance in the same settings could evaluate the effectiveness of national immunization with single-dose varicella vaccine at 12 months of age and potential need for second dose of vaccine.
Authors: Nawal Al Kaabi; Fatma Mohd Ali Sultan Al Olama; Mamoun Al Qaseer; Idris Al Ubaidani; Ener Cagri Dinleyici; Wail Ahmad Hayajneh; Abdul Rahman Bizri; Maysoon Loulou; Tidiane Ndao; Lara J Wolfson Journal: Hum Vaccin Immunother Date: 2019-09-03 Impact factor: 3.452