Experts urge varicella vaccine rethink

British physicians have called for the routine immunisation of children with varicella vaccine, after a report highlighted the incidence of severe complications and death among sufferers.

The research, published in the Archives of Disease in Childhood, concluded that routine vaccination is the most effective means of reducing risk.

At present, only healthcare workers and others likely to be at risk of contracting or passing on the infection, are routinely immunised in the UK.

The report is based upon active monitoring by paediatricians in the UK and Ireland of children up to the age of 16 admitted to hospital with severe complications resulting from chickenpox infection.

During the monitoring period, which ran for 13 months between 2002 and 2003, 188 cases were reported to the British Paediatric Surveillance Unit.

Of these, 112 children met the criteria, giving a case rate of 0.82 per 100,000. Their average age was 3 years.

The complications included septic shock, pneumonia, and encephalitis, as well as ataxia, toxic shock syndrome, and necrotising fasciitis.

Almost half the children (46%) had additional bacterial infections. Six children died. After discharge, four out of 10 children had ongoing problems as a result of their infection, including, most commonly, ataxia or skin scarring.

Most of these children were healthy before they contracted the virus, say the authors, and universal immunisation may have prevented complications.

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