title: Hospitalization of newborns and young infants for chickenpox in France.
abstract: Chickenpox is often considered more severe during the first year of life, but its course is usually mild during the first 3 months of life, presumably owing to the persistence of maternal antibodies. Hospitalization and intravenous acyclovir therapy are generally restricted to severe cases but also systematically recommended in newborns in France, irrespective of the clinical severity of the infection. This recommendation was launched in 1998 when Varicella zoster virus (VZV)-specific immunoglobulins were not available in the country and has remained unchanged since. The aim of this prospective observational study was to describe complications of varicella infection in a population of 745 children hospitalized for varicella before 1 year of age, with a specific focus on newborns. Complications occurred in 65% of cases. They were very rare before the age of 1 month (10%) but their incidence then increased progressively with age and probably the disappearance of maternal antibodies: 42% (1-2 months), 66% (3-5 months), 70% (6-8 months), and 79% (9-12 months). Conclusion Chickenpox is usually mild in newborns because most of them are protected by VZV maternal antibodies. Unless the absence of maternal VZV immunity is demonstrated, newborns with mild chickenpox should not require antiviral therapy.
authors.affiliation: Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Saint Maur des Fossés, France. activ@activfrance.fr
authors.forename: Aurélie
authors.initials: A
authors.lastname: Lécuyer
authors.forename: Corinne
authors.initials: C
authors.lastname: Levy
authors.forename: Joel
authors.initials: J
authors.lastname: Gaudelus
authors.forename: Daniel
authors.initials: D
authors.lastname: Floret
authors.forename: Benoit
authors.initials: B
authors.lastname: Soubeyrand
authors.forename: Evelyne
authors.initials: E
authors.lastname: Caulin
authors.forename: Robert
authors.initials: R
authors.lastname: Cohen
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Grimprel
mesh_terms: D016009:Chi-Square Distribution; D002644:Chickenpox / Q000150:complications / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors
references.citation: Clin Vaccine Immunol. 2009 Apr;16(4):484-7
references.pmid: 19176690
references.citation: Med J Aust. 2001 Mar 19;174(6):288-92
references.pmid: 11297117
references.citation: Pediatr Infect Dis J. 2006 Jan;25(1):41-4
references.pmid: 16395101
references.citation: Pediatr Infect Dis. 1985 Sep-Oct;4(5):503-7
references.pmid: 4047961
references.citation: Vaccine. 2006 Apr 12;24(16):3258-60
references.pmid: 16459000
references.citation: Clin Microbiol Infect. 2007 May;13(5):546-9
references.pmid: 17378927
references.citation: Epidemiol Infect. 2002 Dec;129(3):599-606
references.pmid: 12558344
references.citation: Vaccine. 2001 Apr 30;19(23-24):3097-103
references.pmid: 11312004
references.citation: Epidemiol Infect. 2007 Jan;135(1):131-8
references.pmid: 16740185
references.citation: Biken J. 1980 Mar;23(1):9-14
references.pmid: 6254500
references.citation: Southeast Asian J Trop Med Public Health. 1992 Mar;23(1):22-5
references.pmid: 1523475
references.citation: Pediatrics. 1976 Nov;58(5):692-6
references.pmid: 185578
references.citation: J Pediatr. 1996 Oct;129(4):529-36
references.pmid: 8859259