title: Varicella in a Paediatric Intensive Care Unit: 10-year review from Starship Children's Hospital, New Zealand.
abstract: OBJECTIVE
  Varicella is now a vaccine-preventable disease but is generally considered benign, making it a low priority for a funded universal immunisation scheme. We aimed to increase the knowledge of the severity, morbidity and mortality caused by varicella, by a review of cases requiring paediatric intensive care in New Zealand where vaccine is available but not funded.
  
  
  METHODS
  This is a retrospective chart review of children admitted to the paediatric intensive care unit (PICU) over a 10-year period (July 2001-July 2011) identified from the PICU database with a primary or secondary code for varicella.
  
  
  RESULTS
  Thirty-four cases were identified and 26 cases were included. Of the 26 cases, 84.6% were Maori or Pacific Island ethnicity, 54% had no preceding medical condition and 23% were immunocompromised. Main PICU admission reasons were neurologic (38.5%), secondary bacterial sepsis or shock (26.9%), respiratory (15.4%), disseminated varicella (11.5%), or other causes (7.7%). Fifty per cent of children required inotropic support and 81% invasive ventilation. Four children died (15%), three of whom were immunocompromised. A further eight children (31%) had ongoing disability at hospital discharge.
  
  
  CONCLUSIONS
  Varicella, or its secondary complications, requiring paediatric intensive care, carries high mortality, particularly for immunocompromised patients, and long-term morbidities, mostly affecting previously healthy children.
authors.affiliation: Department of Paediatric Infectious Disease, Starship Children's Hospital, Auckland, New Zealand.
authors.forename: Sophie Chien-Hui
authors.initials: SC
authors.lastname: Wen
authors.forename: Fiona
authors.initials: F
authors.lastname: Miles
authors.forename: Brent
authors.initials: B
authors.lastname: McSharry
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D002644:Chickenpox / Q000145:classification / Q000150:complications / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D008485:Medical Audit; D009520:New Zealand / Q000453:epidemiology; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: intensive care; outcome; paediatric; varicella