title: Varicella paediatric hospitalisations in Belgium: a 1-year national survey.
abstract: BACKGROUND
  Varicella universal vaccination (UV) has been implemented in many countries for several years. Nevertheless, varicella UV remains debated in Europe and few data are available on the real burden of infection. We assessed the burden of varicella in Belgium through analysis of hospitalised cases during a 1-year period.
  
  
  METHODS
  Data on children admitted to hospital with varicella were collected through a national network from November 2011 to October 2012. Inclusion criteria were either acute varicella or related complications up to 3 weeks after the rash.
  
  
  RESULTS
  Participation of 101 hospitals was obtained, covering 97.7% of the total paediatric beds in Belgium. 552 children were included with a median age of 2.1 years. Incidence of paediatric varicella hospitalisations reached 29.5/10(5) person-years, with the highest impact among those 0-4 years old (global incidence and odds of hospitalisation: 79/10(5) person-years and 1.6/100 varicella cases, respectively). Only 14% (79/552) of the cohort had an underlying chronic condition. 65% (357/552) of children had ≥1 complication justifying their admission, 49% were bacterial superinfections and 10% neurological disorders. Only a quarter of children (141/552) received acyclovir. Incidence of complicated hospitalised cases was 19/10(5) person-years. Paediatric intensive care unit admission and surgery were required in 4% and 3% of hospitalised cases, respectively. Mortality among Belgian paediatric population was 0.5/10(6) and fatality ratio 0.2% among our cohort.
  
  
  CONCLUSIONS
  Varicella demonstrated a substantial burden of disease in Belgian children, especially among the youngest. Our thorough nationwide study, run in a country without varicella UV, offers data to support varicella UV in Belgium.
authors.affiliation: Paediatric Infectious Disease Unit, Hôpital Universitaire des Enfants Reine Fabiola (HUDERF), Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Sophie
authors.initials: S
authors.lastname: Blumental
authors.affiliation: Unit of Epidemiology and Infectious Diseases, Scientific Institute of Public Health (SIPH), Brussels, Belgium.
authors.forename: Martine
authors.initials: M
authors.lastname: Sabbe
authors.affiliation: Paediatric Infectious Disease Unit, Hôpital Universitaire des Enfants Reine Fabiola (HUDERF), Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Lepage
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use; D001530:Belgium / Q000453:epidemiology; D002644:Chickenpox / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D019433:Chickenpox Vaccine; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D000998:Antiviral Agents; D019433:Chickenpox Vaccine; D000212:Acyclovir
keywords: Epidemiology; Europe; Herpes zoster; vaccination; varicella