Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization
Abstract Background Varicella is generally considered a mild disease. Disease burden is not well known and country-level estimation is challenging. As varicella disease is not notifiable, notification criteria and rates vary between countries. In general, existing surveillance systems do not capture...
Main Authors: | , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2017-05-01
|
Series: | BMC Infectious Diseases |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s12879-017-2445-2 |
id |
doaj-ec08ba537965494ea076f78a42e5f3c2 |
---|---|
record_format |
Article |
spelling |
doaj-ec08ba537965494ea076f78a42e5f3c22020-11-25T03:40:01ZengBMCBMC Infectious Diseases1471-23342017-05-0117111610.1186/s12879-017-2445-2Estimation of the burden of varicella in Europe before the introduction of universal childhood immunizationMargarita Riera-Montes0Kaatje Bollaerts1Ulrich Heininger2Niel Hens3Giovanni Gabutti4Angel Gil5Bayad Nozad6Grazina Mirinaviciute7Elmira Flem8Audrey Souverain9Thomas Verstraeten10Susanne Hartwig11P95 Pharmacovigilance and Epidemiology ServicesP95 Pharmacovigilance and Epidemiology ServicesDivision of Paediatric Infectious Diseases and Vaccinology, University of Basel Children’s HospitalInteruniversity Institute for Biostatistics and statistical Bioinformatics, Hasselt UniversityDepartment of Medical Sciences, University of FerraraUniversidad Rey Juan CarlosDepartment of Primary Care and Public Health, Imperial College LondonDepartment of Infectious Disease Epidemiology and Modelling, Norwegian Institute of Public HealthDepartment of Infectious Disease Epidemiology and Modelling, Norwegian Institute of Public HealthAixialP95 Pharmacovigilance and Epidemiology ServicesSanofi Pasteur MSDAbstract Background Varicella is generally considered a mild disease. Disease burden is not well known and country-level estimation is challenging. As varicella disease is not notifiable, notification criteria and rates vary between countries. In general, existing surveillance systems do not capture cases that do not seek medical care, and most are affected by underreporting and underascertainment. We aimed to estimate the overall varicella disease burden in Europe to provide critical information to support decision-making regarding varicella vaccination. Methods We conducted a systematic literature review to identify all available epidemiological data on varicella IgG antibody seroprevalence, primary care and hospitalisation incidence, and mortality. We then developed methods to estimate age-specific varicella incidence and annual number of cases by different levels of severity (cases in the community, health care seekers in primary care and hospitals, and deaths) for all countries belonging to the European Medicines Agency (EMA) region and Switzerland. Results In the absence of universal varicella immunization, the burden of varicella would be substantial with a total of 5.5 million (95% CI: 4.7–6.4) varicella cases occurring annually across Europe. Variation exists between countries but overall the majority of cases (3 million; 95% CI: 2.7–3.3) would occur in children <5 years. Annually, 3–3.9 million patients would consult a primary care physician, 18,200–23,500 patients would be hospitalised, and 80 varicella-related deaths would occur (95% CI: 19–822). Conclusions Varicella disease burden is substantial. Most cases occur in children <5 years old but adults require hospitalisation more often and are at higher risk of death. This information should be considered when planning and evaluating varicella control strategies. A better understanding of the driving factors of country-specific differences in varicella transmission and health care utilization is needed. Improving and standardizing varicella surveillance in Europe, as initiated by the European Centre for Disease Prevention and Control (ECDC), is important to improve data quality to facilitate inter-country comparison.http://link.springer.com/article/10.1186/s12879-017-2445-2VaricellaDisease burdenEurope |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Margarita Riera-Montes Kaatje Bollaerts Ulrich Heininger Niel Hens Giovanni Gabutti Angel Gil Bayad Nozad Grazina Mirinaviciute Elmira Flem Audrey Souverain Thomas Verstraeten Susanne Hartwig |
spellingShingle |
Margarita Riera-Montes Kaatje Bollaerts Ulrich Heininger Niel Hens Giovanni Gabutti Angel Gil Bayad Nozad Grazina Mirinaviciute Elmira Flem Audrey Souverain Thomas Verstraeten Susanne Hartwig Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization BMC Infectious Diseases Varicella Disease burden Europe |
author_facet |
Margarita Riera-Montes Kaatje Bollaerts Ulrich Heininger Niel Hens Giovanni Gabutti Angel Gil Bayad Nozad Grazina Mirinaviciute Elmira Flem Audrey Souverain Thomas Verstraeten Susanne Hartwig |
author_sort |
Margarita Riera-Montes |
title |
Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization |
title_short |
Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization |
title_full |
Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization |
title_fullStr |
Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization |
title_full_unstemmed |
Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization |
title_sort |
estimation of the burden of varicella in europe before the introduction of universal childhood immunization |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2017-05-01 |
description |
Abstract Background Varicella is generally considered a mild disease. Disease burden is not well known and country-level estimation is challenging. As varicella disease is not notifiable, notification criteria and rates vary between countries. In general, existing surveillance systems do not capture cases that do not seek medical care, and most are affected by underreporting and underascertainment. We aimed to estimate the overall varicella disease burden in Europe to provide critical information to support decision-making regarding varicella vaccination. Methods We conducted a systematic literature review to identify all available epidemiological data on varicella IgG antibody seroprevalence, primary care and hospitalisation incidence, and mortality. We then developed methods to estimate age-specific varicella incidence and annual number of cases by different levels of severity (cases in the community, health care seekers in primary care and hospitals, and deaths) for all countries belonging to the European Medicines Agency (EMA) region and Switzerland. Results In the absence of universal varicella immunization, the burden of varicella would be substantial with a total of 5.5 million (95% CI: 4.7–6.4) varicella cases occurring annually across Europe. Variation exists between countries but overall the majority of cases (3 million; 95% CI: 2.7–3.3) would occur in children <5 years. Annually, 3–3.9 million patients would consult a primary care physician, 18,200–23,500 patients would be hospitalised, and 80 varicella-related deaths would occur (95% CI: 19–822). Conclusions Varicella disease burden is substantial. Most cases occur in children <5 years old but adults require hospitalisation more often and are at higher risk of death. This information should be considered when planning and evaluating varicella control strategies. A better understanding of the driving factors of country-specific differences in varicella transmission and health care utilization is needed. Improving and standardizing varicella surveillance in Europe, as initiated by the European Centre for Disease Prevention and Control (ECDC), is important to improve data quality to facilitate inter-country comparison. |
topic |
Varicella Disease burden Europe |
url |
http://link.springer.com/article/10.1186/s12879-017-2445-2 |
work_keys_str_mv |
AT margaritarieramontes estimationoftheburdenofvaricellaineuropebeforetheintroductionofuniversalchildhoodimmunization AT kaatjebollaerts estimationoftheburdenofvaricellaineuropebeforetheintroductionofuniversalchildhoodimmunization AT ulrichheininger estimationoftheburdenofvaricellaineuropebeforetheintroductionofuniversalchildhoodimmunization AT nielhens estimationoftheburdenofvaricellaineuropebeforetheintroductionofuniversalchildhoodimmunization AT giovannigabutti estimationoftheburdenofvaricellaineuropebeforetheintroductionofuniversalchildhoodimmunization AT angelgil estimationoftheburdenofvaricellaineuropebeforetheintroductionofuniversalchildhoodimmunization AT bayadnozad estimationoftheburdenofvaricellaineuropebeforetheintroductionofuniversalchildhoodimmunization AT grazinamirinaviciute estimationoftheburdenofvaricellaineuropebeforetheintroductionofuniversalchildhoodimmunization AT elmiraflem estimationoftheburdenofvaricellaineuropebeforetheintroductionofuniversalchildhoodimmunization AT audreysouverain estimationoftheburdenofvaricellaineuropebeforetheintroductionofuniversalchildhoodimmunization AT thomasverstraeten estimationoftheburdenofvaricellaineuropebeforetheintroductionofuniversalchildhoodimmunization AT susannehartwig estimationoftheburdenofvaricellaineuropebeforetheintroductionofuniversalchildhoodimmunization |
_version_ |
1724536937808658432 |