More evidence that children need to get this childhood disease, not adults. - SM
http://id.medscape.com/reuters/prof/2001/11/11.09/20011108epid002.html
Deaths From
Chickenpox Among Adults Increasing in UK
LONDON (Reuters Health) Nov 08 - The number of adult
deaths from chickenpox is increasing in England and Wales, according to the
results of a study published on Friday. The findings underscore the serious
nature of the disease, particularly for adults, Dr. Norman Noah from the London
School of Hygiene and Tropical Medicine told Reuters Health.
Dr. Noah and colleagues reviewed the 1995 to 1997 death certificates from England
and Wales in which chickenpox or varicella were mentioned. They then sent
questionnaires to physicians to clarify the diagnosis.
Of the 119 death certificates obtained, the study team estimated that 79%
were genuinely attributable to chickenpox. According to the authors, chickenpox
is responsible for approximately 25 deaths annually, with fatality of around
one in 10,000 cases.
Deaths in adults accounted for 48% of all deaths from chickenpox in 1967 to
1977, but has risen to make up 81% of all deaths by 1986 to 1997, according to
the report.
"GPs see four children to every one adult with chickenpox, but the
ratio of deaths is reversed, with four adults to every one child dying from the
disease. Adults with chickenpox should see their GP sooner rather than
later," Dr. Noah told Reuters Health.
Deaths were twice as likely in men than women, and individuals born outside
the UK were three times more likely to die than those born within the UK,
according to the report in the November 9th issue of the British Medical
Journal.
"Further studies will be needed to reveal whether underlying conditions
are responsible for the increased mortality in men," said Dr. Noah.
"There is some evidence that individuals from tropical and temperate
countries have a different experience of chickenpox. Adults from these
countries are less likely to be immune to chickenpox, possibly because fewer
get the disease during childhood," he added.
"Chickenpox is responsible for more deaths than measles, mumps,
whooping cough and [Haemophilus influenzae type B] meningitis combined.
It is not a mild disease," he added.
A chickenpox vaccine is available but has not yet been licensed in the UK.
Dr. Noah said that although vaccination in the US has reduced the incidence of
disease, "this doesn't mean that vaccines need to be used everywhere else
in the world."
"There are still a number of questions that need to be answered before
vaccination can be recommended in the UK. For example, if a live varicella
vaccine is given to children, we are not sure what their experience of shingles
will be in later life," he said.
BMJ 2001;323:1091-1093.
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