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Incidence of varicella zoster virus infection low among pediatric cancer patients
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MEMPHIS, Tenn. — The incidence of varicella zoster virus infection is relatively low among a population of pediatric cancer patients, according to recent study results presented at the St. Jude/PIDS Pediatric Infectious Diseases Research Conference.
Sergio Gomez, MD, of the department of hematology at the Hospital de Ninos Sor Maria Ludovica in Argentina, and colleagues evaluated 153 pediatric cancer patients at a pediatric hospital in Argentina between September 2010 and June 2013 to determine the burden of varicella zoster virus (VZV) infection. Incidence, case-fatality proportions and corresponding mid-P-exact 95% confidence limits (CL) for VZV were estimated. Sixty-eight patients were diagnosed with acute lymphoblastic leukemia and more than half were male (54%).
Overall, there was a VZV incidence proportion of 2.6% (95% CL, 0.08-6.2) and all cases were among males.
Patients with acute myeloid leukemia had an incidence rate of VZV infection of 14% (95% CL, 3.6-33) compared with an incidence rate of 1.9% (95% CL, 0.03-6.2) for patients with acute lymphoblastic leukemia (P=.02).
No deaths were reports among any of the patients infected with VZV.
“We came to find out that incidence is pretty low and this is a place, keep in mind too, that they don’t have any systematic vaccination program in place for children to begin with,” Gomez told Infectious Diseases in Children. “That makes it kind of interesting, too. It lends support for the idea that maybe it is better to let them go through the process.”
For more information:
Gomez S. Abstract 201420. Presented at: St. Jude/PIDS Pediatric Infectious Diseases Research Conference 2014; Feb. 21-22, 2014; Memphis, Tenn.
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Anne A. Gershon, MD
The problem with this scientifically is that there were only two cases of varicella, according to my calculations. No estimate of severity can be made on the basis of two cases. In the “old days” in the United States, chickenpox was fatal in 7% of children, even if antiviral therapy was given.
We don't know the age of these children or how many of them had varicella in the past (including at a time before they developed malignancy). We are also not told whether the two children got antiviral therapy and how and also how sick they were with varicella. Again in the “old days” in the United States there was significant morbidity from varicella in children with acute lymphoblastic leukemia, as well as mortality.
The conclusion, “It lends support for the idea that maybe it is better to let them go through the process,” is naïve. This kind of data is not an argument against using varicella vaccine.
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