The following story appeared in the “Michigan Immunization Update” (Summer/Fall 1999 issue). It is reprinted here with permission from the Michigan Department of Community Health.
Though fatal outcomes are rare, chickenpox (varicella) can result in death. The Michigan health care community was reminded of that sobering fact this spring with the report of an eight-year-old boy’s varicella-related death. The child, who had not been vaccinated against chickenpox, died from complications of invasive group A streptococcal (GAS) infection approximately one week after the onset of varicella rash.
Varicella has increasingly become recognized as a risk factor for GAS disease. An investigation of an outbreak of GAS in a Boston day care center in 1997 found antecedent or concurrent varicella infection to be a significant risk factor for GAS infection. Investigations of several other varicella-related deaths have similarly noted severe, invasive group A strep infection as a possible complication of chickenpox.
This is the fourth reported varicella-related death in Michigan since 1997. Two deaths were reported in that year, a two-year-old child and a 42-year-old adult. An eight-year-old child died in 1998. None had previously received chickenpox vaccine, which was licensed for use in the U.S. in 1995. Nationally, it is estimated that approximately 100 varicella-related deaths occur each year.
As part of a comprehensive effort to assess the impact of vaccination on varicella-related morbidity and mortality, CDC now encourages state public health agencies to investigate varicella-related deaths…. Health care providers should report varicella-related deaths immediately to the local health department of the patient’s residence….
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