PRO/EDR> Varicella update (03): Chile, Brazil, fatal


A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

Date: Fri 19 May 2023
Source: Correiobraziliense [in Portuguese, machine trans., edited]

In December 2022, the São Paulo City Hall recorded 56 outbreaks of
chickenpox. There were 213 cases of infection during the analyzed
period, an increase of 65% compared to the previous year [2021]. The
disease usually manifests itself more frequently in children at the
end of winter, says the Epidemiological Surveillance System (SVE).

In 2010, before the vaccine against chickenpox was part of the
immunization schedule of the Unified Health System (SUS), 1082
outbreaks were registered, with 12 380 infected notified. During the
COVID-19 pandemic, the anti-vaccination movement gained strength. Data
released in July 2022 by the World Health Organization (WHO) showed
that the biggest drops in immunization rates in the last 30 years were
recorded worldwide. It is estimated that at the time, 25 million
children were behind on their vaccination card.

In Brazil, in just 3 years, the child vaccination rate dropped from
93.1% in 2019 to 71.49% in 2021, according to the United Nations
Children’s Fund (UNICEF). This represents 3 out of 10 children who
have not received the necessary protection against life-threatening
and preventable illnesses.

Despite being more common among young people and children, adults can
also contract the disease more intensely, as was the case of Brazilian
[RC], who died due to complications from chickenpox.

[RC] was 38 years old, was a personal trainer, lived in Chile, and was
diagnosed with chickenpox in December last year [2022]. The
professional led a healthy life until contracting the disease in the
most serious form. A recent examination found that the virus continued
to act inside [RC’s] body and affected some organs, such as the
kidney, in addition to 2 lesions in the brain.

Today, about 90% of people get chickenpox in childhood between 2 and 8
years old. In adults, the disease usually has more intense symptoms,
especially if there was no vaccination in the 1st years of life, and
the person may have a greater number of blisters on the body, compared
to children, in addition to high fever, earache, headache, and sore
throat in some cases.

For Alex Araújo, CEO of 4Life Prime Occupational Health, vaccination
is an ally of child health, and its main outcome is to prevent
mortality and ensure quality of life: “Vaccination is essential to
keep children healthy, as [by] protecting against viruses and
bacteria, it helps to prevent many diseases that can harm the
development of the child.”

Brazil is among the 10 countries with the highest number of young
people with a delay in vaccination. It is worth remembering that the
application of the varicella vaccine occurs in 2 doses from 12 months
of age; it can also be applied to 9-month-old babies under medical
guidance, but the dose must be reapplied when the child reaches 12

Chickenpox is a difficult disease to track. Only outbreaks are
notified to the Ministry of Health, that is, cases treated at home do
not enter the account. According to the organization’s estimate, an
average of 3 million people are infected with the disease each year.

The most serious complications occur when the virus migrates to
strategic organs such as the lungs and brain. Pneumonia, for example,
occurs as a result of either chickenpox overcoming resistance and
invading the lungs or, as the body is more susceptible, bacteria
manage to trigger the infection.

“Chickenpox can be easily transmitted, either through coughing,
sneezing, or even contaminated objects, that is, direct and indirect
contagion,” explains Yuri Leite, founder of Securecard. “It is
important to emphasize that if the individual presents any symptoms
that may indicate the presence of chickenpox, such as high fever,
presence of red spots on the body, tiredness, and lack of appetite,
the patient should immediately see a doctor. Even before symptoms
appear, between 14 and 21 days after infection, a person is already
starting to transmit the virus. It is necessary to be aware,” adds the

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