Varicella infection in paediatric oncology patients: implication on elective vaccination

Abstract

Varicella infection in paediatric cancer patients could result in significant morbidity and mortality. We reviewed our patients cohort from January 89 to June 96 and found 5.6% (10 of 180) developed chickenpox. Nine had mild clinical disease and responded to acyclovir treatment and one died of disseminated varicella. Majority of the infected patients were receiving relatively mild chemotherapy and seven acquired the disease via community exposure. Interruption of the chemotherapy schedule was a concern with a median delay of 3 weeks (range 7 to 60 days). Another 7 patients developed zoster and all recovered with acyclovir. The median delay of chemotherapy was 7 days (range 5 to 9 days). With the introduction of varicella vaccine, an elective vaccination regimen has been developed for children with cancer. This practice is cost-effective and will minimize the use of VZJG and acyclovir.