Twenty Years of Medically-Attended Pediatric Varicella and Herpes Zoster in Ontario, Canada: A Population-Based Study
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{"title"=>"Twenty years of medically-attended pediatric varicella and herpes zoster in Ontario, Canada: A population-based study", "type"=>"journal", "authors"=>[{"first_name"=>"Anne E.", "last_name"=>"Wormsbecker", "scopus_author_id"=>"35303707500"}, {"first_name"=>"Jun", "last_name"=>"Wang", "scopus_author_id"=>"56835830300"}, {"first_name"=>"Laura C.", "last_name"=>"Rosella", "scopus_author_id"=>"23489789700"}, {"first_name"=>"Jeffrey C.", "last_name"=>"Kwong", "scopus_author_id"=>"7005301949"}, {"first_name"=>"Chi Yon", "last_name"=>"Seo", "scopus_author_id"=>"56835200800"}, {"first_name"=>"Natasha S.", "last_name"=>"Crowcroft", "scopus_author_id"=>"8427406200"}, {"first_name"=>"Shelley L.", "last_name"=>"Deeks", "scopus_author_id"=>"57130196400"}], "year"=>2015, "source"=>"PLoS ONE", "identifiers"=>{"doi"=>"10.1371/journal.pone.0129483", "sgr"=>"84941341489", "pmid"=>"26177077", "scopus"=>"2-s2.0-84941341489", "issn"=>"19326203", "pui"=>"605951783", "isbn"=>"1932-6203"}, "id"=>"769887a1-e293-3f47-8eda-1e2686b6bd57", "abstract"=>"OBJECTIVE To determine if reductions in medically-attended pediatric varicella and herpes zoster occurred in Ontario, Canada, after publicly-funded varicella immunization was implemented in 2004. METHODS For fiscal years (FY) 1992-2011, we examined data on varicella and herpes zoster physician office visits, emergency department (ED) visits, hospitalizations (including for varicella-associated skin and soft tissue infections [SSTI]), and intensive care unit (ICU) admissions, among those aged <18 years. The pre-vaccine, privately-available, and vaccine program eras were FY1992-1998, FY1999-2003, and FY2004-2011, respectively. We used Poisson regressionand Kruskal-Wallis tests (all at the p<0.05 level of significance), and compared rates using incidence rate ratios (IRRs) and 95% confidence intervals (CIs). RESULTS Incidence of varicella office visits declined over the study period from a high of 25.1/1,000 in FY1994 to a low of 3.2/1,000 in FY2011. ED visits and hospitalizations followed similar patterns of decreasing rates later in the study period. IRRs comparing the vaccine program versus pre-vaccine eras were 0.29 (95%CI: 0.26-0.32) for office visits, 0.29 (95%CI: 0.21-0.40) for ED visits, and 0.41 (95%CI: 0.10-1.69) for hospitalizations. Annual declines in varicella office visits were 7.7%, 9.1%, 8.4%, and 8.4% per year among children aged <1 year, 1-4 years, 5-11 years, and ≥12 years, respectively (all p<0.001). Age-specific rates of varicella-associated SSTI declined significantly among children <12 years (p<0.001) and rates of ICU admissions decreased significantly for children <1 year (p = 0.02). (p<0.001) over the study period. For children aged 5-17 years, herpes zoster office visits decreased whereas ED visits increased (both p<0.001) and there was a small, non-significant (p = 0.07), decrease in hospitalizations. CONCLUSION Medically-attended varicella decreased during the study period, particularly since varicella vaccine was publicly-funded. Results suggest immunization program-related changes in varicella epidemiology, including herd effects, demonstrated by reductions in varicella in program-ineligible age groups. We did not observe a consistent impact on herpes zoster.", "link"=>"http://www.mendeley.com/research/twenty-years-medicallyattended-pediatric-varicella-herpes-zoster-ontario-canada-populationbased-stud", "reader_count"=>21, "reader_count_by_academic_status"=>{"Unspecified"=>4, "Professor > Associate Professor"=>1, "Librarian"=>2, "Researcher"=>3, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>3, "Other"=>2, "Student > Master"=>1, "Student > Bachelor"=>1, "Professor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>4, "Professor > Associate Professor"=>1, "Librarian"=>2, "Researcher"=>3, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>3, "Other"=>2, "Student > Master"=>1, "Student > Bachelor"=>1, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>6, "Medicine and Dentistry"=>13, "Social Sciences"=>1, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>13}, "Social Sciences"=>{"Social Sciences"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Unspecified"=>{"Unspecified"=>6}}, "reader_count_by_country"=>{"Mexico"=>1, "Spain"=>1}, "group_count"=>3}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/2176957"], "description"=>"<p>Incidence of varicella a) physician office visits (n = 600,208), b) ED visits (n = 55,472), and c) hospitalizations (n = 2,701) among Ontario children by fiscal years 1992–2011.</p>", "links"=>[], "tags"=>["vaccine program eras", "lt", "herpes zoster office visits", "FY 2011. ED visits", "Incidence rate ratios", "ci", "study period", "ssti", "herpes zoster", "ED visits", "varicella office visits", "irr", "icu", "herpes zoster physician office visits"], "article_id"=>1484192, "categories"=>["Biological Sciences"], "users"=>["Anne E. Wormsbecker", "Jun Wang", "Laura C. Rosella", "Jeffrey C. Kwong", "Chi Yon Seo", "Natasha S. Crowcroft", "Shelley L. Deeks"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129483.g001", "stats"=>{"downloads"=>1, "page_views"=>23, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Incidence_of_varicella_a_physician_office_visits_n_600_208_b_ED_visits_n_55_472_and_c_hospitalizations_n_2_701_among_Ontario_children_by_fiscal_years_1992_8211_2011_/1484192", "title"=>"Incidence of varicella a) physician office visits (n = 600,208), b) ED visits (n = 55,472), and c) hospitalizations (n = 2,701) among Ontario children by fiscal years 1992–2011.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-07-15 04:02:45"}
  • {"files"=>["https://ndownloader.figshare.com/files/2176958"], "description"=>"<p>Age-specific varicella physician office visits among Ontario children by fiscal year, 1992–2011.</p>", "links"=>[], "tags"=>["vaccine program eras", "lt", "herpes zoster office visits", "FY 2011. ED visits", "Incidence rate ratios", "ci", "study period", "ssti", "herpes zoster", "ED visits", "varicella office visits", "irr", "icu", "herpes zoster physician office visits"], "article_id"=>1484193, "categories"=>["Biological Sciences"], "users"=>["Anne E. Wormsbecker", "Jun Wang", "Laura C. Rosella", "Jeffrey C. Kwong", "Chi Yon Seo", "Natasha S. Crowcroft", "Shelley L. Deeks"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129483.g002", "stats"=>{"downloads"=>1, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Age_specific_varicella_physician_office_visits_among_Ontario_children_by_fiscal_year_1992_8211_2011_/1484193", "title"=>"Age-specific varicella physician office visits among Ontario children by fiscal year, 1992–2011.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-07-15 04:02:45"}
  • {"files"=>["https://ndownloader.figshare.com/files/2176959"], "description"=>"<p>Age-specific varicella-associated SSTI hospitalizations among Ontario children by fiscal year, 2002–2011.</p>", "links"=>[], "tags"=>["vaccine program eras", "lt", "herpes zoster office visits", "FY 2011. ED visits", "Incidence rate ratios", "ci", "study period", "ssti", "herpes zoster", "ED visits", "varicella office visits", "irr", "icu", "herpes zoster physician office visits"], "article_id"=>1484194, "categories"=>["Biological Sciences"], "users"=>["Anne E. Wormsbecker", "Jun Wang", "Laura C. Rosella", "Jeffrey C. Kwong", "Chi Yon Seo", "Natasha S. Crowcroft", "Shelley L. Deeks"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129483.g003", "stats"=>{"downloads"=>2, "page_views"=>26, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Age_specific_varicella_associated_SSTI_hospitalizations_among_Ontario_children_by_fiscal_year_2002_8211_2011_/1484194", "title"=>"Age-specific varicella-associated SSTI hospitalizations among Ontario children by fiscal year, 2002–2011.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-07-15 04:02:45"}
  • {"files"=>["https://ndownloader.figshare.com/files/2176960"], "description"=>"<p>Incidence of herpes zoster physician office visits, ED visits and hospitalizations among Ontario children 5–17 years by fiscal years 1992–2011.</p>", "links"=>[], "tags"=>["vaccine program eras", "lt", "herpes zoster office visits", "FY 2011. ED visits", "Incidence rate ratios", "ci", "study period", "ssti", "herpes zoster", "ED visits", "varicella office visits", "irr", "icu", "herpes zoster physician office visits"], "article_id"=>1484195, "categories"=>["Biological Sciences"], "users"=>["Anne E. Wormsbecker", "Jun Wang", "Laura C. Rosella", "Jeffrey C. Kwong", "Chi Yon Seo", "Natasha S. Crowcroft", "Shelley L. Deeks"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129483.g004", "stats"=>{"downloads"=>1, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Incidence_of_herpes_zoster_physician_office_visits_ED_visits_and_hospitalizations_among_Ontario_children_5_8211_17_years_by_fiscal_years_1992_8211_2011_/1484195", "title"=>"Incidence of herpes zoster physician office visits, ED visits and hospitalizations among Ontario children 5–17 years by fiscal years 1992–2011.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-07-15 04:02:45"}
  • {"files"=>["https://ndownloader.figshare.com/files/2176961"], "description"=>"<p>Notes: 1. For varicella-associated SSTI, privately-available varicella vaccine period consists of FY 2002–2003.</p><p>Comparison of incidence of medically-attended varicella and hospitalization for complicated varicella in Ontario children among pre-varicella vaccine, privately-available varicella vaccine and varicella vaccine program periods.</p>", "links"=>[], "tags"=>["vaccine program eras", "lt", "herpes zoster office visits", "FY 2011. ED visits", "Incidence rate ratios", "ci", "study period", "ssti", "herpes zoster", "ED visits", "varicella office visits", "irr", "icu", "herpes zoster physician office visits"], "article_id"=>1484196, "categories"=>["Biological Sciences"], "users"=>["Anne E. Wormsbecker", "Jun Wang", "Laura C. Rosella", "Jeffrey C. Kwong", "Chi Yon Seo", "Natasha S. Crowcroft", "Shelley L. Deeks"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129483.t001", "stats"=>{"downloads"=>7, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Comparison_of_incidence_of_medically_attended_varicella_and_hospitalization_for_complicated_varicella_in_Ontario_children_among_pre_varicella_vaccine_privately_available_varicella_vaccine_and_varicella_vaccine_program_periods_/1484196", "title"=>"Comparison of incidence of medically-attended varicella and hospitalization for complicated varicella in Ontario children among pre-varicella vaccine, privately-available varicella vaccine and varicella vaccine program periods.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-07-15 04:02:45"}
  • {"files"=>["https://ndownloader.figshare.com/files/2176962"], "description"=>"<p>Notes: 1. SSTI (Skin and soft tissue infection). 2. ICU (Intensive care unit). 3. For varicella-associated SSTI, privately-available varicella vaccine period consists of FY 2002–2003.</p><p>Median (IQR) age of varicella cases by clinical setting in the pre-varicella vaccine period, the privately-available varicella vaccine period and varicella vaccine program period.</p>", "links"=>[], "tags"=>["vaccine program eras", "lt", "herpes zoster office visits", "FY 2011. ED visits", "Incidence rate ratios", "ci", "study period", "ssti", "herpes zoster", "ED visits", "varicella office visits", "irr", "icu", "herpes zoster physician office visits"], "article_id"=>1484197, "categories"=>["Biological Sciences"], "users"=>["Anne E. Wormsbecker", "Jun Wang", "Laura C. Rosella", "Jeffrey C. Kwong", "Chi Yon Seo", "Natasha S. Crowcroft", "Shelley L. Deeks"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129483.t002", "stats"=>{"downloads"=>6, "page_views"=>19, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Median_IQR_age_of_varicella_cases_by_clinical_setting_in_the_pre_varicella_vaccine_period_the_privately_available_varicella_vaccine_period_and_varicella_vaccine_program_period_/1484197", "title"=>"Median (IQR) age of varicella cases by clinical setting in the pre-varicella vaccine period, the privately-available varicella vaccine period and varicella vaccine program period.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-07-15 04:02:45"}
  • {"files"=>["https://ndownloader.figshare.com/files/2176963"], "description"=>"<div><p>Objective</p><p>To determine if reductions in medically-attended pediatric varicella and herpes zoster occurred in Ontario, Canada, after publicly-funded varicella immunization was implemented in 2004.</p><p>Methods</p><p>For fiscal years (FY) 1992-2011, we examined data on varicella and herpes zoster physician office visits, emergency department (ED) visits, hospitalizations (including for varicella-associated skin and soft tissue infections [SSTI]), and intensive care unit (ICU) admissions, among those aged <18 years. The pre-vaccine, privately-available, and vaccine program eras were FY1992-1998, FY1999-2003, and FY2004-2011, respectively. We used Poisson regressionand Kruskal-Wallis tests (all at the p<0.05 level of significance), and compared rates using incidence rate ratios (IRRs) and 95% confidence intervals (CIs).</p><p>Results</p><p>Incidence of varicella office visits declined over the study period from a high of 25.1/1,000 in FY1994 to a low of 3.2/1,000 in FY2011. ED visits and hospitalizations followed similar patterns of decreasing rates later in the study period. IRRs comparing the vaccine program versus pre-vaccine eras were 0.29 (95%CI: 0.26-0.32) for office visits, 0.29 (95%CI: 0.21-0.40) for ED visits, and 0.41 (95%CI: 0.10-1.69) for hospitalizations. Annual declines in varicella office visits were 7.7%, 9.1%, 8.4%, and 8.4% per year among children aged <1 year, 1-4 years, 5-11 years, and ≥12 years, respectively (all p<0.001). Age-specific rates of varicella-associated SSTI declined significantly among children <12 years (p<0.001) and rates of ICU admissions decreased significantly for children <1 year (p = 0.02). (p<0.001) over the study period. For children aged 5-17 years, herpes zoster office visits decreased whereas ED visits increased (both p<0.001) and there was a small, non-significant (p = 0.07), decrease in hospitalizations.</p><p>Conclusion</p><p>Medically-attended varicella decreased during the study period, particularly since varicella vaccine was publicly-funded. Results suggest immunization program-related changes in varicella epidemiology, including herd effects, demonstrated by reductions in varicella in program-ineligible age groups. We did not observe a consistent impact on herpes zoster.</p></div>", "links"=>[], "tags"=>["vaccine program eras", "lt", "herpes zoster office visits", "FY 2011. ED visits", "Incidence rate ratios", "ci", "study period", "ssti", "herpes zoster", "ED visits", "varicella office visits", "irr", "icu", "herpes zoster physician office visits"], "article_id"=>1484198, "categories"=>["Biological Sciences"], "users"=>["Anne E. Wormsbecker", "Jun Wang", "Laura C. Rosella", "Jeffrey C. Kwong", "Chi Yon Seo", "Natasha S. Crowcroft", "Shelley L. Deeks"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129483", "stats"=>{"downloads"=>13, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Twenty_Years_of_Medically_Attended_Pediatric_Varicella_and_Herpes_Zoster_in_Ontario_Canada_A_Population_Based_Study_/1484198", "title"=>"Twenty Years of Medically-Attended Pediatric Varicella and Herpes Zoster in Ontario, Canada: A Population-Based Study", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-07-15 04:02:45"}

PMC Usage Stats | Further Information

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  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"4"}
  • {"unique-ip"=>"11", "full-text"=>"11", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"5"}
  • {"unique-ip"=>"4", "full-text"=>"3", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"6"}
  • {"unique-ip"=>"6", "full-text"=>"6", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"7"}
  • {"unique-ip"=>"6", "full-text"=>"11", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"8"}
  • {"unique-ip"=>"9", "full-text"=>"10", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"10"}
  • {"unique-ip"=>"6", "full-text"=>"5", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"2"}
  • {"unique-ip"=>"11", "full-text"=>"8", "pdf"=>"10", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"3"}
  • {"unique-ip"=>"10", "full-text"=>"7", "pdf"=>"8", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"4"}
  • {"unique-ip"=>"8", "full-text"=>"8", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"5"}
  • {"unique-ip"=>"11", "full-text"=>"17", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"8"}
  • {"unique-ip"=>"7", "full-text"=>"7", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"9"}
  • {"unique-ip"=>"10", "full-text"=>"10", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"10"}
  • {"unique-ip"=>"6", "full-text"=>"5", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"12"}
  • {"unique-ip"=>"8", "full-text"=>"8", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"2"}
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Relative Metric

{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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