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Pox Parties



Actuality subject, December 2011

Actuality subject, December 2011



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Pox Parties Pox Parties Presentation Transcript

  • A dangerous trend in the USAPauline FLIPOMélanie TILTE 1December 2nd, 2011
  • Headache Fever Blisters Tiredness Itching Chicken pox Sore (Varicella) throat 22http://www.cdc.gov
  • American parents’ first reaction 3
  • USA - Before 1995 Each year 4 million people would get the chicken pox About 10,500 – 13,000 were hospitalized Majority : healthy children and 100 to 150 died adultshttp://www.cdc.gov 4Walter A., Orenstein M.D., National Immunization Program. Overview of the US Vaccination Program
  • Why a VZV vaccine? Varicella develops in nearly all persons living in the US • > 90% of adults immune to VZV Complications rate higher for persons ≥ 15 and < 1 years of age • Bacterial infection of skins lesions, pneumonia, dehydratation, encephalitis, hepatitis VZV vaccine licensed in several European countries (1984), Japan (1986), Korea (1988) • No safety concerns after the administration of > 2 million doses in these countries Varicella is less severe among vaccinated persons than unvaccinated persons • Afebrile, fewer vesicular lesions, shorter duration of illness Difference of incidence of herpes zoster • 18 per 100000 persons/year for vaccinated people • 77 per 100000 persons/year after natural Varicella 5MMWR, Advisory Committee on Immunization Practices (ACIP). Prevention of Varicella. July 12, 1996, Vol 45, No RR-11
  • Cost-effectiveness of a Routine Varicella Vaccination program for US children One dose/child under 6 30-year period following introduction $35/dose At school entry, vaccination coverage level = 97% by the 6th year Medical costs Work-loss costs • Varicella treatment : Acyclovir • Parents missing work when their children • Vaccinated people : no Acyclovir have the chickenpox ($201) • Complications • Adults contracting chickenpox Taking into account • Evidence about vaccine efficacy • Effects of expected changes in the age distribution of the disease • Empirical data on the costs of medical utilization and work loss from varicella 6Lieu, Tracy A et al. Cost-effectiveness of a Routine Varicella Vaccination program for US Children. JAMA; 1994; 271 (5), 375-381
  • Cost-effectiveness of a Routine Varicella Vaccination program for US children 7Lieu, Tracy A et al. Cost-effectiveness of a Routine Varicella Vaccination program for US Children. JAMA; 1994; 271 (5), 375-381
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  • Recommendation map Kg: Kindergarten 10http://www.immunize.org/laws/vari_two.pdf Gr: School Grade
  • Effects of vaccination 11
  • Effects of vaccinationMatthew M. Davis et al. Decline in varicella-related hospitalizations and expenditures for children and adults after introduction of 12varicella vaccine in the United States. Pediatrics; 2004; 114; 785-792.
  • What about France? ● Herpes zoster prevention : insufficient data ● >15 years vaccinating 11 years old children necessary to avoid 1 death, 30 severe complications and 30.000 cases ● Safety data : rash (injection site 1-4%, generalized 1-6%) ● Efficacy data : single-dose vaccination of children > 1 : not enough ● Fear : ↑ varicella among adolescents/adults and herpes zoster among the elderly ● Routine varicella vaccination not recommended for children > 1 ● Recommended, if no varicella history : - Vaccination within 3 days following exposure (adults & immunocompetent) - Health care workers - Contact with young children & immunodeficient people - Children organ recipientConseil Supérieur dHygiène Publique de France – Section Maladies Transmissibles – Avis relatif à la vaccination contre la varicelle 13 13(19 mars 2004)
  • “Ils sont fous ces américains” New driftsMailing infected clothes, saliva samples, infected lollipops... Danger for workers of mailing companies Risk of 20 years of imprisonment: under biohazard regulation (like anthrax)Looking for more dangerous diseases : Measles, mumps… 14
  • Thanks for your attention 15 15