The automated records of over 250,000 members of a health maintenance
organization were analyzed to assess the epidemiology of varicella and
its complications between 1 July 1990 and 30 June 1992. All complicat
ions were verified by review of full-text medical records. The inciden
ce rates of varicella in persons <15 years of age were 20%-50% lower t
han published figures, probably reflecting underreporting. The rates i
n those greater than or equal to 15 years old, however, were greater t
han those reported for 1972-1978 (607 vs. 291/10(5) years, 15-19 years
old; 175 vs. 33/10(5) years, greater than or equal to 20 years old).
The rates of hospitalization for uncomplicated varicella, skin superin
fections, and pneumonia in children were, respectively, 15, 11, and 4
times higher than previous estimates. Hospitalization rates for adults
with pneumonia and uncomplicated varicella were >5 times higher than
prior figures. Thus, varicella in adults and varicella complications i
n general may be more frequent than previously estimated.