Epidemiology and cost analysis of varicella in Italy: results of a sentinel study in the pediatric practice

Background. Describing the epidemiology of varicella is relevant to the dev elopment of specific prevention strategies and to building up of economic m odels evaluating the cost:efficiency ratios of these strategies. Aim. Our study was designed to describe the epidemiology of chickenpox amon g Italian children and to assess the resulting economic and health burden o n the country. Methods. Thirty nine Italian pediatricians participated in a sentinel netwo rk on pediatric infectious diseases representing a total pediatric populati on of 30 168 children. Each case of varicella observed from January through December, 1997, was recorded. Economic analysis was conducted from the soc ietal point of view. All costs were broken down into two groups: direct and indirect costs. Results. A total of 1599 cases of varicella were reported among children 0 to 14 years old. There were 1266 primary cases (mean age, 4.5 +/- 2 years) and 333 secondary cases (mean age, 3.6 +/- 3.2 years). The global incidence of chickenpox was 51.01/1000/year. Complications were seen in 56 cases (3. 5%). Drugs were prescribed in 672 cases. A group of adults (364 susceptible and 193 with uncertain status) were exposed to primary cases. Seventy (12. 5%) were eventually infected among whom there were 4 pregnant women. For pe diatric patients an average cost of $146.90 (250 400 lire) was estimated; t his is largely accounted for by indirect costs. Conclusions. The epidemiology of varicella in Italy is consistent with that found in previous studies in industrialized countries. Severe complication s did not occur in our population. We believe that the health arguments in favor of universal vaccination of children >18 months of age do not differ in our own country from those of other industrialized nations. Our data cou ld now be incorporated into pharmacoeconomic models to establish cost-effic ient strategies for Italy.