120 Missed Opportunities for Varicella Prevention, 2000–2002
Bibliographic record
Abstract
To review hospital admissions for varicella infection since a vaccine became readily available and identify missed opportunities for disease prevention. This information will be helpful in advocating for implementation of the varicella vaccine in all provinces of Canada as it demonstrates the potential severity of chickenpox. Active surveillance of hospital admissions for varicella infection and related complications was conducted at the 12 Canadian tertiary care pediatric centers participating in the IMPACT program. The study period spanned from January 2000 to December 2002. Cases were defined by clinical syndrome, with or without virologic tests. 819 chickenpox-related admissions were identified in children = 12 months of age during the 3 years. The age range was 12 months to 16 years with a mean of 4.14 years. Of these, 617 (75%) were immuno-competent at the time of infection/hospital admission and therefore eligible to receive varicella vaccine. Secondary bacterial infection was the most common complication (67%) among those eligible for vaccine. The more serious complications reported were: 57 (9.2%) thrombocytopenia, 48 (7.8%) bacterial pneumonia, 36 (5.8%) bacteremia, 19 (3.0%) encephalitis, 14 (2.3%) viral pneumonia, 14 (2.3%) osteomyelitis, 13 (2.1%) septic or viral arthritis, 11 (1.8%) necrotizing fasciitis, 11 (1.8%) orbital cellulitis, 8 (1.3%) septic or toxic shock, 8 (1.3%) post-varicella stroke, 5 (0.8%) hemorrhagic varicella, 5 (0.8%) disseminated intravascular coagulation, 4 (0.6%) Guillain Barre syndrome, 3 (0.5%) adult respiratory distress syndrome and 3 (0.5%) viral meningitis. Of the 819 children, 4 died of varicella-related causes, 3 with normal immunity and one receiving corticosteroid treatment for lung disease. An additional 2 children under 1 year of age died of varicella-related causes. Both children were previously healthy 4 and 9 month old infants. The exposures were household contacts, 1 an adult the other a child. Both developed infections leading to septic shock and death. Varicella infection and its complications result in a substantial number of children being hospitalized with life-threatening morbidity. Implementation of a Canada-wide varicella immunization program could prevent more than 75% of the varicella-related hospital admissions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".