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Epidemiological and clinical characteristics and the approach to infant chickenpox in primary care

  • Original Article
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Chickenpox is not common in the first year of life (infant varicella) and there is a lack of data on its presentation, especially in primary care. A year-long observational study (July 2015–2016) carried out by a research network of primary care pediatricians throughout Spain.Two hundred and sixty-four pediatricians gathered data from 358 cases of clinically diagnosed chickenpox in infants. The illness was considered mild in 78% of infants < 7 months compared to 65% in those aged 7 to 12 months (p = 0.0144). Fever (46%) was present in 35% of children ≤ 6 months compared to 55% in older children (p = 0.0005). The number of skin lesions was > 50 in 35% of children ≤ 6 months old compared to 47% in > 7 months (p = 0.0273). From the 2% of hospitalized children 86% were younger than 7 months. Oral antiviral treatment was given in 33% of cases ≤ 6 months compared to 18% in older patients (p = 0.0023). Doubts about administering the chickenpox vaccine at a later date were expressed by 18% of pediatricians.

Conclusion: Chickenpox is considered benign, having a mild effect on most infants. There is less clinical effect in infants ≤ 6 months although this age group is hospitalized more and is prescribed more antiviral treatment. There are doubts among pediatricians about the subsequent need for vaccination.

What is Known:

• Chickenpox is uncommon and of uncertain evolution in the first year of life

• Hospital admissions for chickenpox are more frequent in the first year of life

What is New:

• The course of chickenpox in the first year of life is mild, especially in infants younger than 7 months despite the fact they are hospitalized more and are treated more frequently with antivirals. Antivirals are prescribed to 1 in 4 children with chickenpox under 12 months of age.

• Almost 50% of pediatricians recommend a subsequent vaccination against chickenpox especially if it occurs in the first 6 months of life.

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Abbreviations

PC:

Primary care

AR:

Autonomous region

SD:

Standard deviation

CI:

Confidence interval

OR:

Odds ratio

PAPenRed:

Pediatric Epidemiological Surveillance Network of Spanish Primary Care Pediatrics Association

References

  1. Baldo V, Baldovin T, Russo F, Busana MC, Piovesan C, Bordignon G, Giliberti A, Trivello R (2009) Varicella: epidemiological aspects and vaccination coverage in the Veneto region. BMC Infect Dis 9:150

    Article  PubMed  PubMed Central  Google Scholar 

  2. Bilcke J, Ogunjimi B, Marais C, de Smet F, Callens M, Callaert K, van Kerschaver E, Ramet J, van Damme P, Beutels P (2012) The health and economic burden of chickenpox and herpes zoster in Belgium. Epidemiol Infect 140:2096–2109

    Article  CAS  PubMed  Google Scholar 

  3. Blumental S, Sabbe M, Lepage P (2016) Varicella paediatric hospitalisations in Belgium: a 1-year national survey. Arch Dis Child 101:16–22

    Article  PubMed  Google Scholar 

  4. Bollaerts K, Riera-Montes M, Heininger U, Hens N, Souverain A, Verstraeten T, Hartwig S (2017) A systematic review of varicella seroprevalence in European countries before universal childhood immunization: deriving incidence from seroprevalence data. Epidemiol Infect 145:2666–2677

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Chaves SS, Lopez AS, Watson TL, Civen R, Watson B, Mascola L, Seward JF (2011) Varicella in infants after implementation of the US varicella vaccination program. Pediatrics 128:1071–1077

    Article  PubMed  Google Scholar 

  6. Cohen J, Breuer J (2015) Chickenpox: treatment. BMJ Clin Evid 2015:0912

    PubMed  PubMed Central  Google Scholar 

  7. Comité asesor de vacunas. Varicela en menores de 12 meses y vacuna. 8 de junio de 2016. Available at: http://vacunasaep.org/profesionales/pregunta-al-cav/situaciones-especiales/varicela-en-menores-de-12-meses-y-vacuna. Last accessed on March 2018

  8. Dubos F, Grandbastien B, Hue V, Martinot A (2007) Epidemiology of hospital admissions for paediatric varicella infections: a one-year prospective survey in the pre-vaccine era. Epidemiol Infect 135:131–138

    Article  CAS  PubMed  Google Scholar 

  9. Emery C, Lancon F, Fagnani F, Pechevis M, Durand I, Floret D (2006) ENVOL study on the medical management of varicella and its complications in French ambulatory care. Med Mal Infect 36:92–98

    Article  CAS  PubMed  Google Scholar 

  10. European Centre for Disease and Control. Varicella Surveillance Report 2010. Available at: https://ecdc.europa.eu/en/publications-data/varicella-surveillance-report-2010. Last accessed on April 2018

  11. European Centre for Disease Prevention and Control. Varicella vaccination in the European Union.Stockholm:ECDC;2015. Available at: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/Varicella-Guidance-2015.pdf

  12. Fornaro P, Gandini F, Marin M, Pedrazzi C, Piccoli P, Tognetti D, Assael BM, Lucioni C, Mazzi S (1999) Epidemiology and cost analysis of varicella in Italy: results of a sentinel study in the pediatric practice. Italian Sentinel Group on Pediatric Infectious Diseases. Pediatr Infect Dis J 18:414–419

    Article  CAS  PubMed  Google Scholar 

  13. Gershon AA (2017) Is chickenpox so bad, what do we know about immunity to varicella zoster virus, and what does it tell us about the future? J Inf Secur 74(Suppl 1):S27–S33

    Google Scholar 

  14. Gershon AA, Raker R, Steinberg S, Topf-Olstein B, Drusin LM (1976) Antibody to Varicella-Zoster virus in parturient women and their offspring during the first year of life. Pediatrics 58:692–696

    CAS  PubMed  Google Scholar 

  15. Gil-Prieto R, Garcia-Garcia L, San-Martin M, Gil-de-Miguel A (2014) Varicella vaccination coverage inverse correlation with varicella hospitalizations in Spain. Vaccine 32:7043–7046

    Article  PubMed  Google Scholar 

  16. Glode HI, Broccia MD, Glenthoj JP, Harder K, Jensen L, von Linstow ML, Poulsen A, Mølbak K (2017) Children hospitalized with Varicella in Denmark: sensitivity of the National Patient Register. Pediatr Infect Dis J 36:31–35

    Article  Google Scholar 

  17. Gowin E, Wysocki J, Michalak M, Januszkiewicz-Lewandowska D (2017) Too young to be vaccinated: hospitalizations caused by varicella among children in the first year of life. Int J Infect Dis 62:52–55

    Article  PubMed  Google Scholar 

  18. Guillen JM, Samaniego-Colmenero ML, Hernandez-Barrera V, Gil A (2009) Varicella paediatric hospitalizations in Spain. Epidemiol Infect 137:519–525

    Article  CAS  PubMed  Google Scholar 

  19. Heininger U, Desgrandchamps D, Schaad UB (2006) Seroprevalence of Varicella-Zoster virus IgG antibodies in Swiss children during the first 16 months of age. Vaccine 24:3258–3260

    Article  CAS  PubMed  Google Scholar 

  20. Helmuth IG, Poulsen A, Suppli CH, Molbak K (2015) Varicella in Europe-a review of the epidemiology and experience with vaccination. Vaccine 33:2406–2413

    Article  PubMed  Google Scholar 

  21. Immunization Action Coalition. Ask the Expert. Varicella (chickenpox). Available at: http://www.immunize.org/askexperts/experts_var.asp. Last accessed on March 2018

  22. Iseli A, Aebi C, Banz K, Brunner M, Schmutz AM, Heininger U (2009) Prospective surveillance of varicella-zoster virus infections in an out-patient setting in Switzerland. Hum Vaccin 5:843–846

    Article  PubMed  Google Scholar 

  23. Lecuyer A, Levy C, Gaudelus J, Floret D, Soubeyrand B, Caulin E, Cohen R, Grimprel E (2010) Pediatricians Working Group. Hospitalization of newborns and young infants for chickenpox in France. Eur J Pediatr 169:1293–1297

    Article  PubMed  Google Scholar 

  24. Leuridan E, Hens N, Hutse V, Aerts M, Van DP (2011) Kinetics of maternal antibodies against rubella and varicella in infants. Vaccine 29:2222–2226

    Article  CAS  PubMed  Google Scholar 

  25. Martinez de Aragon MV, Peña-Rey I, Alcalde E, Castellanos T, Villaverde A, Salamanca L, Red Nacional de Vigilancia Epidemiológica. Situación la Varicela en España. 2006. Centro Nacional de Epidemiología. ISCIII. Available at: http://www.isciii.es/ISCIII/es/contenidos/fd-servicios-cientifico-tecnicos/fd-vigilancias-alertas/fd-enfermedades/pdf_2018/InformevaricelaCNE2006.pdf. Last accessed on April 2018

  26. Merino AH (2015) Lactantes con Varicela en el primer año de vida: ¿deben vacunarse después? Mesa Redonda Jornada Comité Asesor de Vacunas. 2015 Marzo 13–14. Murcia. Available at: http://vacunasaep.org/sites/vacunasaep.org/files/M15-4.3-varicela-menor-1-año.pdf. Last accessed on March 2018

  27. Ozaki T, Nagai H, Kimura T, Ichikawa T, Suzuki S, Kito H, Asano Y (1980) The age distribution of neutralizing antibodies against varicella-zoster virus in healthy individuals. Biken J 23:9–14

    CAS  PubMed  Google Scholar 

  28. Pinquier D, Gagneur A, Balu L, Brissaud O, Gras Le GC, Hau-Rainsard I, Mory O, Picherot G, De Pontual L, Stephan JL et al (2009) Prevalence of anti-varicella-zoster virus antibodies in French infants under 15 months of age. Clin Vaccine Immunol 16:484–487

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Pinquier D, Lecuyer A, Levy C, Gagneur A, Pradat P, Soubeyrand B, Grimprel E (2011) Pediatricians Working Group. Inverse correlation between varicella severity and level of anti-Varicella Zoster Virus maternal antibodies in infants below one year of age. Hum Vaccin 7:534–538

    Article  PubMed  Google Scholar 

  30. Red de Vigilancia Epidemiológica Pediátrica de la Asociación Española de Pediatría de Atención Primaria. Available at: https://www.aepap.org/grupos/papenred/biblioteca/estudio-infecciones-precoces-por-el-virus-varicela-zozter. Last accessed on March 2018

  31. Riera-Montes M, Bollaerts K, Heininger U, Hens N, Gabutti G, Gil A, Nozad B, Mirinaviciute G, Flem E, Souverain A, Verstraeten T, Hartwig S (2017) Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization. BMC Infect Dis 17:353

    Article  PubMed  PubMed Central  Google Scholar 

  32. Saez-Llorens X, De SO, De MD, Rubio MP (2002) Complications and costs associated with chickenpox in immunocompetent children. Rev Panam Salud Publica 12:111–116

    Article  PubMed  Google Scholar 

  33. Salleras L, Dominguez A, Vidal J, Plans P, Salleras M, Taberner JL (2000) Seroepidemiology of varicella-zoster virus infection in Catalonia (Spain). Rationale for universal vaccination programmes. Vaccine 19:183–188

    Article  CAS  PubMed  Google Scholar 

  34. Sheikh S, Biundo E, Courcier S, Damm O, Launay O, Maes E, Marcos C, Matthews S, Meijer C, Poscia A, Postma M, Saka O, Szucs T, Begg N (2018) A report on the status of vaccination in Europe. Vaccine 36:4979–4992

    Article  PubMed  Google Scholar 

  35. Turel O, Bakir M, Gonen I, Hatipoglu N, Aydogmus C, Hosaf E, Siraneci R (2013) Children hospitalized for varicella. Complications and cost burden. Value in Health Regional Issues 2:226–230

    Article  PubMed  Google Scholar 

  36. van Lier A, van Erp J, Donker GA, van der Maas NA, Sturkenboom MC, de Melker HE (2014) Low varicella-related consultation rate in the Netherlands in primary care data. Vaccine 32:3517–3524

    Article  PubMed  Google Scholar 

  37. Wagenpfeil S, Neiss A, Banz K, Wutzler P (2004) Empirical data on the varicella situation in Germany for vaccination decisions. Clin Microbiol Infect 10:425–430

    Article  CAS  PubMed  Google Scholar 

  38. Ziebold C, von Kries R, Lang R, Weigl J, Schmitt HJ (2001) Severe complications of varicella in previously healthy children in Germany: a 1-year survey. Pediatrics 108:E79

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This work is the result of a joint effort of collaborating pediatricians and coordinators of the nationwide PAPenRED network, to whom we thank for their selfless efforts in the interests of primary care research. The following is the list of network collaborators for this study: Abad-Balaguer B, Acitores-Suz E, Aguilera-López L, Aizpurua-Galdeano MA, Albaladejo-Beltrán S, Alcaraz-Quiñonero M, Alonso-Bernardo LM, Álvarez-Bueno E, Álvarez de Laviada-Mulero T, Aparicio-Rodrigo M, Arana Cañedo-Argüelles C, Arnal-Alonso JM, Arranz-Sanjuan R, Arroyo-Úbeda R, Asensi-Monzo MT, Astiz-Blanco MI, Ayechu-Díaz A, Balaguer-Martínez JV, Barea-García JJ, Barral-Mena E, Barrios-González EM, Batalla-Fadó L, Bayona-Ferrer I, Bejarano-López MA, Belda-García MT, Benítez-Rubio MR, Bercedo-Sanz A, Bernabé-Moyano MA, Bernad-Usoz JV, Biosca-Pàmies M, Blanco-González J, Blesa-Baviera LC, Bombín-Granado JM, Bonet-Garrosa A, Botana del Arco IM, Botella-Serrano B, Boullosa M, Bravo-Acuña J, Bretón-Peña AI, Burgaleta-Sagaseta AM, Caballero-Morales MA, Cairó-Corominas S, Calavia-Moreno C, Callejas-Pozo JE, Calvo-Lorenzo MT, Canadell-Villaret D, Cantarero-Vallejo MD, Capell-Redondo G, Carballal-Mariño M, Carmona-Cedrés N, Caro-Gómez A, Carrera-Polanco M, Carretero L, Casado-Sánchez ML, Casares-Alonso I, Cascón-Criado E, Casellas de-Asprer A, Casquet-Barceló A, Caubet-Busquet I, Cayuela-Guerrero C, Cerezo del-Olmo Y, Chinarro-Martínez P, Coello-Torres Z, Coto-Fuente MM, de Frutos Gallego E, De la Fuente García MA, De La Fuente Romero DM, De las Heras Díaz-Varela C, Del Castillo Aguas G, Del Toro Calero C, Diaz-Cirujano AI, Díaz-Sánchez A, Diaz-Zaera O, Domínguez-Aurrecoechea B, Duelo-Marcos M, Elorza-Beitia C, Escanciano-Garcia Y, Escribano-Romero MJ, Esparza-Olcina MJ, Espín-Quirante C, Espinazo-Ramos O, Esquivel-Ojeda JN, Fabregat-Ferrer E, Fernández-León A, Fernández-Pastor F, Fernández-Cuesta-Valcarce MA, Ferrándiz-Cerdá B, Flores-Erro U, Fontalva-Ballesteros MB, Galán-Rico J, Galardi-Andonegui MS, Gallego-Iborra A, Garach-Gómez A, Garcés-Sánchez M, García-Mérida MJ, García-Pérez R, García-Rebollar CA, García-Rodríguez AI, García-Santiago M, García-Onieva- Artázcoz M, García-Teresa García E, Garrido-Redondo M, Gil-Alexandres I, Gil-Camarero E, Giménez San Andrés M, Giribet-Folch M, Gómez-Maraver M, Gómez-Sorrigueta P, González-Cortés MV, González-Herrero M, González-Rodríguez MP, González-Valdés S, Gracia-Alfonso MA, Grau-García AI, Gros-Esteban D, Guillot-Roselló B, Gutiérrez-Abad C, Gutiérrez-Blasco J, Gutiérrez-Sigler MD, Heras-Galindo JA, Hernández-Encinas MA, Hernández-Guillén R, Hernández-Ortiz MY, Hernando-Helguero P, Hernando-Zarate Z, Iofrío De Arce A, Iribarren-Udobro I, Iturrioz-Mata A, Jaldo-Jiménez MR, Jaramillo-Hidalgo D, Jiménez-Alés R, Jiménez-Hereza JM, Jové-Naval J, Juanes de Toledo B, Juliá-Benito JC, Labordena-Barceló C, Laso-Murillo P, Ledesma-Albarrán JM, Lobelle-González C, Lobera-Navaz P, López-Alonso R, Lorente-García S, Lorente-García-Mauriño AM, Losa-Frías V, Lupiani-Castellanos P, Marco-Puche A, Marfil-Olink S, Márquez-Moreno MD, Martin-Carballo G, Martin-Delgado MI, Martín LM, Martin-Rial S, Martínez-Moral N, Martínez-Rubio MV, Martínez-Rubio A, Martos-Lozano C, Méndez-Gallego S, Menéndez-BADA T, Menéndez-González N, Mengual-Gil J, Mínguez-Verdejo R, Miranda-Berrioategortúa I, Moneo-Hernández I, Montañés-Sánchez AM, Montes-Peña M, Muñoz-Hiraldo ME, Murcia-García J, Mustieles-Moreno C, Navarro-Cabañas G, Navarro-Quesada FJ, Navas-Heredia CM, Novo-Rodríguez AI, Nuño-Martín F, Ordoñez-Alonso A, Ortells-Ramón I, Padilla-Esteban ML, Padilla-Sánchez MC, Palomares-Gimeno MJ, Palomino-Urda N, Panizo-Santos MB, Parejo-Carranza R, Pavo-Garcia MR, Peix-Sambola MA, Pena-Nieto MJ, Peñarroja-Peirats S, Pérez-Candas JI, Pérez de Saracho Taramona M, Pérez-García I, Pérez-Gavilán J, Pérez-Serrano MJ, Pérez-Tomás RM, Pérez-Vidal MT, Pinilla-Fuentes JA, Polo-Mellado MC, Prado-Muñoz S, Pulido-Bosch MR, Pumarola-Batlle M, Quintanilla-Sánchez M, Ramírez-Gavira RM, Ramos-Zugasti M, Rey del Castillo C, Ribera-Sirvent C, Rico-Marí E, Ripoll-Lozano A, Rivas-Abraldes N, Riveros-Huckstadt MP, Robles-García J, Rodríguez-Delgado J, Rodríguez-Fernández MM, Rodríguez-Fernández-Oliva CR, Rodríguez-Lombardía CA, Rodríguez-Mur P, Rodriguez-Varela A, Rodríguez-López-Márquez GA, Rodríguez-Moldes-Vázquez B, Rodríguez-Salinas-Pérez E, Romero-Reyes C, Ruiz-Chércoles E, Ruiz-Sánchez JF, Ruiz-Canela-Cáceres J, Ruiz-Cuevas-Garcias P, Saenz de Urturi-Sánchez A, Sáez De Lafuente-Arriazu A, Salvá-Siquier A, Sanantonio-Valdearcos F, Sánchez-Andrada RM, Sánchez-Calderón M, Sánchez-Cordero N, Sánchez-Diaz MD, Sánchez-Echenique M, Sánchez-Fuentes V, Sánchez-García Monge MC, Sánchez-González B, Sánchez-Jiménez MC, Sánchez-Pina C, Sánchez-Precioso S, Sancho-Madrid B, Satrústegui-Gamboa F, Segovia-Ferrera C, Seijas-Vázquez L, Serna-Saugar MC, Serrano-Gómez ML, Servera-Ginard CI, Somoza-Martín M, Soriano-Faura J, Suárez-Vicent E, Surribas-Murillo C, Torres Álvarez de Arcaya ML, Úbeda-Sansano I, Valdivia-Jiménez C, Valls-Durán T, Vaquerizo-Pollino MJ, Vega-Pérez MS, Velasco-Guijarro O, Vera-Domínguez MI, Viar-Urieta M, Vigueras-Abellán JJ, Vila-Alonso M, Vila-Buch G, Vílchez-Pérez JS, Villafruela-Álvarez C, Villaizán-Pérez C, Villar-Fernández MD, Viudes de Velasco A, and Viver-Gómez S.

Also, we thank an anonymous referee for comments that help in improving the understanding of the results put forward in this work.

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Authors and Affiliations

  1. Primary health care El Calero, Servicio Canario de Salud, Las Palmas, Spain

    Yessica Rodriguez-Santana

  2. Primary health care La Guancha-San Juan de la Rambla, Servicio Canario de Salud, Santa Cruz de Tenerife, Spain

    Elena Sanchez-Almeida

  3. Primary health care José Ramón Muñoz Fernández, Servicio Aragonés de Salud, Zaragoza, Spain

    Cesar Garcia-Vera

  4. Hospital Universitario Infantil Miguel Servet, Zaragoza, Spain

    Maria Garcia-Ventura

  5. Primary health care Miralbueno, Servicio Aragonés de Salud, Zaragoza, Spain

    Laura Martinez-Espligares

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  1. Yessica Rodriguez-Santana
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  2. Elena Sanchez-Almeida
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  3. Cesar Garcia-Vera
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  4. Maria Garcia-Ventura
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  5. Laura Martinez-Espligares
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Consortia

PAPenRED

  • B. Abad-Balaguer
  • , E. Acitores-Suz
  • , L. Aguilera-López
  • , M. A. Aizpurua-Galdeano
  • , S. Albaladejo-Beltrán
  • , M. Alcaraz-Quiñonero
  • , L. M. Alonso-Bernardo
  • , E. Álvarez-Bueno
  • , T. Álvarez de Laviada-Mulero
  • , M. Aparicio-Rodrigo
  • , C. Arana Cañedo-Argüelles
  • , J. M. Arnal-Alonso
  • , R. Arranz-Sanjuan
  • , R. Arroyo-Úbeda
  • , M. T. Asensi-Monzo
  • , M. I. Astiz-Blanco
  • , A. Ayechu-Díaz
  • , J. V. Balaguer-Martínez
  • , J. J. Barea-García
  • , E. Barral-Mena
  • , E. M. Barrios-González
  • , L. Batalla-Fadó
  • , I. Bayona-Ferrer
  • , M. A. Bejarano-López
  • , M. T. Belda-García
  • , M. R. Benítez-Rubio
  • , A. Bercedo-Sanz
  • , M. A. Bernabé-Moyano
  • , J. V. Bernad-Usoz
  • , M. Biosca-Pàmies
  • , J. Blanco-González
  • , L. C. Blesa-Baviera
  • , J. M. Bombín-Granado
  • , A. Bonet-Garrosa
  • , I. M. Botana del Arco
  • , B. Botella-Serrano
  • , M. Boullosa
  • , J. Bravo-Acuña
  • , A. I. Bretón-Peña
  • , A. M. Burgaleta-Sagaseta
  • , M. A. Caballero-Morales
  • , S. Cairó-Corominas
  • , C. Calavia-Moreno
  • , J. E. Callejas-Pozo
  • , M. T. Calvo-Lorenzo
  • , D. Canadell-Villaret
  • , M. D. Cantarero-Vallejo
  • , G. Capell-Redondo
  • , M. Carballal-Mariño
  • , N. Carmona-Cedrés
  • , A. Caro-Gómez
  • , M. Carrera-Polanco
  • , L. Carretero-Carretero
  • , M. L. Casado-Sánchez
  • , I. Casares-Alonso
  • , E. Cascón-Criado
  • , A. Casellas de-Asprer
  • , A. Casquet-Barceló
  • , I. Caubet-Busquet
  • , C. Cayuela-Guerrero
  • , Y. Cerezo del-Olmo
  • , P. Chinarro-Martínez
  • , Z. Coello-Torres
  • , M. M. Coto-Fuente
  • , E. de Frutos Gallego
  • , M. A. De la Fuente Garcias
  • , D. M. De La Fuente Romero
  • , C. De las Heras Díaz-Varela
  • , G. Del Castillo Aguas
  • , C. Del Toro Calero
  • , A. I. Diaz-Cirujano
  • , A. Díaz-Sánchez
  • , O. Diaz-Zaera
  • , B. Domínguez-Aurrecoechea
  • , M. Duelo-Marcos
  • , C. Elorza-Beitia
  • , Y. Escanciano-Garcia
  • , M. J. Escribano-Romero
  • , M. J. Esparza-Olcina
  • , C. Espín-Quirante
  • , O. Espinazo-Ramos
  • , J. N. Esquivel-Ojeda
  • , E. Fabregat-Ferrer
  • , A. Fernández-León
  • , F. Fernández-Pastor
  • , M. A. Fernández-Cuesta-Valcarce
  • , B. Ferrándiz-Cerdá
  • , U. Flores-Erro
  • , M. B. Fontalva-Ballesteros
  • , J. Galán-Rico
  • , M. S. Galardi-Andonegui
  • , A. Gallego-Iborra
  • , A. Garach-Gómez
  • , M. Garcés-Sánchez
  • , M. J. García-Mérida
  • , R. García-Pérez
  • , C. A. García-Rebollar
  • , A. I. García-Rodríguez
  • , M. García-Santiago
  • , M. García-Onieva-Artázcoz
  • , E. García-Teresa García
  • , M. Garrido-Redondo
  • , I. Gil-Alexandres
  • , E. Gil-Camarero
  • , M. Giménez San Andrés
  • , M. Giribet-Folch
  • , M. Gómez-Maraver
  • , P. Gómez-Sorrigueta
  • , M. V. González-Cortés
  • , M. González-Herrero
  • , M. P. González-Rodríguez
  • , S. González-Valdés
  • , M. A. Gracia-Alfonso
  • , A. I. Grau-García
  • , D. Gros-Esteban
  • , B. Guillot-Roselló
  • , C. Gutiérrez-Abad
  • , J. Gutiérrez-Blasco
  • , M. D. Gutiérrez-Sigler
  • , J. A. Heras-Galindo
  • , M. A. Hernández-Encinas
  • , R. Hernández-Guillén
  • , M. Y. Hernández-Ortiz
  • , P. Hernando-Helguero
  • , Z. Hernando-Zarate
  • , A. Iofrío De Arce
  • , I. Iribarren-Udobro
  • , A. Iturrioz-Mata
  • , M. R. Jaldo-Jiménez
  • , D. Jaramillo-Hidalgo
  • , R. Jiménez-Alés
  • , J. M. Jiménez-Hereza
  • , J. Jové-Naval
  • , B. Juanes de Toledo
  • , J. C. Juliá-Benito
  • , C. Labordena-Barceló
  • , P. Laso-Murillo
  • , J. M. Ledesma-Albarrán
  • , C. Lobelle-González
  • , P. Lobera-Navaz
  • , R. López-Alonso
  • , S. Lorente-García
  • , A. M. Lorente-García-Mauriño
  • , V. Losa-Frías
  • , P. Lupiani-Castellanos
  • , A. Marco-Puche
  • , S. Marfil-Olink
  • , M. D. Márquez-Moreno
  • , G. Martin-Carballo
  • , M. I. Martin-Delgado
  • , L. M. Martín-Martín
  • , S. Martin-Rial
  • , N. Martínez-Moral
  • , M. V. Martínez-Rubio
  • , A. Martínez-Rubio
  • , C. Martos-Lozano
  • , S. Méndez-Gallego
  • , B. A. D. A. T. Menéndez
  • , N. Menéndez-González
  • , J. Mengual-Gil
  • , R. Mínguez-Verdejo
  • , I. Miranda-Berrioategortúa
  • , I. Moneo-Hernández
  • , A. M. Montañés-Sánchez
  • , M. Montes-Peña
  • , M. E. Muñoz-Hiraldo
  • , J. Murcia-García
  • , C. Mustieles-Moreno
  • , G. Navarro-Cabañas
  • , F. J. Navarro-Quesada
  • , C. M. Navas-Heredia
  • , A. I. Novo-Rodríguez
  • , F. Nuño-Martín
  • , A. Ordoñez-Alonso
  • , I. Ortells-Ramón
  • , M. L. Padilla-Esteban
  • , M. C. Padilla-Sánchez
  • , M. J. Palomares-Gimeno
  • , N. Palomino-Urda
  • , M. B. Panizo-Santos
  • , R. Parejo-Carranza
  • , M. R. Pavo-Garcia
  • , M. A. Peix-Sambola
  • , M. J. Pena-Nieto
  • , S. Peñarroja-Peirats
  • , J. I. Pérez-Candas
  • , M. Pérez de Saracho Taramona
  • , I. Pérez-García
  • , J. Pérez-Gavilán
  • , M. J. Pérez-Serrano
  • , R. M. Pérez-Tomás
  • , M. T. Pérez-Vidal
  • , J. A. Pinilla-Fuentes
  • , M. C. Polo-Mellado
  • , S. Prado-Muñoz
  • , M. R. Pulido-Bosch
  • , M. Pumarola-Batlle
  • , M. Quintanilla-Sánchez
  • , R. M. Ramírez-Gavira
  • , M. Ramos-Zugasti
  • , C. Rey del Castillo
  • , C. Ribera-Sirvent
  • , E. Rico-Marí
  • , A. Ripoll-Lozano
  • , N. Rivas-Abraldes
  • , M. P. Riveros-Huckstadt
  • , J. Robles-García
  • , J. Rodríguez-Delgado
  • , M. M. Rodríguez-Fernández
  • , C. R. Rodríguez-Fernández-Oliva
  • , C. A. Rodríguez-Lombardía
  • , P. Rodríguez-Mur
  • , A. Rodriguez-Varela
  • , G. A. Rodríguez-López-Márquez
  • , B. Rodríguez-Moldes-Vázquez
  • , E. Rodríguez-Salinas-Pérez
  • , C. Romero-Reyes
  • , E. Ruiz-Chércoles
  • , J. F. Ruiz-Sánchez
  • , J. Ruiz-Canela-Cáceres
  • , P. Ruiz-Cuevas-García
  • , A. Saenz de Urturi-Sánchez
  • , A. Sáez De Lafuente-Arriazu
  • , A. Salvá-Siquier
  • , F. Sanantonio-Valdearcos
  • , R. M. Sánchez-Andrada
  • , M. Sánchez-Calderón
  • , N. Sánchez-Cordero
  • , M. D. Sánchez-Diaz
  • , M. Sánchez-Echenique
  • , V. Sánchez-Fuentes
  • , M. C. Sánchez-García Monge
  • , B. Sánchez-González
  • , M. C. Sánchez-Jiménez
  • , C. Sánchez-Pina
  • , S. Sánchez-Precioso
  • , B. Sancho-Madrid
  • , F. Satrústegui-Gamboa
  • , C. Segovia-Ferrera
  • , L. Seijas-Vázquez
  • , M. C. Serna-Saugar
  • , M. L. Serrano-Gómez
  • , C. I. Servera-Ginard
  • , M. Somoza-Martín
  • , J. Soriano-Faura
  • , E. Suárez-Vicent
  • , C. Surribas-Murillo
  • , M. L. Torres Álvarez de Arcaya
  • , I. Úbeda-Sansano
  • , C. Valdivia-Jiménez
  • , T. Valls-Durán
  • , M. J. Vaquerizo-Pollino
  • , M. S. Vega-Pérez
  • , O. Velasco-Guijarro
  • , M. I. Vera-Domínguez
  • , M. Viar-Urieta
  • , J. J. Vigueras-Abellán
  • , M. Vila-Alonso
  • , G. Vila-Buch
  • , J. S. Vílchez-Pérez
  • , C. Villafruela-Alvarez
  • , C. Villaizán-Pérez
  • , M. D. Villar-Fernández
  • , A. Viudes de Velasco
  •  & S. Viver-Gómez

Contributions

Y. Rodríguez Santana and E. Sánchez Almeida contributed to the data compilation, interpretation of the findings, writing and reviewing the article, and the final approval of the presented version. C. García Vera contributed to the conception, design and coordination of the study, data analysis, interpretation of the findings, a critical review of the article, and the final approval of the presented version. M. García Ventura contributed to data processing and analysis and the final approval of the submitted version. L Martínez Espligares contributed to the conception, design, data analysis, and interpretation, and had ultimate responsibility for the final manuscript and its approval as presented.

Corresponding author

Correspondence to Yessica Rodriguez-Santana.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical considerations

The PAPenRED project as a whole has obtained the approval of the Aragon Ethics and Scientific Research Committee (Favorable Ruling, Act No. 19/2013, C.P.-C.I. PI13 / 00154). An information sheet was provided for the parents/legal guardians of the children participating in the study and informed consent was signed for the use of data. To ensure the appropriate patient anonymity, the data was codified so that only the patient’s own pediatrician could know their identity.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Communicated by Nicole Ritz

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Rodriguez-Santana, Y., Sanchez-Almeida, E., Garcia-Vera, C. et al. Epidemiological and clinical characteristics and the approach to infant chickenpox in primary care. Eur J Pediatr 178, 641–648 (2019). https://doi.org/10.1007/s00431-019-03332-9

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