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Introduction <p>In the absence of a national varicella vaccine program, it is assumed that the annual proportion of children in Denmark acquiring a varicella infection (chickenpox) corresponds to the birth cohort size, approximately 60,000 per year. Varicella infections impose a burden on families and increase healthcare utilization. Previous studies have estimated the disease burden of severe varicella cases requiring hospitalization. However, information about the burden of mild-to-moderate varicella cases is scarce. We aim to provide insights into the burden of mild-to-moderate varicella cases at the community level.</p> Method <p>We utilized data from the non-emergency medical helpline (1813 helpline) and national hospital admission register to provide adjusted estimates of the burden of moderate varicella cases at the community level among children (&lt; 18&#xa0;years) in Denmark from 2015 to 2023, applying time series regression analysis to counteract underreporting in the 1813 helpline.</p> Results <p>We estimated that 20,439 (95%&#xa0;CI 17,378–23,501) calls to the 1813 helpline were attributed to varicella infections (VZV-associated calls), a 103.1% additional proportion to the 10,068 calls documented in the call notes. The average yearly number of VZV-associated calls was 2271 calls. When correcting for irregular patterns of infection during the COVID-19 pandemic, the average yearly estimated number of VZV-associated calls was 2561. In the first 6&#xa0;months of 2023, we estimated 2552 calls (95%&#xa0;CI 2170–2934). The overall incidence of VZV-associated calls is 623 per 100,000 person-years (95%&#xa0;CI 529.49–716.06), with annual incidence ranging from 291 in 2021 to 910 in 2017.</p> Conclusion <p>The 1813 helpline calls attributed to varicella were double the numbers reported previously in the call notes, indicating a larger impact of mild-to-moderate cases on healthcare services than initially thought. This highlights the importance of addressing challenges with varicella infection burden estimates and adds considerably to the burden of mild-to-moderate cases of varicella on a community level.</p>

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Estimating the Burden of Mild-to-Moderate Varicella-Related Infections by Medical Helpline Usage: A Time Series Analysis from 2015 to 2023 Among Children in Denmark

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  • 发表日期：

    2025年9月13日

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  • Amanda Marie Egeskov-Cavling,
  • Caroline Klint Johannesen,
  • Omid Rezahosseini,
  • Mads Frederik Eiberg,
  • Anja Poulsen,
  • Fredrik Folke,
  • Thea K. Fischer

摘要

Introduction

In the absence of a national varicella vaccine program, it is assumed that the annual proportion of children in Denmark acquiring a varicella infection (chickenpox) corresponds to the birth cohort size, approximately 60,000 per year. Varicella infections impose a burden on families and increase healthcare utilization. Previous studies have estimated the disease burden of severe varicella cases requiring hospitalization. However, information about the burden of mild-to-moderate varicella cases is scarce. We aim to provide insights into the burden of mild-to-moderate varicella cases at the community level.

Method

We utilized data from the non-emergency medical helpline (1813 helpline) and national hospital admission register to provide adjusted estimates of the burden of moderate varicella cases at the community level among children (< 18 years) in Denmark from 2015 to 2023, applying time series regression analysis to counteract underreporting in the 1813 helpline.

Results

We estimated that 20,439 (95% CI 17,378–23,501) calls to the 1813 helpline were attributed to varicella infections (VZV-associated calls), a 103.1% additional proportion to the 10,068 calls documented in the call notes. The average yearly number of VZV-associated calls was 2271 calls. When correcting for irregular patterns of infection during the COVID-19 pandemic, the average yearly estimated number of VZV-associated calls was 2561. In the first 6 months of 2023, we estimated 2552 calls (95% CI 2170–2934). The overall incidence of VZV-associated calls is 623 per 100,000 person-years (95% CI 529.49–716.06), with annual incidence ranging from 291 in 2021 to 910 in 2017.

Conclusion

The 1813 helpline calls attributed to varicella were double the numbers reported previously in the call notes, indicating a larger impact of mild-to-moderate cases on healthcare services than initially thought. This highlights the importance of addressing challenges with varicella infection burden estimates and adds considerably to the burden of mild-to-moderate cases of varicella on a community level.