The authors developed 30 recommendations, 17 on starting DMTs, 10 on switching DMTs in case of breakthrough disease
, and three on stopping DMTs.
Varicella outbreaks involve both infections in unvaccinated children and "breakthrough disease
" in those who have been vaccinated.
Although penicillin prophylaxis and pneumococcal polysaccharide vaccine have decreased the rate of invasive pneumococcal disease (IPD) in this high-risk population, breakthrough disease
still occurs--most commonly among children younger than 3 years--and IPD continues to be a leading cause of death in children with SCD, the researchers explained.
Four published studies have also documented an increase in breakthrough disease
On December 11, MDCH and Oakland County public health epidemiologists, with the technical assistance of CDC, conducted a retrospective cohort study to describe the outbreak, determine varicella vaccine effectiveness (VE), and examine risk factors for breakthrough disease
(i.e., varicella occurring >42 days after vaccination).
SURPASS is expected to enroll 1,800 patients in 27 countries and provide direct comparative data of different treatment options for RRMS patients who experience breakthrough disease
The study, called SURPASS, is expected to enroll 1,800 patients in 27 countries and provide direct comparative data of different treatment options for RRMS patients who experience breakthrough disease
McFarland said a health maintenance organization study found that inhaled steroids given 3 months prior to VZV vaccination were not associated with increased risk of breakthrough disease
(Pediatrics 2003;112:e98-e113), but the study did find increased breakthrough disease
after VZV vaccination when oral steroids were given in the 3 months prior.
To identify breakthrough disease
, clinic and hospital discharge records from both HMOs were screened for having the same International Classification of Diseases, Ninth Revision, (ICD-9) codes (*) for varicella.
Reports of outbreaks of mild cases of chickenpox among immunized children in child care centers led to studies showing that breakthrough cases of disease after vaccination occur in about 15% of children exposed to the wild-type virus, although breakthrough disease
usually produces fewer than 50 lesions; is less severe; and, generally, is half as contagious as natural chickenpox.
In some ongoing studies, children who have received two doses of vaccine have been protected from breakthrough disease
This showed that breakthrough disease
can be highly infectious, Dr.