Pediatric Hospitalization for Varicella in an Italian Pediatric Hospital: How Much Does It Cost?

Background: Varicella is a common pediatric infection. Even if it generally has a benign course, it may complicate and require hospitalization. The aim of our study was to estimate the acute hospitalization cost (AHC) for varicella in the acute phase in a pediatric population. Methods: We calculated the AHC of pediatric patients admitted for varicella at Bambino Gesù Children Hospital, Rome, Italy, from 1 November 2005 to 1 November 2020. Results: In the study period, 825 pediatric patients affected by varicella were hospitalized. The mean hospitalization cost was EUR 4015.35 (range from EUR 558.44 to EUR 42,608.00). Among patients, 55% were unvaccinable due to either their age or their immunosuppression status. They would benefit from herd immunity, reducing the overall AHC by EUR 182,196,506. Since the introduction of the compulsory vaccination against varicella in Italy, we observed a significant reduction in AHC cost of 60.6% in 2019 and of 93.5% in 2020. Finally, from the beginning of the COVID-19 pandemic, we documented a decline of 81.2% and 76.9% in varicella hospitalization, compared to 2018 and 2019, respectively. Conclusions: Varicella AHC is an important economic and health assessment point and can be useful for improving preventive strategies.

What’s New With the Old Coronaviruses?

Coronaviruses contribute to the burden of respiratory diseases in children, frequently manifesting in upper respiratory symptoms considered to be part of the “common cold.” Recent epidemics of novel coronaviruses recognized in the 21st century have highlighted issues of zoonotic origins of transmissible respiratory viruses and potential transmission, disease, and mortality related to these viruses. In this review, we discuss what is known about the virology, epidemiology, and disease associated with pediatric infection with the common community-acquired human coronaviruses, including species 229E, OC43, NL63, and HKU1, and the coronaviruses responsible for past world-wide epidemics due to severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus.

Management of Hospital Visitors

Policies and practices regarding management of visitors vary by hospital system. Current guidance from the Society for Healthcare Epidemiology (SHEA) suggests that practices should be based on (a) the pathogen suspected or confirmed, (b) the underlying medical condition of the patient and the visitor, and (c) the endemicity of that pathogen in the hospital and surrounding community—distinguishing between outbreak and non-outbreak settings. Pediatric infection prevention strategies should strive to balance family centered care with policies that minimize the risk of acquiring or transmitting pathogens. This chapter provides guidance on managing hospital visitors when a child’s infection requires isolation precautions. Age-based visitor restriction policies are reviewed. This chapter also includes discussion about high-consequence pathogens such as Ebola virus.

Handbook of Pediatric Infection Prevention and Control

In the fields of healthcare epidemiology and infection prevention, evidence to guide pediatric practice has been lacking for quite some time. However, in the past few decades, more and more pediatric clinicians, researchers, epidemiologists, and infection preventionists have been contributing to this important field. This textbook discusses topics that pediatric providers must tackle in many settings: in ambulatory clinics, emergency departments, community hospitals, and freestanding university children’s hospitals. Each chapter opens with a clinical scenario (perhaps you have dealt with a few of these scenarios in real life), and follows with questions that are frequently raised when a solution is sought.