Deaths from chickenpox

# Deaths from chickenpox in adults are decreasing {#article-title-2} EDITOR—On the basis of death certificates from the Office for National Statistics from 1995 to 1997, Rawson et al conclude that deaths as a result of chickenpox are increasing in adults in England and Wales.1 More up to date figures from the Office for National Statistics, however, show that chickenpox mortality is decreasing in adults (from 32 deaths in 1996 to 18 in 2000—see figure (a)). Furthermore, the number of deaths from chickenpox and case fatality rates were significantly higher in 1995-7 (period of the analysis) than at any other period. The claim by Rawson et al that deaths in adults are rising is therefore misleading. Deaths from chickenpox (a) and annual consultation rate for chickenpox (b) in England and Wales, 1981-2000 The change in age related varicella mortality is the result of a shift in the age distribution of infection. Over the past two decades there has been an increase in cases in the youngest age group (possibly due to greater attendance of day-care).2–4 Over the same time period there has been a gradual increase in reported incidence in adults, which peaked in the late 1980s and has been falling since (figure (b)). This is broadly reflected in the gradual decrease in deaths in adults during the past decade. The exception to this trend are 1996 and 1997—exactly the time period when Rawson et al performed their study. What has caused these large shifts in the incidence of varicella in adults is still largely unexplained. 1. 1.↵1. Rawson H, 2. Crampin A, 3. Noah N . Deaths from chickenpox in England and Wales 1995–7: analysis of routine mortality data. BMJ 2001; 323: 1091–1093. (10 November.) [OpenUrl][1][Abstract/FREE Full Text][2] 2. 2.↵1. Fairley CK, 2. Miller E . Varicella-zoster virus epidemiology—a changing scene? J Infect Dis 1996; 174(Suppl 3):S314–S319. 3. 3.1. Ross AM, 2. Fleming DM . Chickenpox increasingly affects preschool children. Commun Dis Public Health 2000; 3: 213–215. [OpenUrl][3][PubMed][4] 4. 4.↵1. Brisson M, 2. Edmunds WJ, 3. Law B, 4. Gay NJ, 5. Walld R, 6. Brownell M, 7. et al . Epidemiology of varicella zoster virus infection in Canada and the United Kingdom. Epidemiol Infect 2001; 127: 305–314. [OpenUrl][5][PubMed][6][Web of Science][7] # Epidemiology of chickenpox in United Kingdom needs further investigation {#article-title-7} EDITOR—Rawson et al highlight the … [1]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.aulast%253DRawson%26rft.auinit1%253DH.%26rft.volume%253D323%26rft.issue%253D7321%26rft.spage%253D1091%26rft.epage%253D1093%26rft.atitle%253DDeaths%2Bfrom%2Bchickenpox%2Bin%2BEngland%2Band%2BWales%2B1995-7%253A%2Banalysis%2Bof%2Broutine%2Bmortality%2Bdata%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fbmj.323.7321.1091%26rft_id%253Dinfo%253Apmid%252F11701571%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=bmj&resid=323/7321/1091&atom=%2Fbmj%2F324%2F7337%2F609.2.atom [3]: {openurl}?query=rft.jtitle%253DCommunicable%2Bdisease%2Band%2Bpublic%2Bhealth%2B%252F%2BPHLS%26rft.stitle%253DCommun%2BDis%2BPublic%2BHealth%26rft.aulast%253DRoss%26rft.auinit1%253DA.%2BM.%26rft.volume%253D3%26rft.issue%253D3%26rft.spage%253D213%26rft.epage%253D215%26rft.atitle%253DChickenpox%2Bincreasingly%2Baffects%2Bpreschool%2Bchildren.%26rft_id%253Dinfo%253Apmid%252F11014039%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [4]: /lookup/external-ref?access_num=11014039&link_type=MED&atom=%2Fbmj%2F324%2F7337%2F609.2.atom [5]: {openurl}?query=rft.jtitle%253DEpidemiology%2Band%2BInfection%2B%2528Print%2529%26rft.stitle%253DEpidemiology%2Band%2BInfection%2B%2528Print%2529%26rft.aulast%253DBrisson%26rft.auinit1%253DM.%26rft.volume%253D127%26rft.issue%253D2%26rft.spage%253D305%26rft.epage%253D314%26rft.atitle%253DEpidemiology%2Bof%2Bvaricella%2Bzoster%2Bvirus%2Binfection%2Bin%2BCanada%2Band%2Bthe%2BUnited%2BKingdom.%26rft_id%253Dinfo%253Apmid%252F11693508%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [6]: /lookup/external-ref?access_num=11693508&link_type=MED&atom=%2Fbmj%2F324%2F7337%2F609.2.atom [7]: /lookup/external-ref?access_num=000172246300015&link_type=ISI