We report an outbreak of varicella in a residential home for 29 children(aged 4 to 16 years) with severe physical and learning disability. We report our group's incidence, complication and hospitalisation rate of varicella despite anti-viral therapy. As we did not have a control group we use statistics pertaining to the general population for comparison. All 15 non-immune children contracted varicella within 30 days of the index case. The complication rate was 9 in 15, three time higher than in the general population. The hospitalisation rate was 5 in 15. This is remarkably high. The incidence of hospitalisation in the general population is 1 to 5 per 1,000. In conclusion we suggest that the guidelines for varicella vaccination should include all non-immune children and adults with severe to profound physical and learning disability. We recommend that this disease should be notifiable in the severely physically disabled population. We recommend that within 3 days of exposure to varicella children with severe to profound physical and learning disability are vaccinated to prevent infection (post exposure prophylaxis). These findings are important in countries where varicella vaccination is not part of the routine vaccination program and is not part of the routine vaccination program and is only offered to select groups of children.
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