Varicella infection in the Middle East: Prevalence, complications, and vaccination

Varicella (chickenpox) is the primary infection of varicella‑zoster virus (VZV), it is a mild self‑limiting infection, but it is also highly contagious and can cause severe complications among high‑risk group of individuals. It is usually a childhood infection providing lifelong immunity, but adults without varicella history are also susceptible to infection. High‑risk group of individuals is more likely to develop serious complications. Varicella vaccine was introduced to protect this group of individuals and to prevent epidemic spread of VZV infection in a community. Thus, it was added to the recommended vaccination schedules for children in most developed countries. This review aimed to outline varicella status, seroprevalence, complications, and vaccination in the Middle East region. Based on our findings, children were the most affected age group, but there are also adult cases due to high number of expatriates, especially in Gulf Cooperation Council countries. Central nervous system involvements and skin diseases followed by varicella pneumonia were the most varicella‑associated complications. Varicella vaccine was introduced in most Middle East countries, either mandatory by the Ministries of Health or optional in the private clinics. Few numbers of studies have reported an obvious reduction in varicella prevalence, hospitalizations, and deaths in the Middle East following varicella vaccination. A basic database about varicella infection before the initiation and implementation of a vaccination policy is essential to determine the target group of individuals. As far as our knowledge, this is the first review about varicella infection in the Middle East.