Case 3

2020 ◽  
pp. 14-18
Author(s):  
Andrew Woodhouse
Keyword(s):  
Varicella Zoster Virus ◽  
Immune Globulin ◽  
Passive Immunization ◽  
Evidence Base ◽  
Drug Levels ◽  
Varicella Zoster ◽  
Intravenous Treatment ◽  
Varicella Pneumonia

Chickenpox is caused by varicella-zoster virus and is predominantly a self-limiting disease of childhood. Chickenpox in adults is more likely to be associated with complications such as varicella pneumonia. Treatment with antivirals is helpful in adults if given early after the onset of rash in uncomplicated disease. In complicated disease such as pneumonia, intravenous treatment is essential to optimize drug levels although an evidence base for this is lacking. Exposure to varicella during pregnancy is a particular concern for non-immune women and passive immunization with varicella immune globulin is indicated.

Letter To The Editor

PEDIATRICS ◽  
1979 ◽  
Vol 63 (2) ◽  
pp. 348-348
Author(s):  
C. Henry Kempe ◽  
Anne A. Gershon
Keyword(s):  
High Risk ◽  
Varicella Zoster Virus ◽  
No Value ◽  
Immune Globulin ◽  
Passive Immunization ◽  
Practical Method ◽  
Active Immunization ◽  
Varicella Zoster ◽  
Hyperimmune Globulin ◽  
High Risk Children

The studies of Zaia et al demonstrating a practical method for preparation of hyperimmune globulin, varicella-zoster immune globulin (VZIG), for passive immunization against varicella are encouraging. Consequently, in the future, it should be possible to obtain VZIG for high-risk children who have known exposures to varicella-zoster virus. However, we believe that history has demonstrated that passive immunization is rarely a substitute for active immunization, and varicella is no exception to this rule. Passive immunization will be of no value if (1) persons are unaware that they were exposed or (2) they wait too long after exposure before notifying their physician.

Varicella zoster virus antibody titers after intravenous zoster immune globulin in neonates, and the safety of this preparation

2005 ◽  
Vol 94 (6) ◽  
pp. 790-793 ◽  
Author(s):  
Teresa Murguía-de-Sierra ◽  
Mónica Villa-Guillén ◽  
Dina Villanueva-García ◽  
Antide Molina ◽  
Alejandra Juárez-Chávez ◽  
...  
Keyword(s):  
Varicella Zoster Virus ◽  
Immune Globulin ◽  
Virus Antibody ◽  
Varicella Zoster ◽  
Antibody Titers

scholarly journals Antibody to varicella-zoster virus after passive immunization against chickenpox

1978 ◽  
Vol 8 (6) ◽  
pp. 733-735
Author(s):  
A A Gershon ◽  
S Piomelli ◽  
M Karpatkin ◽  
E Smithwick ◽  
S Steinberg
Keyword(s):  
High Risk ◽  
Varicella Zoster Virus ◽  
Geometric Mean ◽  
Passive Immunization ◽  
Immune Serum ◽  
Immune Serum Globulin ◽  
Serum Globulin ◽  
Varicella Zoster ◽  
Antibody Titers ◽  
Immunofluorescence Antibody

Antibody titers to varicella-zoster virus were measured in varicella-susceptible immunocompromised children 48 h after they received either one of two lots of zoster immune globulin (ZIG) or a selected lot of immune serum globulin (ISG). Globulin was given to modify varicella in these children after exposure to varicella or zoster. Indirect immunofluorescence antibody titers (FAMA) of children after receipt of globulin ranged from less than 1:2 to 1:32. Geometric mean FAMA titers were highest after 1.2 ml of ISG per kg (FAMA titer 1:128) and 0.16 ml of ZIG lot A per kg (FAMA titer 1:1,024). Selected batches of ISG titering 1:128 or greater by FAMA, at a dose of 1.2 ml/kg, may be used to attempt to modify varicella in susceptible high-risk individuals when ZIG is not available.

Varicella in Children With Cancer: Impact of Antiviral Therapy and Prophylaxis

PEDIATRICS ◽  
1987 ◽  
Vol 80 (4) ◽  
pp. 465-472
Author(s):  
Sandor Feldman ◽  
Lennie Loft
Keyword(s):  
Mortality Rate ◽  
Acute Leukemia ◽  
Varicella Zoster Virus ◽  
Antiviral Therapy ◽  
Passive Immunization ◽  
Skin Lesions ◽  
Children With Cancer ◽  
Varicella Zoster ◽  
Adenine Arabinoside ◽  
The Impact

To estimate the impact of antiviral therapy and prophylaxis on the natural course of the infection, 288 cases of varicella in children with cancer were reviewed. Among 127 patients with untreated infections, the overall mortality rate was 7%. Varicella-zoster virus pneumonitis developed in 28% of the untreated patients and was associated with a 25% mortality rate. Pneumonitis was much more likely to develop in patients with acute leukemia than in those with other malignancies (32% v 19%). Similarly, deaths due to pneumonitis were restricted to patients with acute leukemia. Lymphopenia (absolute lymphocyte count <500/µL) was significantly associated with varicella-zoster virus pneumonitis and a higher fatality rate among patients with this complication. Both acyclovir and adenine arabinoside, administered to 18 and 28 patients, respectively, stopped the progression of skin lesions; however, pneumonitis developed in none of the acyclovir recipients after two days of treatment, compared with 29% of the adenine arabinoside recipients (P = .03). Passive immunization in 45 children who subsequently had varicella was associated with an 11% incidence of varicella-zoster virus pneumonitis. Despite passive immunization of approximately 150 children, the attack rate of varicella at our institution remains unchanged. Results of this study demonstrate the efficacy of antiviral therapy and passive immunization in patients with childhood cancer and varicella, but prevention of the infection will require a universal vaccine.

Varicella zoster virus antibody titers after intravenous zoster immune globulin in neonates, and the safety of this preparation

2007 ◽  
Vol 94 (6) ◽  
pp. 790-793 ◽  
Author(s):  
Teresa Murguía-de-Sierra ◽  
Mónica Villa-Guillén ◽  
Dina Villanueva-García ◽  
Antide Molina ◽  
Alejandra Juárez-Chávez ◽  
...  
Keyword(s):  
Varicella Zoster Virus ◽  
Immune Globulin ◽  
Virus Antibody ◽  
Varicella Zoster ◽  
Antibody Titers

scholarly journals Adjuvant treatment of severe varicella pneumonia with intravenous varicella zoster virus-specific immunoglobulins

2019 ◽  
Vol 85 ◽  
pp. 70-73 ◽  
Author(s):  
Davide Mangioni ◽  
Giacomo Grasselli ◽  
Chiara Abbruzzese ◽  
Antonio Muscatello ◽  
Andrea Gori ◽  
...  
Keyword(s):  
Varicella Zoster Virus ◽  
Adjuvant Treatment ◽  
Varicella Zoster ◽  
Varicella Pneumonia

Varicella Vaccine

PEDIATRICS ◽  
1979 ◽  
Vol 63 (2) ◽  
pp. 348-348
Author(s):  
John A. Zaia ◽  
Myron J. Levin
Keyword(s):  
Varicella Zoster Virus ◽  
Immune Globulin ◽  
Varicella Vaccine ◽  
Normal Blood ◽  
Foreseeable Future ◽  
Varicella Zoster

Kempe and Gershon in a commentary on the varicella vaccine (Pediatrics 60:930, December 1977) enumerate the factors that might influence the development of such a vaccine. They state that zoster immune globulin (ZIG), which can modify chickenpox in susceptible immunosuppressed children exposed to the varicella-zoster virus, is often not available. However, we wish to point out that varicella-zoster immune globulin (VZIG) has now been prepared from selected outdated normal blood in quantities that could meet the needs of these children in the foreseeable future.1

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