scholarly journals Varicella Vaccine Meningitis as a Complication of Herpes Zoster in Twice-Immunized Immunocompetent Adolescents

2020 ◽  
Vol 35 (13) ◽  
pp. 889-895 ◽  
Author(s):  
Veena Ramachandran ◽  
Stephen C. Elliott ◽  
Kathie L. Rogers ◽  
Randall J. Cohrs ◽  
Miles Weinberger ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Herpes Zoster ◽  
Varicella Zoster Virus ◽  
Varicella Vaccine ◽  
The United States ◽  
Vaccine Virus ◽  
Virus Reactivation ◽  
Wild Type ◽  
Varicella Zoster ◽  
Intravenous Acyclovir

Varicella-zoster virus vaccination is recommended for virtually all young children in the United States, Canada, and several other countries. Varicella vaccine is a live attenuated virus that retains some of its neurotropic properties. Herpes zoster caused by vaccine virus still occurs in immunized children, although the rate is much lower than in children who had wild-type varicella. It was commonly thought that 2 varicella vaccinations would protect children against the most serious complication of meningitis following herpes zoster; however, 2 meningitis cases have already been published. We now report a third case of varicella vaccine meningitis and define risk factors shared by all 3 immunized adolescents. The diagnosis in cerebrospinal fluid in this third case was verified by amplifying and sequencing portions of the viral genome, to document fixed alleles found only in the vaccine strain. Viral antibody was also detected in the cerebrospinal fluid by confocal microscopy. When compared with the other 2 cases, remarkably all 3 were 14 years old when meningitis occurred. All 3 were treated with intravenous acyclovir, with complete recovery. The adolescent in our case report also had recurrent asthma, which was treated with both prednisone tablets and beclomethasone inhaler before onset of meningitis. When the 3 cases were considered together, they suggested that immunity to varicella-zoster virus may be waning sufficiently in some twice-immunized adolescents to make them vulnerable to varicella vaccine virus reactivation and subsequent meningitis. This complication rarely happens in children after wild-type varicella.

Rapid Molecular Discrimination between Infection with Wild-Type Varicella-Zoster Virus and Varicella Vaccine Virus

Infection ◽  
2002 ◽  
Vol 30 (5) ◽  
pp. 320-322 ◽  
Author(s):  
U. Lässker ◽  
T. C. Harder ◽  
M. Hufnagel ◽  
M. Suttorp
Keyword(s):  
Varicella Zoster Virus ◽  
Varicella Vaccine ◽  
Vaccine Virus ◽  
Wild Type ◽  
Varicella Zoster

Varicella-Zoster Virus (Varicella and Shingles)

2021 ◽  
Author(s):  
Anne Gershon
Keyword(s):  
Varicella Zoster Virus ◽  
Varicella Vaccine ◽  
The United States ◽  
Primary Immune Response ◽  
Wild Type Virus ◽  
High Dose ◽  
Healthy Children ◽  
Zoster Vaccine ◽  
Live Attenuated Vaccine ◽  
Varicella Zoster

A live attenuated vaccine against varicella (later also used to prevent zoster) was developed in 1974 by Takahashi and colleagues. Varicella vaccine was licensed for universal immunization of healthy children in the United States in 1995. It is also now used for this purpose in at least 15 additional countries all over the world. Varicella is disappearing in the US. Varicella vaccine has proven extremely safe and side effects are unusual, mild, and less serious than varicella or its complications. 85% of children are protected completely after 1 dose; the 15% who develop varicella despite immunization usually (but not always) have mild infections. These 15%, however, can transmit the wild type virus to others. Therefore, for optimal effect, 2 doses are required, mostly to address children who did not have an optimal primary immune response after the first dose. Waning immunity does not seem to pose a serious problem, but surveillance of vaccinees is continuing. It was demonstrated in 2005 that at a high dose of vaccine – 15 times higher than that used for prevention of varicella in children - zoster in adults can also be safely prevented. The live attenuated zoster vaccine is effective in approximately 50% of healthy individuals over age 60 who have had varicella in the past, and therefore have latent infection with varicella-zoster virus. It is given as one dose, but its effect runs out about 8 years after vaccination. In 2017, a new vaccine against zoster was also introduced. This is a subunit vaccine which does not contain contagious virus. It is even more effective than the older zoster vaccine and is over 95% effective in adults 50–≥70 years of age in preventing zoster and post herpetic neuralgia.

scholarly journals 2767. Variation in Incidence of Pediatric Herpes Zoster by First- and Second-Dose Varicella Vaccine Formulations

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S975-S976
Author(s):  
Sheila Weinmann ◽  
Stephanie Irving ◽  
Padma Koppolu ◽  
Allison Naleway ◽  
Edward Belongia ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Varicella Vaccine ◽  
Vaccine Dose ◽  
Varicella Vaccination ◽  
Vaccine Formulation ◽  
Wild Type ◽  
Varicella Zoster ◽  
Dose Formulation ◽  
Using Data ◽  
Rate Ratios

Abstract Background Varicella (VAR) and measles-mumps-rubella (MMR) vaccines are recommended for children at ages 12–15 months and 4–6 years. These are administered as separate MMR and VAR vaccines (MMR+VAR) or as combined measles-mumps-rubella-varicella (MMRV) vaccine. Herpes zoster (HZ), caused by wild-type or vaccine-strain varicella-zoster virus, can occur in children after varicella vaccination. It is unknown whether HZ incidence after varicella vaccination varies by vaccine formulation or simultaneous receipt of MMR. Methods Using data from six integrated health systems, we examined HZ incidence among children who turned 12 months old during 2003–2008 and received varicella and MMR vaccines according to routine recommendations. All HZ cases ≥ 21 days after first varicella vaccination were identified using ICD-9 codes from inpatient, outpatient, emergency room encounters, and claims data, through 2014. HZ incidence was examined by vaccine formulation (MMR+VAR, MMRV, or VAR without same-day MMR) and doses received and compared using incidence rate ratios (IRR). Results Among 199,797 children, we identified 601 HZ cases. Crude HZ incidence after first-dose MMR+VAR (18.6 [95% CI 11.1–29.2] cases/100,000 person-years) was similar to the rate after first-dose MMRV (17.9 [95% CI 10.6–28.3] cases/100,000 person-years), but approximately double the rate among those with first-dose VAR without same-day MMR (7.5 [95% CI 3.1–15.0] cases/100,000 person-years); see Table 1. The IRR for HZ after first-dose MMR+VAR or MMRV, compared with VAR, was 2.5 (95% CI 1.4–4.4; P = 0.002). When examining any first or second dose formulation, crude HZ incidence was lower after the second varicella vaccine dose (13.9 cases/100,000 person-years), than in the period before the second dose (i.e., between first and second doses or after the first dose in children with only one dose; 21.8 cases/100,000 person-years, P < 0.0001). HZ incidence was also lower after two varicella vaccine doses in each of the three first-dose formulation groups. Conclusion HZ incidence among children varied by first-dose varicella vaccine formulation and number of varicella vaccine doses. Regardless of the first-dose varicella vaccine formulation, children who received two vaccine doses had lower HZ incidence after the second dose. Disclosures All authors: No reported disclosures.

scholarly journals Herpes Zoster Infection Presenting as Aseptic Meningitis and Dermatomal Rash in Immunocompetent Adult

2020 ◽  
Vol 2020 ◽  
pp. 1-3 ◽  
Author(s):  
Suyash Dawadi ◽  
Sudesh Lamsal ◽  
Bhupendra Shah
Keyword(s):  
Herpes Zoster ◽  
Varicella Zoster Virus ◽  
Aseptic Meningitis ◽  
Elderly Population ◽  
Virus Reactivation ◽  
Herpes Zoster Infection ◽  
Immunocompetent Adult ◽  
Varicella Zoster ◽  
Vesicular Rash ◽  
Immunocompromised Status

Herpes zoster is a localized, painful, and vesicular rash involving one or adjacent dermatomes caused by varicella-zoster virus reactivation. Herpes zoster presenting as aseptic meningitis is prevalent among elderly population and people with immunocompromised status. However, it is a rare phenomenon in the young immunocompetent adult; hence, we are reporting a case of a herpes zoster infection presenting as aseptic meningitis and dermatological manifestation in a 19-year-old immunocompetent male.

scholarly journals Prevention & Management of Herpes Zoster- an Update

2014 ◽  
Vol 41 (3) ◽  
pp. 53-56
Author(s):  
AKM Rejaul Haque ◽  
A Sultana ◽  
A Habib ◽  
ASM Zakaria
Keyword(s):  
Herpes Zoster ◽  
Virus Infection ◽  
Varicella Zoster Virus ◽  
Age Factors ◽  
Varicella Vaccine ◽  
Varicella Zoster Virus Infection ◽  
Post Herpetic Neuralgia ◽  
Varicella Zoster ◽  
Burning Pain ◽  
Chronic Corticosteroid

Herpes zoster (commonly referred to as "shingles") results .from reactivation of the varicella-zoster virus infection, or chickenpox. Were as varicella is generally a disease of childhood, herpes zoster becomes more common with increasing age Factors that decrease immune function, such as human immunodeficiency virus infection, chemotherapv, malignancies and chronic corticosteroid use, may also increase the risk of developing herpes zoster. Reactivation of latent varicella-zoster virus from dorsal root ganglia is responsible.for lhe classic dermatomal rash and pain that occur with herpes zoster. Burning pain typically precedes the rash by several days and can persist for several months after the rash resolves. With post herpetic neuralgia, a complication of herpes zoster, pain may persist well after resolution of the rash and can be highly debilitating. Although the diagnosis of the conditions is generally straightforward, treatment can be frustrating for the patient and physician. Approaches to management include treatment of the herpes zoster infection and associated pain, prevention of post herpetic neuralgia, and control of the neuropathic pain until the condition resolves. Herpes zoster is contagious to those who have not had varicella or have not received the varicella vaccine. The role of the varicella vaccine in preventing herpes zoster is uncertain, but is being studied. The management of herpes zoster is challenging because many patients develop troublesome complication. So, appropriate management o/'herpes zoster is very important to avoid complication. On the other hand prevention is better than cure. Immunization with varicella zoster virus vaccine may boost humoral and cell mediated and decrease the incidence of zoster in population. So effectiveness of a vaccination program need to be evaluated. immunity DOI: http://dx.doi.org/10.3329/bmj.v41i3.18961 Bangladesh Medical Journal 2012 Vol.41(3): 53-56

scholarly journals Detection of Antibodies to Varicella-Zoster Virus in Recipients of the Varicella Vaccine by Using a Luciferase Immunoprecipitation System Assay

2014 ◽  
Vol 21 (9) ◽  
pp. 1288-1291 ◽  
Author(s):  
Jeffrey I. Cohen ◽  
Mir A. Ali ◽  
Ahmad Bayat ◽  
Sharon P. Steinberg ◽  
Hosun Park ◽  
...  
Keyword(s):  
Varicella Zoster Virus ◽  
High Throughput ◽  
Fluorescent Antibody ◽  
Varicella Vaccine ◽  
The United States ◽  
Antibody Detection ◽  
Enzyme Linked Immunosorbent Assay ◽  
Viral Capsid Antigen ◽  
Glycoprotein E ◽  
Varicella Zoster

ABSTRACTA high-throughput test to detect varicella-zoster virus (VZV) antibodies in varicella vaccine recipients is not currently available. One of the most sensitive tests for detecting VZV antibodies after vaccination is the fluorescent antibody to membrane antigen (FAMA) test. Unfortunately, this test is labor-intensive, somewhat subjective to read, and not commercially available. Therefore, we developed a highly quantitative and high-throughput luciferase immunoprecipitation system (LIPS) assay to detect antibody to VZV glycoprotein E (gE). Tests of children who received the varicella vaccine showed that the gE LIPS assay had 90% sensitivity and 70% specificity, a viral capsid antigen enzyme-linked immunosorbent assay (ELISA) had 67% and 87% specificity, and a glycoprotein ELISA (not commercially available in the United States) had 94% sensitivity and 74% specificity compared with the FAMA test. The rates of antibody detection by the gE LIPS and glycoprotein ELISA were not statistically different. Therefore, the gE LIPS assay may be useful for detecting VZV antibodies in varicella vaccine recipients. (This study has been registered at ClinicalTrials.gov under registration no. NCT00921999.)

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