Modified Chickenpox in Children Immunized With the Oka/Merck Varicella Vaccine

PEDIATRICS ◽  
1993 ◽  
Vol 91 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Barbara M. Watson ◽  
Sharon A. Piercy ◽  
Stanley A. Plotkin ◽  
Stuart E. Starr
Keyword(s):  
Virus Infection ◽  
Varicella Zoster Virus ◽  
Median Time ◽  
Index Case ◽  
Varicella Vaccine ◽  
Skin Lesions ◽  
Varicella Zoster Virus Infection ◽  
Healthy Children ◽  
Varicella Zoster ◽  
Index Cases

Oka/Merck varicella vaccine has been studied in this institution since 1981. Persistence of antibody for 6 to 8 years has been demonstrated; however, cases of chickenpox have been seen in immunized children. The severity of chickenpox in healthy children who have received Oka/Merck varicella vaccine since 1981 is described. All vaccinees who developed chickenpox-like rashes more than 6 weeks postimmunization were exammined. Of 2163 vaccinees, 164 were examined, of whom 114 had rashes consistent with chickenpox. When sera were available (46%), antibody studies uniformly confirmed varicella-zoster virus infection. Chickenpox occurred 2 to 96 months (median of 44 months) postimmunization. The range for the number of skin lesions was 1 to 285 (median 18) in seroconverters. Symptoms included itching in 39%, fever in 9%, headaches in 7%, lymphadenopathy in 3%, and malaise in 2%; 54% were asymptomatic, except for the rash. The median time to total healing was 5 days. The median time lost from school was 2 days. Thirteen of the children in whom infections developed had failed to seroconvert after immunization. Their infections were similar in severity to those of children who had seroconverted originally. When varicella was introduced into families as a result of chickenpox in an immunized family member (index case), the rate of secondary chickenpox among immunized siblings was 12.2%. Eleven such secondary cases were similar in severity to the 9 index cases. It is concluded that chickenpox is generally mild in previously immunized children.

scholarly journals Estudo Clínico-Epidemiológico da Infeção Complicada por Vírus Varicela-Zoster na Idade Pediátrica

2015 ◽  
Vol 28 (6) ◽  
pp. 741 ◽  
Author(s):  
Catarina Maia ◽  
Jacinta Fonseca ◽  
Isabel Carvalho ◽  
Helena Santos ◽  
Diana Moreira
Keyword(s):  
Virus Infection ◽  
Varicella Zoster Virus ◽  
Bacterial Infections ◽  
Cellular Tissue ◽  
Infectious Complications ◽  
Varicella Zoster Virus Infection ◽  
Healthy Children ◽  
Respiratory Complications ◽  
Multicenter Studies ◽  
Varicella Zoster

<strong>Introduction:</strong> In Portugal, the incidence of complicated infection by varicella-zoster virus is unknown. The purpose of this study was to describe the epidemiological and clinical features of complicated infection by varicella-zoster virus in children.<br /><strong>Material and Methods:</strong> Retrospective review of the clinical files of patients admitted between January 1999 and July 2013, with a diagnosis of complicated varicella-zoster virus infection.<br /><strong>Results:</strong> Ninety-four patients were hospitalized with complicated varicella-zoster virus infection, two of them by reactivation of latent infection. The median age was 38 (IQR 18 - 65) months. The most frequent types of complications were bacterial overinfection of the skin and subcutaneous cellular tissue (37.2%) and respiratory complications (24.5%). Other complications were neurologic complications (19.1%), gastrointestinal (9.6%), hematologic (5.3%) and osteoarticular (4.3%). In 38 patients invasive bacterial infections were diagnosed, with bacteremia in 6 patients. The median age was highest in the immunological complications compared with infectious complications. Neurological complications occurred mainly in healthy children, while infectious complications, including the invasive bacterial infections were more frequent in patients treated with ibuprofen and/or corticosteroids. The evolution was favorable in most cases.<br /><strong>Discussion:</strong> The complications of varicella-zoster virus infection occurred mainly in pre-school age and in healthy children. Infectious complications, particularly respiratory complications and bacterial overinfection of the skin and subcutaneous cellular tissue, were the most frequent. There was association between infectious complications and previous therapy with ibuprofen and / or corticosteroids.<br /><strong>Conclusion:</strong> Multicenter studies should be planned in order to optimize and adjust the vaccine strategies to our reality.

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 Appendicitis Caused by Primary Varicella Zoster Virus Infection in a Child with DiGeorge Syndrome

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Lotte Møller Smedegaard ◽  
Claus Bohn Christiansen ◽  
Linea Cecilie Melchior ◽  
Anja Poulsen
Keyword(s):  
Abdominal Pain ◽  
Virus Infection ◽  
Varicella Zoster Virus ◽  
Digeorge Syndrome ◽  
Viral Infections ◽  
Perforated Appendicitis ◽  
Varicella Zoster Virus Infection ◽  
Healthy Children ◽  
Varicella Zoster ◽  
Two Samples

Introduction. Chickenpox is caused by varicella zoster virus (VZV). Although predominantly a mild disease, it can cause considerable morbidity and in rare occasions even mortality in healthy children as well as increased morbidity and mortality in immunocompromised patients. The aetiology of appendicitis is largely unknown but is thought to be multifactorial. Appendicitis is a suspected, but not well documented, complication from varicella zoster virus infection. Case Presentation. A five-year-old girl diagnosed with DiGeorge syndrome and a prolonged primary VZV infection was admitted due to abdominal pain, increasing diarrhoea, vomiting, and poor general condition. She developed perforated appendicitis and an intraperitoneal abscess. VZV DNA was detected by PCR in two samples from the appendix and pus from the abdomen, respectively. The child was treated with acyclovir and antibiotics and the abscess was drained twice. She was discharged two weeks after referral with no sequela. Conclusion. Abdominal pain in children with viral infections can be a challenge, and appendicitis has to be considered as a complication to acute viral diseases, especially if the child is immunocompromised.

scholarly journals Varicella zoster virus infection causing urinary retention in a child with HIV infection

2012 ◽  
Vol 13 (4) ◽  
pp. 202
Author(s):  
G S Wessels ◽  
C F Heyns
Keyword(s):  
Virus Infection ◽  
Hiv Infection ◽  
Varicella Zoster Virus ◽  
Urinary Retention ◽  
Skin Lesions ◽  
Varicella Zoster Virus Infection ◽  
Varicella Zoster ◽  
Perineal Skin ◽  
Transurethral Catheter ◽  
Sacral Nerves

An 11-year-old boy receiving antiretroviral therapy for HIV infection and antibacterial therapy for pulmonary tuberculosis presented with urinary retention due to varicella zoster virus infection involving the sacral nerves, confirmed on serological testing. The perineum over dermatomes S2 - S4 on the left was involved with a vesicular and superficially erosive rash. A transurethral catheter was inserted and the patient was treated with acyclovir (300 mg 6-hourly for 5 days). At follow-up 4 weeks later, the perineal skin lesions had healed, the catheter was removed and the patient was able to pass urine.

Live Attenuated Varicella Vaccine: The KMcC Strain in Healthy Children

PEDIATRICS ◽  
1983 ◽  
Vol 71 (3) ◽  
pp. 307-312
Author(s):  
Allan M. Arbeter ◽  
Stuart E. Starr ◽  
Robert E. Weibel ◽  
Beverly J. Neff ◽  
Stanley A. Plotkin
Keyword(s):  
Varicella Zoster Virus ◽  
Lymphocyte Proliferation ◽  
Fluorescent Antibody ◽  
Varicella Vaccine ◽  
Skin Lesions ◽  
Healthy Children ◽  
Varicella Zoster ◽  
Immune Adherence ◽  
50Th Passage

The KMcC strain of live, attenuated varicella-zoster virus vaccine was studied in healthy children as a preliminary step toward varicella vaccine studies with this strain in children with leukemia. Forty-three children were immunized: 26 with the 40th passage vaccine and 17 with the 50th passage. Studies included surveillance for clinical reactivity, oropharyngeal excretion of vaccine virus, viruria, and viremia. Antibody responses were assayed by fluorescent antibody to membrance antigens and immune adherence hemagglutination. Cell-mediated immune responses were assayed by lymphocyte proliferation to varicella-zoster virus specific antigens. There was 100% seroconversion to the KMcC passage 40 and 50 vaccines (by fluorescent antibody to membrane antigen assay). Every child studied developed in vitro lymphocyte proliferation to varicella-zoster virus antigens. Papular skin lesions, probably vaccine related, occurred in 31% of the 40th passage vaccinees but in only 6% of the 50th passage vaccinees. The 50th passage KMcC strain vaccine is sufficiently immunogenic and safe to initiate clinical studies with leukemia patients.

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