Sample records for chickenpox

  1. Chickenpox (United States)

    ... Old Feeding Your 8- to 12-Month-Old Feeding Your 1- to 2-Year-Old Chickenpox ... español Varicela About Chickenpox Chickenpox used to be a common childhood illness in the United States, especially in kids ...

  2. Chickenpox Prevention and Treatment (United States)

    ... Multimedia Related Links Medline Plus Shingles Prevention & Treatment Language: English Español (Spanish) Recommend on Facebook ... by Your Doctor Español: Prevención y tratamiento Prevention The best way to prevent chickenpox is to ...

  3. Eruptive keloids after chickenpox

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    Nicolas Kluger


    Full Text Available Hypertrophic scars and keloids result from abnormal wound healing in predisposed individuals. They occur within months of cutaneous trauma (surgical wounds, piercing, lacerations or inflammation (acne, folliculitis, vaccination site. They have rarely been reported after chickenpox. Herein we report a dramatic case in a 4-year-old black girl and discuss the issues related to the management of hypertrophic scars and keloids in this peculiar situation.

  4. [Chickenpox, burns and grafts]. (United States)

    Rojas Zegers, J; Fidel Avendaño, L


    An outbreak of chickenpox that occurred at the Burns Repair Surgery Unit, Department of Children's Surgery, Hospital R. del Río, between June and November, 1975, is reported. 27 cases of burned children were studied, including analysis of correlations of the stages and outcome of the disease (varicela), the trauma (burns) and the graft (repair surgery). As a result, the authors emphasize the following findings: 1. Burns and their repair are not aggravating factors for varicella. In a small number of cases the exanthema looked more confluent in the graft surgical areas and in the first degree burns healing spontaneously. 2. Usually there was an uneventful outcome of graft repair surgery on a varicella patient, either during the incubation period, the acme or the convalescence. 3. The fact that the outmost intensity of secondary viremia of varicella occurs before the onset of exanthemia, that is, during the late incubation period, is confirmed.

  5. One Family's Struggle with Chickenpox

    Medline Plus

    Full Text Available ... thimerosal vaccine safety q & a videos chickenpox (varicella) hepatitis b hib hpv pertussis (whooping cough) pneumococcal rotavirus shingles media room Flu's Gonna Lose M.O.V.E. newsfeeds PSAs publications infectious disease workshop pediatric hepatitis report someone you know has hbv/hcv standard ...

  6. Simultaneous Onset of Chickenpox and Scarlet Fever: a Case Report

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    M Karimi


    Full Text Available Introduction: Chickenpox is a contagious febrile illness with rash that is caused by varicella zoster virus. Most children up to age 15 are infected with the virus. Scarlet fever is caused by erythrogenic toxin of streptococcus group A and usually causes skin reactions such as fine red and often itchy papules on the trunk and extremities as well as skin redness, especially on the groin and forearm. Case: Patient is a 3-year-old girl that two days after chickenpox while she had active lesions of the chickenpox, was infected with scarlet fever. Skin lesions at different stages along with the clinical symptoms confirmed the diagnosis of chickenpox. Chickenpox is a febrile illness, more contagious and associated with the rash, which rarely has been reported with scarlet fever. Macular lesions spreading all over the body especially the trunk, with strawberry red tongue and exudative lesions of tonsils with good response to penicillin confirmed the complication of scarlet fever following chickenpox. Rarely scarlet fever is a complication of chickenpox and symptoms of both conditions may be seen simultaneously. Considering that diagnosis of both diseases are based on clinical findings, so physicians should start the appropriate treatment if they have clinical suspicion.

  7. Chickenpox ARDS in a health care worker following occupational exposure.

    LENUS (Irish Health Repository)

    Knaggs, A


    A case is described of chickenpox acute respiratory distress syndrome in an ambulance driver after the inter-hospital transfer of a patient known to have chickenpox pneumonia. Following this exposure, he neither avoided patient contact nor received varicella zoster immune globulin. He subsequently required 13 days of ventilatory support before making a full recovery. The case described supports the contention that health care workers should be screened by serology for immunity to chickenpox before patient contact occurs, with subsequent vaccination of those who are non-immune, when the vaccine becomes available.

  8. Burden of Chickenpox on Families: A Study in Quebec

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    Philippe De Wals


    Full Text Available OBJECTIVE: To estimate the nonhospital costs of treating chickenpox and to ascertain the opinion of parents regarding the usefulness of vaccination. DESIGN: Retrospective postal survey. SETTING: Province of Quebec. PARTICIPANTS: Random sample of 3333 families with children aged six months to 12 years. OUTCOME MEASURES: For cases of chickenpox that occurred between September 1, 1997 and August 31, 1998, the use of health services, time away from school or work, patient care required, direct and indirect costs for the families and the health care system, and the opinion of parents regarding chickenpox and the vaccine were evaluated. RESULTS: The response rate was 64.7%, and 18.8% of households reported a history of chickenpox, a total of 693 cases. A physician was consulted in 45.8% of these cases, and medication was used in 91.7%. The frequency of hospitalizations was 0.6%. Time away from work or school caused by the disease was 4.1 days on average, with 46.5% of absences being attributed to the risk of contagion. The total average cost of a case of chickenpox was $225. Direct expenses for households accounted for 11% of the total cost, public sector direct costs 7%, indirect costs related to absence from work 38% and caregiving time 45%. A majority of parents (70% were in favour of a systematic childhood immunization program. CONCLUSIONS: Chickenpox without complications is disruptive for families, but the direct costs for families and the public sector are relatively small.

  9. Hemorrhagic Bronchopneumonia in Adults with Chickenpox. A Case Report

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    Miguel Ángel Serra Valdés


    Full Text Available Chickenpox is an acute viral infectious disease that is highly contagious and very common in children. When it occurs in adults, age increases severity, with complications that can lead to death in a short period of time. Among the most lethal complications we can find pneumonia and bronchopneumonia, injuries overinfection caused by streptococci and staphylococci with severe sepsis, diverse bleeding, encephalitis, shock, hemorrhagic nephritis with renal failure and necrotizing fasciitis, among others. The case of an 83 years old male patient, with a history of chronic obstructive pulmonary disease and ischemic cerebrovascular atherosclerotic disease that contracted chickenpox and whose evolution was very rapid, with acute respiratory failure and bronchopneumonia massive hemorrhagic shock, to the point of death, is presented. Given the increased incidence of chickenpox, according to reports of the Pedro Kouri Institute of Tropical Medicine, we decided to have this case published.

  10. Chickenpox – What You Need to Know

    Centers for Disease Control (CDC) Podcasts


    This podcast discusses chickenpox, its symptoms, how it spreads, and how to protect you and your family from getting it.  Created: 9/29/2011 by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases.   Date Released: 9/29/2011.

  11. Outbreak of chickenpox in a refugee camp of northern Thailand

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    Camélique Olivier


    Full Text Available Abstract Although chickenpox is a generally mild, self-limited illness of children, it can cause fatal disease in adults. Accumulating reports from tropical countries showed a high prevalence of seronegativity among the adults, implying that varicella diseases could become a heavy burden in tropical countries. However, in the situation of humanitarian emergencies in tropical areas, chickenpox has largely been ignored as a serious communicable disease, due to lack of data regarding varicella mortality and hospital admissions in such a context. This is the first report describing an outbreak of chickenpox in a refugee camp of tropical region. In 2008, we experienced a varicella outbreak in ethnic Lao Hmong refugee camp in Phetchabun Province, northern Thailand. The attack rate was 4.0% (309/7,815 and this caused 3 hospitalizations including one who developed severe varicella pneumonia with respiratory failure. All hospitalizations were exclusively seen in adults, and the proportion of patients ≥15 years old was 13.6% (42/309. Because less exposure to varicella-zoster virus due to low population density has previously been suggested to be one of the reasons behind higher prevalence of susceptible adults in tropics, the influx of displaced people from rural areas to a densely populated asylum might result in many severe adult cases once a varicella outbreak occurs. Control interventions such as vaccination should be considered even in refugee camp, if the confluence of the risk factors present in this situation.

  12. Unusually severe varicella zoster (VZV) virus viral (aseptic) meningitis in an unimmunized, immunocompetent host with chickenpox. (United States)

    Cunha, Burke A; Warren-Favorito, Heather; Mickail, Nardeen


    Chickenpox is caused by the varicella zoster virus (VZV) and may be more severe in adults than in children. Central nervous system (CNS) manifestations of chickenpox and VZV are uncommon, for example, encephalitis and cerebellar ataxis. Viral (aseptic) meningitis is a rare CNS complication of VZV. The cerebrospinal fluid (CSF) profile in VZV viral (aseptic) meningitis is indistinguishable from other causes of viral meningitis. The clue to most of the diagnoses of VZV aseptic meningitis is based on the temporal relationship between antecedent or concomitant chickenpox. Chickenpox is a clinical diagnosis based on the appearance and distribution of the rash. The rash of chickenpox is vesicular/pruritic and typically appears in crops over 3 successive days. VZV vesicles are fragile, superficial, and surrounded by a erythematous halo. Common nonspecific laboratory findings in chickenpox include leukopenia, thrombocytopenia, and elevated serum transaminases (serum glutamate-oxaloacetate transaminase/serum glutamate-pyruvate transaminase). The erythrocyte sedimentation rate (ESR) is not highly elevated in chickenpox. In VZV aseptic meningitis, the CSF shows a lymphocytic pleocytosis with normal protein, glucose, and lactic acid levels. CSF red blood cells are not a feature of VZV meningitis. We present the case of a healthy unimmunized adult who was hospitalized with chickenpox complicated by VZV aseptic meningitis with an unusually severe headache and nuchal rigidity that occurred during hospitalization.

  13. A patient with bilateral facial palsy associated with hypertension and chickenpox: learning points. (United States)

    Al-Abadi, Eslam; Milford, David V; Smith, Martin


    Bilateral facial nerve paralysis is an uncommon presentation and even more so in children. There are reports of different causes of bilateral facial nerve palsy. It is well-established that hypertension and chickenpox causes unilateral facial paralysis and the importance of checking the blood pressure in children with facial nerve paralysis cannot be stressed enough. The authors report a boy with bilateral facial nerve paralysis in association with hypertension and having recently recovered from chickenpox. The authors review aspects of bilateral facial nerve paralysis as well as hypertension and chickenpox causing facial nerve paralysis.

  14. Epidemiological game-theory dynamics of chickenpox vaccination in the USA and Israel. (United States)

    Liu, Jingzhou; Kochin, Beth F; Tekle, Yonas I; Galvani, Alison P


    The general consensus from epidemiological game-theory studies is that vaccination coverage driven by self-interest (Nash vaccination) is generally lower than group-optimal coverage (utilitarian vaccination). However, diseases that become more severe with age, such as chickenpox, pose an exception to this general consensus. An individual choice to be vaccinated against chickenpox has the potential to harm those not vaccinated by increasing the average age at infection and thus the severity of infection as well as those already vaccinated by increasing the probability of breakthrough infection. To investigate the effects of these externalities on the relationship between Nash and utilitarian vaccination coverages for chickenpox, we developed a game-theory epidemic model that we apply to the USA and Israel, which has different vaccination programmes, vaccination and treatment costs, as well as vaccination coverage levels. We find that the increase in chickenpox severity with age can reverse the typical relationship between utilitarian and Nash vaccination coverages in both the USA and Israel. Our model suggests that to obtain herd immunity of chickenpox vaccination, subsidies or external regulation should be used if vaccination costs are high. By contrast, for low vaccination costs, improving awareness of the vaccine and the potential cost of chickenpox infection is crucial.

  15. Simultaneous chickenpox and measles infection among migrant children who stayed in Italy during the second half of June 2011

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    Igor Ivi?-Hofman


    Full Text Available We are reporting on a household outbreak of measles, in which cases of simultaneous measles and chickenpox infection occured in children of a family who resided in Italy during the incubation period (June 2011. In three children, fever and generalized confluent macular rash were the dominant symptoms. Serology testing revealed simultaneous measles and chickenpox infection in four children.

  16. Precipitation of stroke-like event by chickenpox in a child with MELAS syndrome

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    Jian-Ren Liu


    Full Text Available The mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes syndrome (MELAS is a rare congenital disorder of mitochondrial DNA (mtDNA. Herein we report a case of MELAS, whose second stroke-like episode was provoked by chickenpox. A point mutation at nucleotide (nt 3243 in mtDNA supported the diagnosis of MELAS in this case. History of myopathy, the presence of lesions that did not conform to accepted distributions of vascular territories on cranial magnetic resonance imaging (MRI, normal result of cranial magnetic resonance angiography, hyperintensity on diffusion weighted MRI and apparent diffusion coefficient mapping indicating the presence of vasogenic edema in the fresh stroke-like lesion, and mitochondrial DNA analysis helped to exclude the diagnosis of ischemic cerebral infarction which can also be induced by chickenpox.

  17. Experimental studies on the prevention and treatment of chickenpox and herpes zoster with measles vaccine. (United States)

    Li, W H; Ming, Z L; Chen, Q; Li, Y


    In 151 chickenpox patients treated with live attenuated measles vaccine, the cure rate was 100%. In 145 cases of herpes zoster, the effective rate was 100% (completely cured in 91.7% and improved in 8.3%). In the treated group, the time needed for the subsidence of fever and skin rash and the duration of the disease were markedly shorter than those in the control group (P less than 0.01). It is particularly effective for alleviating pain, preventing and relieving postherpetic neuralgia in patients with zoster. The application of measles vaccine to the patients in the chickenpox incubation period might prevent the development of the disease, and decrease the incidence and death rate of varicella zoster virus infection in highly susceptible patients. The mechanism of its anti-viral action and production of interferon in the body is discussed.

  18. Chickenpox pneumonia. Case presentation. Dora Ngiza hospital, Port Elizabeth, South Africa.

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    Gilberto Serrano Ocaña


    Full Text Available Chickenpox is an exanthematic highly infectious disease produced by the Varicella zoster virus (VZV, commonly occurs in childhood, 90% of cases occurred in children under 12 years of age, 10% of the population over 15 years is susceptible to suffer it. It is an airborne illness, the inhale virus cause an infection in the initial respiratory epithelium, the virus spreads to distant cells of the reticuloendothelial system, finally, there is a state of viremia with skin lesions, although the spread can also be extended to the viscera. The deterioration of the cell-mediated immunity caused by coexisting diseases, HIV infection, cancer, hemato-oncology illnesses, steroid use, as well as advanced age, smoking, chronic obstructive pulmonary disease and hemorrhagic nature of the Skin lesions, are risk factors for developing Varicella-Zoster pneumonia. In this article we describe a case of chickenpox in a young HIV positive patient complicated with Varicella-Zoster pneumonia. Despite of the treatment with acyclovir, prednisone and supportive measures had a fatal outcome.

  19. Brote de varicela en Herrera del Duque (Badajoz Chickenpox outbreak in Herrera del Duque, Badajoz, Spain

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    F.J. Valadés


    Full Text Available Introducción: La varicela es una enfermedad de distribución mundial con una elevada morbilidad y pocas complicaciones, aunque puede presentar cuadros clínicos graves en inmunodeprimidos y adultos sanos. El objeto de este estudio es identificar y describir las características y los costes de un brote epidémico en Extremadura, cuya tasa anual de casos declarados al sistema de Enfermedades de Declaración Obligatoria (EDO oscila en alrededor de 5 por 1.000 habitantes. Métodos: Estudio descriptivo con búsqueda activa de casos entre los meses de noviembre del año 2000 y marzo de 2001, y de la susceptibilidad de la cohorte escolarizada del colegio de Herrera del Duque (Badajoz. Las definiciones de casos fueron recogidas de los protocolos de la Red de Vigilancia de la comunidad extremeña. La confirmación microbiológica se realizó por aislamiento del virus y por presencia de marcadores IgM e IgG en el suero del enfermo. Se analizaron los costes tangibles directos e indirectos y los no tangibles del brote. Resultados: De los 75 casos identificados, 71 (94,7% eran niños de entre uno y 9 años, predominando el sexo masculino. La tasa de ataque fue de 18,5 casos por 1.000 habitantes, y del 68,2% en convivientes menores de 10 años. La evolución fue benigna, sin ingresos hospitalarios ni complicaciones. Se encontró un 71,6% de niños susceptibles en los de entre 3 y 8 años. Se analizó una posible agregación temporal de casos en el colegio, obteniéndose un riesgo relativo (RR de 5,01 (p Introduction: Chickenpox is a worldwide disease with high morbidity but few complications, although complications can be sevre in immunocompromised individuals and healthy adults. The annual chickenpox rate declared to the National Notification Disease Surveillance System is approximately 5 cases per 1,000 inhabitants in Extremadura (Spain. The aim of this study was to identify and describe the characteristics and cost of an epidemic outbreak of chickenpox

  20. Chickenpox pneumonia. Case presentation. Dora Ngiza hospital, Port Elizabeth, South Africa. Neumonia varicelosa. Presentacion de caso.

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    Ilen Ochoa Tamayo


    Full Text Available Chickenpox is an exanthematic highly infectious disease produced by the Varicella zoster virus (VZV, commonly occurs in childhood, 90% of cases occurred in children under 12 years of age, 10% of the population over 15 years is susceptible to suffer it. It is an airborne illness, the inhale virus cause an infection in the initial respiratory epithelium, the virus spreads to distant cells of the reticuloendothelial system, finally, there is a state of viremia with skin lesions, although the spread can also be extended to the viscera. The deterioration of the cell-mediated immunity caused by coexisting diseases, HIV infection, cancer, hemato-oncology illnesses, steroid use, as well as advanced age, smoking, chronic obstructive pulmonary disease and hemorrhagic nature of the Skin lesions, are risk factors for developing Varicella-Zoster pneumonia. In this article we describe a case of chickenpox in a young HIV positive patient complicated with Varicella-Zoster pneumonia. Despite of the treatment with acyclovir, prednisone and supportive measures had a fatal outcome.La varicela es una infección exantemática producida por el virus Varicela zoster (VZV que comúnmente ocurre en la infancia. Se reporta el 90 % de los casos en niños menores de 12 años, el 10 % de la población mayor de 15 años es susceptible a padecerla. La enfermedad se adquiere por inhalación de partículas que contienen el virus y que son expulsadas por la nasofaringe de individuos infectados. Esto causa una infección inicial en el epitelio respiratorio. El virus se disemina a células distantes del sistema retículo endotelial y, finalmente, se produce un estado de viremia con manifestaciones en la piel, aunque la diseminación también se puede extender a las vísceras. El deterioro de la inmunidad celular ocasionado por enfermedades coexistentes, infección por VIH, cáncer, enfermedad hemato-oncológica, uso de esteroides, así como, la edad avanzada, el hábito de fumar

  1. An observational study of complications in chickenpox with special reference to unusual complications in an apex infectious disease hospital, Kolkata, India

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    A K Kole


    Full Text Available Background: Chickenpox can cause serious complications and even death in persons without any risk factors. Aims: To observe the different complications with special reference to unusual complications of chickenpox and their outcomes. Materials and Methods: The present study was a prospective observational study where 300 patients suffering from chickenpox were evaluated with special reference to unusual complications and outcomes. Results: The usual complications of chickenpox commonly observed were acute hepatitis in 30 (10% and cerebellar ataxia in 22 patients (7.3%, whereas common unusual complications were acute pancreatitis in 45 (15%, hemorrhagic rash in 10 (3.3%, Guillain-Barrι syndrome in 4 (1.3%, disseminated intravascular coagulation in 4 (1.3%, necrotizing fasciitis in 4 (1.3%, and acute renal failure in 3 patients (1%. It had been observed that most of these unusual complications occurred in patients without any risk factor. A total of 18 patients (6% died in this study and of them 12 patients (4% died due to unusual complications. Conclusions: Compulsory childhood varicella vaccination including vaccination of risk groups and susceptible individuals are all essential to reduce the incidence of chickenpox, associated complications, and subsequent death.


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    Kirsanova T.O.


    Full Text Available Introduction. Chickenpox (CP in recent years has tended to steady increase in the incidence of various regions of Ukraine, especially among children. The situation regarding the incidence of PA nowadays, especially among children, determines the relevance of infection and requires the solution of problems in finding the most effective ways to prevent the population of Ukraine against CP. Purpose: to theoretically justify the introduction of the National vaccination calendar of Ukraine vaccine against CP based on the study of modern epidemiological, clinical and paraclinical features of CP in children of Kharkiv region of Ukraine. Materials and methods. The analysis of statistical data on the incidence of PA in Kharkiv region and 2780 data from case histories of children aged one month PA-18, admitted to the Kharkiv Regional Hospital of Pediatric Infectious Diseases in the last five years. The diagnosis is established on the basis of characteristic clinical manifestations. Results and discussion. During the period 2010-2014 epidemiological curve morbidity in children with CP has tended to rise with maximum performance in 2011, prevailed among patients, children who lived in the city. The largest recorded incidence in children under 15 years old, had a tendency to increase the proportion of high school age children. Among dominated diseased children attending organized children's groups (kindergartens, schools, including more than a third part of patients lived in closed children's institutions (orphanages, boarding schools, etc.. Clear seasonal disease was traced to the rise of the autumn-winter period. Monitoring the number of children with CP, admitted to hospital, also showed growth in their numbers. The reason for hospitalization were: pronounced intoxication syndrome, abundant rash on skin and mucous membranes, complicated disease, epidemiological indications. The most affected age groups were children 1-10 years. The disease ran mostly in

  3. 一起水痘突发疫情流行病学分析%Epidemiological Analysis on An Outbreak of Chickenpox

    Institute of Scientific and Technical Information of China (English)

    彭玉琴; 王红卫


    目的:对北京市怀柔区某小学一起水痘突发疫情进行流行病学分析,为今后更好的处理水痘暴发疫情提供流行病学依据.方法:收集中国疾病控制信息系统中北京市怀柔区某小学的一起水痘突发疫情个案病例和突发疫情信息,采用描述流行病学方法分析流行病学特征.结果:水痘发病年龄(6~12) 岁,以一年级为主,共27 例,占总病例数的67.50%; 应急后免疫未超过1个月发病的2例,免疫史超过3年的发病3例,超过4年的发病3例,超过5年的发病25 例,分别占5.88% 、8.82% 、8.82% 、73.53%.结论:水痘易在学校等集体单位暴发流行,发病以低年级儿童为主,免疫史超过5年的突破病例较多.学校等集体单位在严格落实各项防控措施的同时,接种水痘减毒活疫苗(Varicella Attenuated Live Vaccine;VarV) 是预防和控制水痘最有效和最可靠的手段.%Objective:To analysis an outbreak of chickenpox in a primary school of Beijing Huairou district, to provide epidemiological basis for dealing with the epidemic of chickenpox. Methods: the information of chickenpox cases of a primary school in Beijing Huairou district was collected from Chinese Centers for Disease Control Information System, and descriptive epidemiology was used to analyze epidemiology characters of chickenpox .Results: The average age of cases was 7.08y(rangre 6y ~12y). The cases were diagnosed maily in grade 1, about 27 cases accounting for 67.50%. 2 cases within 1 month immune following stress, 3 cases withI more than 3 years immune history, 3 cases with more than 4 years immune history, 25 cases with more than 5 years immune history were diagnosed,accounting for 5.88%, 8.82%, 8.82% and 73.53% respectively. Conclusion:Chickenpox is outbreaked in collective units such as schools frequently, and the incidence cases are maily in low-grade children especially who with more than 5-year immune history. Schools and other collective units should implement

  4. Ultra-violet radiation is responsible for the differences in global epidemiology of chickenpox and the evolution of varicella-zoster virus as man migrated out of Africa

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    Rice Philip S


    Full Text Available Abstract Background Of the eight human herpes viruses, varicella-zoster virus, which causes chickenpox and zoster, has a unique epidemiology. Primary infection is much less common in children in the tropics compared with temperate areas. This results in increased adult susceptibility causing outbreaks, for example in health-care workers migrating from tropical to temperate countries. The recent demonstration that there are different genotypes of varicella-zoster virus and their geographic segregation into tropical and temperate areas suggests a distinct, yet previously unconsidered climatic factor may be responsible for both the clinical and molecular epidemiological features of this virus infection. Presentation of the hypothesis Unlike other human herpes viruses, varicella-zoster virus does not require intimate contact for infection to occur indicating that transmission may be interrupted by a geographically restricted climatic factor. The factor with the largest difference between tropical and temperate zones is ultra-violet radiation. This could reduce the infectiousness of chickenpox cases by inactivating virus in vesicles, before or after rupture. This would explain decreased transmissibility in the tropics and why the peak chickenpox incidence in temperate zones occurs during winter and spring, when ultra-violet radiation is at its lowest. The evolution of geographically restricted genotypes is also explained by ultra-violet radiation driving natural selection of different virus genotypes with varying degrees of resistance to inactivation, tropical genotypes being the most resistant. Consequently, temperate viruses should be more sensitive to its effects. This is supported by the observation that temperate genotypes are found in the tropics only in specific circumstances, namely where ultra-violet radiation has either been excluded or significantly reduced in intensity. Testing the Hypothesis The hypothesis is testable by exposing

  5. Varicela complicada en un hospital pediátrico de referencia, Perú 2001-2011 Complicated chickenpox in a national pediatric Peruvian hospital, 2001-2011

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    Edwin Miranda-Choque


    Full Text Available El objetivo de estudio fue describir las características clínicas y epidemiológicas de los casos de varicela complicada atendidos en el Instituto Nacional de Salud del Niño (INSN del Perú durante los años 2001 al 2011. Se realizó una serie de casos que incluyó un total de 1073 niños con varicela complicada. La mediana de la edad fue de 2,5 años (RIQ 1,1-4,8 años; 578 (54% fueron de sexo masculino. El tipo de complicación más frecuente fueron las infecciones secundarias de piel y partes blandas con 768 casos (72%, se registró 13 (1,4% fallecidos. En conclusión, en el INSN se hospitalizan con mayor frecuencia casos de varicela complicada en niños menores de cinco años, con un tiempo de hospitalización corto y con una baja proporción de fallecidos, la mayoría de complicaciones siendo relacionadas con las infecciones secundarias de piel y partes blandasThe objective of the study was to describe the clinical and epidemiological characteristics of complicated chickenpox cases seen at the National Institute of Children’s Health (INSN, Spanish acronym of Peru from 2001 to 2011. A case series was collected, including a total of 1,073 children with complicated chickenpox. The median age was 2.5 years (IQR 1.1-4.8 years, of which 578 (54% were male. The most frequent complications were secondary skin and soft tissue infections with 768 cases (72%. 13 deaths (1.4% were recorded. In conclusion, the hospitalizations due to complicated chickenpox in the INSN included mostly children under five, with a short stay and a low proportion of deaths most complications being related to secondary skin and soft tissue infections

  6. Varicella (Chickenpox) Vaccine (United States)

    ProQuad® (as a combination product containing Measles Vaccine, Mumps Vaccine, Rubella Vaccine, Varicella Vaccine) ... up to about 1 person in 5) and measles-like rash (about 1 person in 20) than MMR and varicella vaccines given separately. Moderate Problems:Seizure (jerking or staring) ...

  7. Travelers' Health: Varicella (Chickenpox) (United States)

    ... in an Area with Zika? Find a Clinic Yellow Fever Vaccinations Clinics FAQ Disease Directory Resources Resources for ... CE Courses and Training Presentations for Health Professionals Yellow Fever Vaccine Course About the Yellow Fever Vaccine Course ...

  8. One Family's Struggle with Chickenpox

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  9. One Family's Struggle with Chickenpox

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  10. One Family's Struggle with Chickenpox

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  11. One Family's Struggle with Chickenpox

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  12. One Family's Struggle with Chickenpox

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  13. Avaliação da suscetibilidade à varicela no paciente pediátrico portador de insuficiência renal crônica Evaluation of chickenpox susceptibility in children with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Evandro Roberto Baldacci


    Full Text Available OBJETIVO: Avaliar a suscetibilidade natural à varicela de crianças e adolescentes portadores de insuficiência renal crônica (IRC. MÉTODOS: Estudo transversal de 83 pacientes com idade acima de 18 meses e inferior a 18 anos, durante 2000 e 2001, com ritmo de filtração glomerular (RFG abaixo de 70mL/min/1,73m², portando cartão vacinal preconizado pela Fundação Nacional de Saúde e que não receberam nenhuma dose da vacina específica. Do total, três pacientes (3/83 foram excluídos, por terem recebido doses da vacina por meio de órgãos não governamentais. A sorologia foi realizada pelo método Enzyme-Linked Immuno Sorbent Assay, considerando-se títulos sorológicos protetores acima de 100mUA/mL. RESULTADOS: Os pacientes renais crônicos tinham idade mediana de 11 anos, 66% eram masculinos, 60% procedentes do próprio município de São Paulo, com RFG médio de 33,6mL/min/1,73m². O diagnóstico clínico de varicela por profissional médico ocorreu em 39 pacientes; destes, 10% se mostraram soronegativos. Dos 80 pacientes restantes, 21 (26% apresentaram títulos não protetores para varicela. A prevalência de suscetibilidade em menores de seis anos foi 7,93 (IC95%=3,29-19,12 vezes superior à de maiores de seis anos. CONCLUSÕES: Houve diminuição da suscetibilidade à varicela com a idade. Pacientes abaixo de seis anos foram cerca de oito vezes mais suscetíveis à varicela que os renais crônicos com idade mais avançada e duas vezes mais suscetíveis do que a população pediátrica brasileira de mesma idade.OBJECTIVE: To evaluate the immune response to chickenpox natural infection in pediatric patients with chronic renal insufficiency. METHODS: This cross-sectional study enrolled 83 patients between 18 months and 18 years old, with glomerular filtration rate below 70mL/min/1.73m², during the years 2000 and 2001, who did not received specific immunization according to official documentation. Three patients (3/83 had been

  14. Aplicación del teorema del umbral estocástico de Whittle a un brote de varicela Application of Whittle's stochastic threshold theorem to a chickenpox outbreak

    Directory of Open Access Journals (Sweden)

    Doracelly Hincapié Palacio


    Full Text Available OBJETIVO: Estimar el ritmo reproductivo básico en un brote de varicela, aplicar el teorema umbral estocástico para estimar la probabilidad de la ocurrencia del brote e identificar medidas preventivas. MÉTODOS: El estudio fue realizado en una guardería de 16 niños, con 13 susceptibles, un infectado inicial y dos niños inmunes por antecedente de enfermedad. Se partió de un modelo estocástico: susceptible - infectado - removido. Se estimó el ritmo de reproducción básico de la enfermedad R0, usando un método de máxima verosimilitud basado en el conocimiento de la distribución de probabilidades para el tamaño total de la epidemia y haciendo una aproximación de epidemia casi-completa. Con el R0 obtenido se aplicó el teorema de umbral estocástico para obtener algunas medidas preventivas que podrían impedir la irrupción del brote de varicela. RESULTADOS: Cada infectado inicial produjo tres casos nuevos de infección, requiriendo para impedir el brote, una cobertura mínima de vacunación del 62%, o disminuir en 62% el contacto entre miembros del grupo o aumentar en 170% la remoción de infectados. CONCLUSIONES: El teorema del umbral estocástico permite identificar medidas que se podrían implementar para prevenir y controlar brotes de varicela. Aunque la distribución del tamaño de la epidemia en forma bimodal con similar probabilidad de ocurrencia de brotes grandes y pequeños, señala la incertidumbre del proceso epidémico en grupos pequeños, requiriéndose un estrecho seguimiento de los brotes en tales grupos.OBJECTIVE: To estimate the basic reproductive rate of a chickenpox outbreak, to apply the stochastic threshold theorem to estimate the probability of an outbreak occurrence and to identify preventive measures. METHODS: The study was carried out in a daycare center comprising 16 children, 13 susceptible, one infected and two children with acquired immunity by previous disease. A stochastic susceptible - infected - removed

  15. Social epidemiology of a large outbreak of chickenpox in the Colombian sugar cane producer region: a set theory-based analysis Epidemiología social de una gran epidemia de varicela en la región colombiana productora de caña de azúcar: un análisis basado en teoría de conjuntos

    Directory of Open Access Journals (Sweden)

    Alvaro J. Idrovo


    Full Text Available There are few social epidemiologic studies on chickenpox outbreaks, although previous findings suggested the important role of social determinants. This study describes the context of a large outbreak of chickenpox in the Cauca Valley region, Colombia (2003 to 2007, with an emphasis on macro-determinants. We explored the temporal trends in chickenpox incidence in 42 municipalities to identify the places with higher occurrences. We analyzed municipal characteristics (education quality, vaccination coverage, performance of health care services, violence-related immigration, and area size of planted sugar cane through analyses based on set theory. Edwards-Venn diagrams were used to present the main findings. The results indicated that three municipalities had higher incidences and that poor quality education was the attribute most prone to a higher incidence. Potential use of set theory for exploratory outbreak analyses is discussed. It is a tool potentially useful to contrast units when only small sample sizes are available.Hay pocos estudios de epidemiología social sobre epidemias de varicela, aunque resultados previos sugieren un importante rol de los determinantes sociales. Este estudio describe el contexto de una gran epidemia de varicela en la región del Valle del Cauca, Colombia (2003 a 2007, con énfasis en algunos macro-determinantes. Exploramos las tendencias temporales de la incidencia de varicela en 42 municipios para identificar los lugares con mayor ocurrencia. Analizamos las características municipales (calidad de educación, cobertura de vacunación, desempeño de los servicios de salud, inmigración relacionada con violencia, y área cultivada con caña de azúcar mediante análisis basados en teoría de conjuntos. Diagramas de Venn de Edward fueron usados para presentar los principales hallazgos. Los resultados indicaron que tres municipios tuvieron las mayores incidencias y que la educación de pobre calidad fue el atributo m

  16. 上海市闵行区4~17岁儿童水痘减毒活疫苗接种情况及其保护效果%Analysis of protective effect of using chickenpox live attenuated vaccine among 4-17 years old children in Minhang district, Shanghai

    Institute of Scientific and Technical Information of China (English)

    杜艳; 余峰; 张莉萍; 汪曦; 金宝芳; 王烨; 梅克雯; 陆佳; 蒋露芳


    Objectives To survey on the vaccination of varicella live attenuated vaccine among 4-17 children in Minhang District, and analyze the protective effect against varicella.Methods We collected outbreak chickenpox cases reported from infectious disease report system and surveillance units in Minhang district from 1st May in 2012 to 30th Apr in 2013.The 1∶3 matched case-control study was conducted to questionnaire the legal guardian of the cases and control group, and calculate the protective effect and effective term of protection.The survey included vaccination, chickenpox exposure history, previous history of varicella illness, suffering from the symptoms of chickenpox, the vaccinations brand, etc.The criteria of accepted case were those healthy students who were in the same class with those chickenpox cases.The accepted matched controlling data were those children who were from the same class with outbreak chickenpox cases without varicelliform eruption, similar live condition, the closest house, the same gender, the closest age.This study investigated 390 cases of patients and the control group included 1 170 cases. Chi-square test was used to compare the vaccination of cases and controls, as well as the incidence of chickenpox vaccination different brands VarV, Mantel-Haenzel chi-square test was applied to compare the protective effect of the two groups.Results VarV overall vaccination rate was 68.3%( 1 065/1 560 ) , among them, the case group coverage was 45.1% ( 176/390 ) , significantly lower than the control group (76.0%(889/1 170)) (χ2 =128.55,P<0.01) .The coverage in children of 4-10 years old group was 88.4%(375/424), significantly higher than the 11-17 years old group (60.7%(690/1 136)) (χ2 =109.40,P <0.01 ) .The overall protective effect of VarV was 78.10%( 71.82%-82.98%) .Vaccinated group incidence ratio was 16.5% ( 176/1 065 ) , significantly lower than the unvaccinated group ( 43.2%(214/495))(χ2 =128.55,P<0.01).The chickenpox risk of the children

  17. Giant cell hepatitis and autoimmune hemolytic anemia after chickenpox. (United States)

    Baran, Maşallah; Özgenç, Funda; Berk, Ömer; Gökçe, Demir; Kavakli, Kaan; Yilmaz, Funda; Şen, Sait; Yağci, Raşit Vural


    Autoimmune hemolytic anemia with giant cell hepatitis is a distinct entity in children. It is usually fatal with progressive liver disease. Immunosuppressive treatment with conventional drugs offers some response; however, it is usually only temporary. Alternative therapeutic options with monoclonals have been reported with promising remission of the disease. We report a case with autoimmune hemolytic anemia+giant cell hepatitis after varicella infection. She was resistant to standard immunosuppressive combinations, and rescue therapy with rituximab was used. Remission was not achieved with the drug and the child died with septic complication.

  18. Solar radiation and water vapor pressure to forecast chickenpox epidemics. (United States)

    Hervás, D; Hervás-Masip, J; Nicolau, A; Reina, J; Hervás, J A


    The clear seasonality of varicella infections in temperate regions suggests the influence of meteorologic conditions. However, there are very few data on this association. The aim of this study was to determine the seasonal pattern of varicella infections on the Mediterranean island of Mallorca (Spain), and its association with meteorologic conditions and schooling. Data on the number of cases of varicella were obtained from the Network of Epidemiologic Surveillance, which is composed of primary care physicians who notify varicella cases on a compulsory basis. From 1995 to 2012, varicella cases were correlated to temperature, humidity, rainfall, water vapor pressure, atmospheric pressure, wind speed, and solar radiation using regression and time-series models. The influence of schooling was also analyzed. A total of 68,379 cases of varicella were notified during the study period. Cases occurred all year round, with a peak incidence in June. Varicella cases increased with the decrease in water vapor pressure and/or the increase of solar radiation, 3 and 4 weeks prior to reporting, respectively. An inverse association was also observed between varicella cases and school holidays. Using these variables, the best fitting autoregressive moving average with exogenous variables (ARMAX) model could predict 95 % of varicella cases. In conclusion, varicella in our region had a clear seasonality, which was mainly determined by solar radiation and water vapor pressure.

  19. Evolution of cocirculating varicella-zoster virus genotypes during a chickenpox outbreak in Guinea-Bissau

    DEFF Research Database (Denmark)

    Depledge, Daniel P; Gray, Eleanor R; Kundu, Samit;


    UNLABELLED: Varicella-zoster virus (VZV), a double-stranded DNA alphaherpesvirus, is associated with seasonal outbreaks of varicella in nonimmunized populations. Little is known about whether these outbreaks are associated with a single or multiple viral genotypes and whether new mutations rapidl...


    Directory of Open Access Journals (Sweden)

    Fernanda Aimée NOBRE


    Full Text Available SUMMARY We describe the case of an eight-year-old boy with X-linked agammaglobulinemia who developed mild varicella despite regular intravenous immunoglobulin (IVIG therapy. He maintained protective antibody levels against varicella and the previous batches of IVIG that he received had adequate varicella-specific IgG levels. The case illustrates that IVIG may not prevent VZV infection.


    Nobre, Fernanda Aimée; Gonzalez, Isabela Garrido da Silva; de Moraes-Pinto, Maria Isabel; Costa-Carvalho, Beatriz Tavares


    We describe the case of an eight-year-old boy with X-linked agammaglobulinemia who developed mild varicella despite regular intravenous immunoglobulin (IVIG) therapy. He maintained protective antibody levels against varicella and the previous batches of IVIG that he received had adequate varicella-specific IgG levels. The case illustrates that IVIG may not prevent VZV infection.

  2. Optic neuritis (United States)

    ... disease Cryptococcosis , a fungal infection Bacterial infections, including tuberculosis, syphilis, Lyme disease , and meningitis Viral infections, including viral encephalitis , measles , rubella , chickenpox , ...

  3. Infections (United States)

    ... Infections Adenovirus Bronchiolitis Campylobacter Infections Cat Scratch Disease Cellulitis Chickenpox Chlamydia Cold Sores Common Cold Coxsackievirus Infections Croup Cytomegalovirus (CMV) Dengue Fever Diphtheria E. Coli ...

  4. Congenital varicella syndrome in a monochorionic diamniotic twin pregnancy

    Directory of Open Access Journals (Sweden)

    Vania A Villota


    Full Text Available Congenital varicella syndrome encompasses a broad spectrum of malformations present in children of mothers who developed chickenpox during the first 20 weeks of gestation. We report a case of a monochorionic diamniotic twin pregnancy, with maternal exposure to chickenpox during the thirteenth week of gestation, which produced one symptomatic and one healthy child.

  5. TORCH Test (United States)

    ... Epstein-Barr Virus Antibodies , Chickenpox and Shingles Tests , Parvovirus B19 All content on Lab Tests Online has ... enterovirus, Epstein-Barr virus , varicella-zoster virus , and parvovirus B19 . ^ Back to top When is it ordered? ...

  6. MMRV (measles, mumps, rubella, and varicella) vaccine - what you need to know (United States)

    ... usually wait until they recover before getting MMRV vaccine. Children who are only mildly ill may usually get ... than getting measles, mumps, rubella, or chickenpox. Most children who get MMRV vaccine do not have any problems with it. Mild ...

  7. Children: General Health (United States)

    ... by-Step Guide Too Late for the Flu Vaccine? Your Child's Changing Voice Your Child's Immunizations Your Child's Immunizations: Chickenpox Vaccine Your Child's Immunizations: Diphtheria, Tetanus & Pertussis Vaccine (DTaP) Your Child's ...

  8. MMRV (Measles, Mumps, Rubella, and Varicella) Vaccine: What You Need to Know (United States)

    ... STATEMENT MMRV Vaccine What You Need to Know (Measles, Mumps, Rubella and Varicella) Many Vaccine Information Statements ... and V aricella (chickenpox) can be serious diseases: Measles • Causes rash, cough, runny nose, eye irritation, fever. • ...

  9. Shingles (Herpes Zoster) (United States)

    ... a painful, blistering rash. Shingles: Overview Also called herpes zoster Anyone who has had chickenpox can get shingles. ... involve the eye are called ocular shingles or herpes zoster ophthalmicus. Signs and symptoms of shingles in the ...

  10. Two New Flavone Glucosides from Serratula strangulata

    Institute of Scientific and Technical Information of China (English)


    @@ Introduction Genus Serratula (Compositae) consists of about 70 species distributed throughout the world[1]. Serratula species have been used as folk medicine to treat chickenpox, toxicosis,high cholesterol in China[2].

  11. Native Hawaiian and Pacific Islander Health - Multiple Languages: MedlinePlus (United States)

    ... PDF Health Information Translations Chickenpox Vaccine English Bakuna Laban sa Bulutong-Tubig - Tagalog (Tagalog) PDF Immunization Action ... Haemophilus Influenzae Type b (Hib) Vaccine English Bakuna Laban sa Haemophilus Influenzae Type b (Hib) - Tagalog (Tagalog) ...

  12. Chaos Versus Noisy Periodicity: Alternative Hypotheses for Childhood Epidemics (United States)

    Olsen, L. F.; Schaffer, W. M.


    Whereas case rates for some childhood diseases (chickenpox) often vary according to an almost regular annual cycle, the incidence of more efficiently transmitted infections such as measles is more variable. Three hypotheses have been proposed to account for such fluctuations. (i) Irregular dynamics result from random shocks to systems with stable equilibria. (ii) The intrinsic dynamics correspond to biennial cycles that are subject to stochastic forcing. (iii) Aperiodic fluctuations are intrinsic to the epidemiology. Comparison of real world data and epidemiological models suggests that measles epidemics are inherently chaotic. Conversely, the extent to which chickenpox outbreaks approximate a yearly cycle depends inversely on the population size.

  13. Myokarditis med massivt troponin T-udslip forårsaget af varicella zoster-infektion hos teenager

    DEFF Research Database (Denmark)

    Nystrup, Kristin Brønnum; Stantchev, Hristo


    Chickenpox is a common childhood infection caused by the varicella-zoster virus. Complications are rare. We report on a 15-year-old boy who developed myocarditis during a varicella-zoster infection. The patient presented with severe chest pain, examinations revealed significant ST-elevations in t......Chickenpox is a common childhood infection caused by the varicella-zoster virus. Complications are rare. We report on a 15-year-old boy who developed myocarditis during a varicella-zoster infection. The patient presented with severe chest pain, examinations revealed significant ST...

  14. Role of ventilation in airborne transmission of infectious agents in the built environment - a multidisciplinary systematic review

    DEFF Research Database (Denmark)

    Li, Yiping; Leung, G.M.; Tang, J.W.


    /spread of infectious diseases such as measles, tuberculosis, chickenpox, influenza, smallpox and SARS. There is insufficient data to specify and quantify the minimum ventilation requirements in hospitals, schools, offices, homes and isolation rooms in relation to spread of infectious diseases via the airborne route....

  15. Your Child's Immunizations (United States)

    ... the number of shots a child receives. The Vaccines Your Child Needs The following vaccinations and schedules are recommended ... are developed. Your doctor will determine the best vaccinations and schedule for your child. Recommended vaccinations: Chickenpox (varicella) vaccine Diphtheria, tetanus, and ...

  16. An updated approach to treating and preventing herpes zoster. (United States)

    Garrubba, Carl; Donkers, Kelly


    Varicella zoster virus (VZV) causes chickenpox and herpes zoster. Herpes zoster is a common infection in older adults and can lead to potentially debilitating postherpetic neuralgia. This article reviews the diagnosis and management of herpes zoster, including strategies to reduce disease frequency and severity with the herpes zoster vaccine.

  17. The epidemiology of varicella and herpes zoster in The Netherlands: implications for varicella zoster virus vaccination.

    NARCIS (Netherlands)

    Melker, Hester E de; Berbers, Guy A M; Hahné, Susan J M; Rümke, Hans; Hof, Susan van den; Wit, G Ardine de; Boot, Hein J


    We studied the epidemiology of varicella (chickenpox) and herpes zoster (shingles) in The Netherlands to assess the desirability to implement routine varicella zoster virus vaccination in The Netherlands. Data on seroprevalence of varicella zoster virus in the general population (1995-1996), consult

  18. Varicella vaccination in HIV-1-infected children after immune reconstitution

    NARCIS (Netherlands)

    V. Bekker; G.H.A. Westerlaken; H. Scherpbier; S. Alders; H. Zaaijer; D. van Baarle; T. Kuijper


    Background: HIV-1-infected children have an increased risk of severe chickenpox. However, vaccination is not recommended in severely immunocompromised children. Objective: Can the live-attenuated varicella zoster virus (VZV) Oka strain be safely and effectively given to HIV-1-infected children despi

  19. Infections (United States)

    ... Does My Child Need? How to Safely Give Acetaminophen Is It a Cold or the Flu? Is the Flu Vaccine a Good Idea for Your Family? Too Late for the Flu Vaccine? Common Childhood Infections Can Chronic Ear Infections Cause Long-Term Hearing Loss? Chickenpox Cold Sores Common Cold Diarrhea Fever and ...

  20. Simian varicella virus infection of Chinese rhesus macaques produces ganglionic infection in the absence of rash

    NARCIS (Netherlands)

    W.J.D. Ouwendijk (Werner ); R. Mahalingam (Ravi); V. Traina-Dorge (Vicki); G. van Amerongen (Geert); M. Wellish (Mary); A.D.M.E. Osterhaus (Albert); D. Gilden (Don); G.M.G.M. Verjans (George)


    textabstractVaricella-zoster virus (VZV) causes varicella (chickenpox), becomes latent in ganglia along the entire neuraxis, and may reactivate to cause herpes zoster (shingles). VZV may infect ganglia via retrograde axonal transport from infected skin or through hematogenous spread. Simian varicell

  1. Comprehensive analysis of varicella-zoster virus proteins using a new monoclonal antibody collection

    NARCIS (Netherlands)

    T.L. Roviš (Tihana Lenac); S.M. Bailer (Susanne); V.R. Pothineni (Venkata R); W.J.D. Ouwendijk (Werner ); H. Šimić (Hrvoje); M. Babić (Marina); K. Miklić (Karmela); S. Malić (Suzana); M.C. Verweij; M. Baiker (Martin); O. Gonzalez (Orland); A. Brunn (Albrecht von); R. Zimmer; K. Früh (Klaus); G.M.G.M. Verjans (George); S. Jonjic (Stipan); J. Haasb (Jürgeni)


    textabstractVaricella-zoster virus (VZV) is the etiological agent of chickenpox and shingles. Due to the virus's restricted host and cell typetropism and the lack of tools for VZV proteomics, it is one of the least-characterized human herpesviruses. We generated 251monoclonal antibodies (MAbs) again

  2. Necrosis of nose skin after varicella zoster infection : A case report

    NARCIS (Netherlands)

    Snel, Bart Jorrit; Visconti, Giuseppe; Grabietz, Patrice D.; Werker, Paul M. N.


    Varicella zoster virus (VZV) is the causal agent of varicella (chickenpox) and herpes zoster (shingles). Primary VZV infection is a common childhood disease, but elderly patients and those having a compromised immune system are also at risk. We present the case of progressive necrosis of the nose sk

  3. Phytophotodermatitis after gardening. (United States)

    Wild, G


    Phytophotodermatitis, otherwise known as 'Strimmer's Rash' is an unusual cause of a widespread rash. We present a case of phytophotodermatitis, which was initially misdiagnosed as chickenpox; the correct diagnosis was made after further careful history taking and illustrates the importance of taking a thorough history when presented with what appears to be a spot diagnosis.

  4. Shingles (For Parents) (United States)

    ... Old Feeding Your 8- to 12-Month-Old Feeding Your 1- to 2-Year-Old Shingles ... español Herpes zóster A bout of chickenpox used to be a rite of passage during childhood. With the vaccine to protect against varicella zoster ...

  5. Intracerebral hemorrhage caused by varicella-induced thrombocytopenia. (United States)

    Lizarazo, Jairo; Castellanos, María Fernanda; Omaña, Claudia Rosa; Chaín, Miguel; Villamizar, Sergio


    We present the case of a previously healthy 44-years-old man with chickenpox, severe thrombocytopenia, mucosal hemorrhage, and intracerebral hemorrhage in the right hemisphere. The patient was treated with platelets and high doses of steroids. He recovered although with persistent left homonymous hemianopsia and epilepsy, which were controlled with medication.

  6. Shingles: Hope through Research (United States)

    ... onset. varicella-zoster virus —a virus that causes two distinct diseases, chickenpox and shingles. It is a member of the herpesvirus family. “Varicella” is Latin for little pox; “zoster” is the Greek word for girdle. Medically, zoster is sometimes used as ...

  7. Breakthrough VZV infection after immunization, presenting as herpes zoster.

    NARCIS (Netherlands)

    Schade, R.P.; Bakkers, J.; Cornelissen, M.; Koster-Kamphuis, L.; Melchers, W.J.G.; Galama, J.M.D.


    An immunocompromized, VZV-vaccinated child had a breakthrough infection with VZV, acquired at a day-care centre during a chickenpox outbreak. Interestingly, the infection manifested as herpes zoster of 1 dermatome. Typing showed wild-type virus, which suggests that exogenous reinfection with a new s

  8. One Family's Struggles with HPV (Human Papillomavirus)

    Medline Plus

    Full Text Available ... thimerosal vaccine safety q & a videos chickenpox (varicella) hepatitis b hib hpv pertussis (whooping cough) pneumococcal rotavirus shingles media room Flu's Gonna Lose M.O.V.E. newsfeeds PSAs publications infectious disease workshop pediatric hepatitis report someone you know has hbv/hcv standard ...

  9. One Family's Struggles with Pertussis (Whooping Cough)

    Medline Plus

    Full Text Available ... thimerosal vaccine safety q & a videos chickenpox (varicella) hepatitis b hib hpv pertussis (whooping cough) pneumococcal rotavirus shingles media room Flu's Gonna Lose M.O.V.E. newsfeeds PSAs publications infectious disease workshop pediatric hepatitis report someone you know has hbv/hcv standard ...

  10. One Family's Struggles with Rotavirus

    Medline Plus

    Full Text Available ... thimerosal vaccine safety q & a videos chickenpox (varicella) hepatitis b hib hpv pertussis (whooping cough) pneumococcal rotavirus shingles media room Flu's Gonna Lose M.O.V.E. newsfeeds PSAs publications infectious disease workshop pediatric hepatitis report someone you know has hbv/hcv standard ...

  11. Varicella Vaccination of Children With Leukemia Without Interruption of Maintenance Therapy

    DEFF Research Database (Denmark)

    Smedegaard, Lotte Møller; Poulsen, Anja; Kristensen, Ines Ackerl


    of vaccination and (5) receiving maintenance therapy. Results: Forty-five children were vaccinated. No child died or experienced serious adverse events due to VZV vaccination. Nine children developed late chickenpox despite vaccination. Long-term protection was found in 86% of children not receiving acyclovir......, a vaccine-induced rash reduced the risk of late chickenpox [hazard ratio = 0.08 (0.01, 0.66), P = 0.02]. No child had interruption of maintenance therapy at the time of vaccination, but 33% experienced discontinuation of therapy due to vaccine-induced rash. Dexamethasone was associated with an increased...... risk of vaccine-induced rash [hazard ratio = 2.9 (1.21, 6.90), P = 0.02]. Conclusions: This analysis indicates that VZV vaccination is feasible and justified in seronegative children with ALL, in countries where VZV vaccination is not part of the national vaccination program....

  12. Herpes Zoster in a 3-month-old infant

    Directory of Open Access Journals (Sweden)

    Duarte Malveiro


    Full Text Available Introduction: Herpes Zoster (HZ is rare in infancy and results from reactivation of varicella-zoster virus, latent in the dorsal root ganglia of sensory or cranial nerves after primary infection (chickenpox. Case Report: We describe the case of an healthy infant, three months old, without previous clinical symptoms of chickenpox, in spite of having contacted with the disease at two weeks of life. She was hospitalized for vesicular-papular rash involving unilaterally dermatomes L4 and L5 and was treated with acyclovir with good clinical outcome. Conclusion: The immaturity of the immune system and the interference of maternal antibodies contribute to the manifestation of HZ in the first year of life. In a previously healthy child it is not recommended the exclusion of underlying immunodeficiency or malignant disease.

  13. Cerebellar mutism caused by primary varicella infection in an immunocompetent child. (United States)

    Erol, Ilknur; Özkale, Yasemin; Saygi, Semra; Alehan, Füsun


    Varicella (chickenpox) is a common childhood infection caused by the varicella-zoster virus, which is often self-limiting and usually benign. Although uncommon, neurologic complications of varicella have been documented that include postinfectious cerebellar ataxia, meningoencephalitis, Reye syndrome, myelitis, optic neuritis, stroke, Guillain-Barré syndrome, seventh cranial nerve palsy, and Ramsay-Hunt syndrome. In this case study, the authors describe a 7-year-old girl who presented with varicella skin rash with unsteady gait and anarthria on day 2, and her condition was attributed to cerebellar mutism. To date, this complication has never been reported in a child with primary varicella infection. Therefore, this case study documents a rare but serious complication of childhood chickenpox.

  14. The Effect of Childhood Viral Infections on the Incidence of Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Reza Vazirinejad


    Full Text Available Background: In this study, the history of viral infections of measles, chickenpox and mumps in childhood was compared between the two groups of adults with multiple sclerosis (MS and healthy people. Materials and Methods: In this case-control study, a group of 45 MS patients and a group of 135 healthy people who were similar based on some variables were invited. Patients had a definite diagnosis of MS and control group consisted of people accompanying MS patients. Data were collected by a trained expert in face-to-face interview sessions. For data analysis, odds ratio index was calculated and 95% confidence interval was also computed. The mean age of respondents at the time of viral infections was also compared between the two groups.Results: The proportions of infected people by measles, chickenpox and mumps among MS patients were 58%, 56% and 40%, respectively. These proportions in healthy group were 68%, 52% and 44%, respectively. There was not any significant difference between these proportions in the two groups. Mean age of morbidity for measles, chickenpox and mumps among patients were 6.8±3.1, 8.7±2.98 and 10.6±4.7 years, and were significantly higher that these mean ages (4.1±2.1, 5.3±3.1 and 8.4±2.8, respectively among healthy people (p<0.001.Conclusion: Although there was not any significant difference between the history of morbidity of measles, chickenpox and mumps in the two groups of MS patients and healthy people, the mean ages of these viral infections among MS patients were significantly higher than healthy people.

  15. Viral Genome Sequencing Proves Nosocomial Transmission of Fatal Varicella (United States)

    Depledge, Daniel P.; Brown, Julianne; Macanovic, Jasna; Underhill, Gill; Breuer, Judith


    We report the first use of whole viral genome sequencing to identify nosocomial transmission of varicella-zoster virus with fatal outcome. The index case patient, nursed in source isolation, developed disseminated zoster with rash present for 1 day before being transferred to the intensive care unit (ICU). Two patients who had received renal transplants while inpatients in an adjacent ward developed chickenpox and 1 died; neither patient had direct contact with the index patient. PMID:27571904

  16. Postherpetic Nneuralgia: Review of Treatment Modalities

    Directory of Open Access Journals (Sweden)

    Philip SL Chan


    Full Text Available BACKGROUND: Varicella zoster virus (VZV is the etiological agent for both varicella (chickenpox and herpes zoster (HZ (shingles. HZ results from the reactivation of VZV acquired during childhood. Postherpetic neuralgia (PHN is the most common complication of HZ infection in immunocompetent patients. There is no universally accepted definition of PHN. While the mechanisms producing pain associated with PHN are not fully understood, peripheral and central processes are thought to be important.

  17. Recombinant Varicella-Zoster Virus Vaccines as Platforms for Expression of Foreign Antigens

    Directory of Open Access Journals (Sweden)

    Wayne L. Gray


    Full Text Available Varicella-zoster virus (VZV vaccines induce immunity against childhood chickenpox and against shingles in older adults. The safety, efficacy, and widespread use of VZV vaccines suggest that they may also be effective as recombinant vaccines against other infectious diseases that affect the young and the elderly. The generation of recombinant VZV vaccines and their evaluation in animal models are reviewed. The potential advantages and limitations of recombinant VZV vaccines are addressed.

  18. The Military Immunization Communication Handbook (United States)


    now preventable through vaccination.10 Other diseases such as poliomyelitis , tetanus, measles, mumps, and chickenpox, which were once commonplace in U.S...could have stumbled due to its use of a live- virus vaccine or its mandatory nature. But leaders and healthcare providers were effective in delivering...reactions involved spread of vaccine virus elsewhere in the body. ▼ With the first 850,000 military smallpox vaccinations through August 2005, few

  19. Sero-Prevalence of Antibodies against Varicella Zoster Virus in Children under Seven-Years Old in 2012 in Tehran, Iran.


    Yasaman Vojgani; Saeed Zarei; Samira Rajaei; Leili Chamani-Tabriz; Fatemeh Ghaemimanesh; Nematallah Mohammadinia; Mahmood Jeddi-Tehrani


    Abstract Background Varicella zoster virus (VZV) is a member of herpes family viruses, which causes varicella (chickenpox) after primary infection and herpes zoster (shingles) because of latent virus reactivation from dorsal root ganglia. Generally, prevalence of varicella antibodies increases with age. We aimed to compare the prevalence of anti-VZV antibody in children under seven years old, in order to obtain a preliminarily picture of general presence of these antibodies to design an immun...

  20. Acute disseminated encephalomyelitis in chicken pox

    Directory of Open Access Journals (Sweden)

    Arijit Sinha


    Full Text Available An 11 years old male was admitted with upper motor type of weakness of both lower limbs, retention of urine, impaired consciousness, tremor and convulsion on 11th day after vesicular eruption of chickenpox. He was investigated and treated. MRI Brain and Spine suggests encephalitis and myelitis. Other causes were excluded by relevant investigations. Patient was improved satisfactorily. [Natl J Med Res 2016; 6(1.000: 103-104

  1. The Variegate Neurological Manifestations of Varicella Zoster Virus Infection


    Gilden, Don; Nagel, Maria A.; Cohrs, Randall J; Ravi MAHALINGAM


    Varicella zoster virus (VZV) is an exclusively human neurotropic alphaherpesvirus. Primary infection causes varicella (chickenpox), after which the virus becomes latent in ganglionic neurons along the entire neuraxis. With advancing age or immunosuppression, cell-mediated immunity to VZV declines, and the virus reactivates to cause zoster (shingles), dermatomal distribution, pain, and rash. Zoster is often followed by chronic pain (postherpetic neuralgia), cranial nerve palsies, zoster paresi...

  2. Bacterial Infection Complicating Varicella Infection: A 10-Year Review of Hospitalized Children

    Directory of Open Access Journals (Sweden)

    Golda Milo-Manson


    Full Text Available An increased incidence of Streptococci pyogenes (group A streptococcus [GAS] infections and rheumatic fever has been reported over the past decade. The present study was conducted to determine whether a similar increase in such infections was observed after varicella, an infection previously shown to be associated with a high incidence of streptococcal infections. The charts of all children admitted with chickenpox to the Hospital for Sick Children in Toronto, Ontario from January 1, 1980 to December 31, 1989 were reviewed. Immunocompromised children and those hospitalized for another reason who had an incidental diagnosis of chickenpox were excluded. Twenty-five cases with bacterial infection complicating chickenpox were compared with 103 patients without secondary infection. No statistically significant differences were observed for age, gender, duration of illness prior to hospitalization or duration of hospitalization in the two groups. GAS was the most frequent isolate in the cases, followed by Staphylococcus aureus, Escherichia coli and Haemophilus influenzae. The types of infection were significantly different for GAS compared with other organisms, with a predominance of skin infections in the former group (χ2 analysis, P<0.05. No increase in the incidence of GAS infections was observed over time. This study confirms the importance of GAS infections in patients with varicella, but no increase was observed in hospitalized children during the 10-year study period.

  3. Observation and nursing experience of adverse reactions of children vaccinated with chicken pox vaccine%儿童接种水痘疫苗的不良反应观察及护理体会

    Institute of Scientific and Technical Information of China (English)



    objective: to investigate the children chickenpox vaccine adverse reactions and the nursing countermeasures. Methods: retrospectiveanalysis of 226 cases of children had chickenpox vaccine in our adverse reactions and the nursing measures. Results: all children within a few hours after inoculation, there are different degree of mild fever, swelling pain, mild skin rashes, mild chicken pox adverse reaction, nursing measures, reduce the adverse reaction. Conclusion: the adverse reactions of vaccinated children appear in the corresponding nursing measures, can effectively reduce the occurrence of adverse reactions, and improve the success rate of the vaccination is chickenpox vaccine ascending children's health.%目的:探讨儿童接种水痘疫苗的不良反应及护理对策.方法:回顾分析我院已经接种水痘疫苗的儿童226例的不良反应及护理措施.结果:所有儿童在接种结束后的几小时内,出现有不同程度上的轻微发热、局部红肿疼痛、轻微皮疹、轻度水痘不良反应,采取护理措施后,不良反应减少.结论:针对接种后的儿童出现的不良反应进行相应的护理措施,能够有效的减少不良反应的发生,提高接种是水痘疫苗的成功率,提升儿童的身体健康.

  4. Herpes Zoster Ophthalmicus in HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Boateng Wiafe MD MSc


    Full Text Available Herpes zoster is a common infection caused by the human herpes virus 3, the same virus that causes chickenpox. It is a member of herpes viridae, the same family as the herpes simplex virus, Epstein- Barr virus, and cytomegalovirus. Herpes zoster ophthalmicus occurs when a latent varicella zoster virus in the trigeminal ganglia involving the ophthalmic division of the nerve is reactivated. Of the three divisions of the fifth cranial nerve, the ophthalmic is involved 20 times more frequently than the other divisions.


    Directory of Open Access Journals (Sweden)



    Full Text Available Chickenpox is caused by the Varicella-Zoster virus, a member of the herpes virus family. The same virus also causes herpes zoster (shingles in adults. This infection can be widely detected in developing countries, especially for those tropical countries. It is presented with fever and vesicular lesions all over body. (1,2 Even the pregnant women can get chicken pox, and this becomes an important concern. In this specific paper, we have given the details and discussed 5 cases on chicken pox in term pregnancy and its outcome. We have also discussed the management of VZV (Varicella Zoster Virus infection in pregnancy.

  6. Household size is critical to varicella-zoster virus transmission in the tropics despite lower viral infectivity

    DEFF Research Database (Denmark)

    Nichols, Richard A; Averbeck, Karin T; Poulsen, Anja G;


    with viral genetic information on routes of infection, to obtain precise estimates of disease transmission within and between houses. This community contains many large households in which different families live under a single roof, in living quarters divided by partitions. Our data show that household...... that the epidemiology of chickenpox in tropical Guinea Bissau is dependent on the interaction of the social and physical environments. The distinctive clinical presentation of VZV and its ubiquitous distribution make it an attractive model for estimating the variables that contribute to global differences...... in the transmission of airborne viruses....


    Directory of Open Access Journals (Sweden)

    Anis Ahmed


    Full Text Available Varicella zoster virus causes primary infection as chickenpox, at which time latencyis established in the neurons of the dorsal root ganglia or ganglia of the cranial nerves.Reactivation produces herpes zoster infection (HZI, commonly called shingles. Anunderstanding of the mechanisms of latency is crucial in developing effective therapies forVZV infections of the nervous system. This article describes the pathogenesis of VZVwhich includes immune response to the virus, immune evasion by the virus, mechanism ofits latency and cell-mediated immunity.

  8. Hematoma of the proximal nail fold due to oximeter in a child

    Directory of Open Access Journals (Sweden)

    Patricia Chang


    Full Text Available Boy 4 years old, hospitalized due to hemorrhagic chickenpox and sepsis during his clinical examination besides hemorrhagic crust, vesicles and bullous he has also a cutaneous red lesion localized at the right proximal nail fold of the big toenail (Fig. 1, dermatoscopic view of the lesion (Fig. 2. The diagnosis of hematoma of the proximal nail fold due to oximeter was done. The proximal nail fold hematomas due to oximeter are uncommon dermatoses at this level that are caused for the pressure of the oximeter and it has been seeing in patient in Unit Intensive or Intermediate Unit Care since 2007.

  9. Application of Oral Fluid Assays in Support of Mumps, Rubella and Varicella Control Programs

    Directory of Open Access Journals (Sweden)

    Peter A. C. Maple


    Full Text Available Detection of specific viral antibody or nucleic acid produced by infection or immunization, using oral fluid samples, offers increased potential for wider population uptake compared to blood sampling. This methodology is well established for the control of HIV and measles infections, but can also be applied to the control of other vaccine preventable infections, and this review describes the application of oral fluid assays in support of mumps, rubella and varicella national immunization programs. In England and Wales individuals with suspected mumps or rubella, based on clinical presentation, can have an oral fluid swab sample taken for case confirmation. Universal varicella immunization of children has led to a drastic reduction of chickenpox in those countries where it is used; however, in England and Wales such a policy has not been instigated. Consequently, in England and Wales most children have had chickenpox by age 10 years; however, small, but significant, numbers of adults remain susceptible. Targeted varicella zoster virus (VZV immunization of susceptible adolescents offers the potential to reduce the pool of susceptible adults and oral fluid determination of VZV immunity in adolescents is a potential means of identifying susceptible individuals in need of VZV vaccination. The main application of oral fluid testing is in those circumstances where blood sampling is deemed not necessary, or is undesirable, and when the documented sensitivity and specificity of the oral fluid assay methodology to be used is considered sufficient for the purpose intended.

  10. A systematic approach for the identification of novel, serologically reactive recombinant Varicella-Zoster Virus (VZV antigens

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    Lueking Angelika


    Full Text Available Abstract Background Varicella-Zoster virus causes chickenpox upon primary infection and shingles after reactivation. Currently available serological tests to detect VZV-specific antibodies are exclusively based on antigens derived from VZV-infected cells. Results We present a systematic approach for the identification of novel, serologically reactive VZV antigens. Therefore, all VZV open reading frames were cloned into a bacterial expression vector and checked for small scale recombinant protein expression. Serum profiling experiments using purified VZV proteins and clinically defined sera in a microarray revealed 5 putative antigens (ORFs 1, 4, 14, 49, and 68. These were rearranged in line format and validated with pre-characterized sera. Conclusions The line assay confirmed the seroreactivity of the identified antigens and revealed its suitability for VZV serodiagnostics comparable to commercially available VZV-ELISA. Recombinant ORF68 (gE proved to be an antigen for high-confidence determination of VZV serostatus. Furthermore, our data suggest that a serological differentiation between chickenpox and herpes zoster may be possible by analysis of the IgM-portfolio against individual viral antigens.

  11. The role of solar ultraviolet irradiation in zoster. (United States)

    Zak-Prelich, M.; Borkowski, J. L.; Alexander, F.; Norval, M.


    Ultraviolet radiation (UVR) suppresses many aspects of cell-mediated immunity but it is uncertain whether solar UV exposure alters resistance to human infectious diseases. Varicella-zoster virus (VZV) causes varicella (chickenpox) and can reactivate from latency to cause zoster (shingles). The monthly incidence of chickenpox and zoster in a defined Polish population over 2 years was recorded and ground level solar UV was measured daily. There was a significant seasonality of UVR. Evidence of seasonal variation was found for all zoster cases and for zoster in males, with the lowest number of cases in the winter. The number of zoster cases with lesions occurring on exposed body sites (the face) demonstrated highly significant seasonality with a peak in July/August. Seasonal models for UVR and zoster cases showed similar temporal patterns. By contrast, for varicella, the maximum number of cases was found in March and the minimum in August/September, probably explained by the respiratory spread of VZV. It is tempting to speculate that the increase in solar UVR in the summer could induce suppression of cellular immunity, thus contributing to the corresponding rise in the incidence of zoster. PMID:12558343

  12. Rapid Detection of Herpes Viruses for Clinical Applications (United States)

    Pierson, Duane; Mehta, Satish


    There are eight herpes viruses that infect humans, causing a wide range of diseases resulting in considerable morbidity and associated costs. Varicella zoster virus (VZV) is a human herpes virus that causes chickenpox in children and shingles in adults. Approximately 1,000,000 new cases of shingles occur each year; post-herpetic neuralgia (PHN) follows shingles in 100,000 to 200,000 people annually. PHN is characterized by debilitating, nearly unbearable pain for weeks, months, and even years. The onset of shingles is characterized by pain, followed by the zoster rash, leading to blisters and severe pain. The problem is that in the early stages, shingles can be difficult to diagnose; chickenpox in adults can be equally difficult to diagnose. As a result, both diseases can be misdiagnosed (false positive/negative). A molecular assay has been adapted for use in diagnosing VZV diseases. The polymerase chain reaction (PCR) assay is a non-invasive, rapid, sensitive, and highly specific method for VZV DNA detection. It provides unequivocal results and can effectively end misdiagnoses. This is an approximately two-hour assay that allows unequivocal diagnosis and rapid antiviral drug intervention. It has been demonstrated that rapid intervention can prevent full development of the disease, resulting in reduced likelihood of PHN. The technology was extended to shingles patients and demonstrated that VZV is shed in saliva and blood of all shingles patients. The amount of VZV in saliva parallels the medical outcome.

  13. Varicella and secondary pneumonia in a healthy child: is it time to introduce varicella vaccine in the UK? (United States)

    Paul, Siba P; Abdelrhim, Hisham; Kane, Meridith; Haque, Salma Y


    A previously healthy 8-month-old boy presented to the emergency department with a 1-week history of chickenpox infection. His routine immunizations were up-to-date. His parents reported a high temperature (up to 39.5°C) in the preceding 48 hours and that he also had a mild cough, episodes of vomiting and loose stools. He had fed poorly in the 24 hours before presentation. Clinical assessment revealed a temperature of 36.7°C, heart rate 130/min, respiratory rate of 34/min and crusted chickenpox lesions. The infant was alert, smiling and playful, and systemic examination was otherwise unremarkable. He was admitted for monitoring of his fluid intake and temperature. As the infant continued to vomit intermittently in the 6 hours post admission, blood investigations were done and intravenous fluids were commenced. Laboratory investigations did not reveal biochemical evidence of dehydration, but they did show raised inflammatory markers: white blood cell count 24.8 × 109/litre, neutrophil count 19.8 × 109/litre and C-reactive protein 227mg/litre. In view of these results and the ongoing high fever, a chest X-ray was performed, revealing right upper lobe consolidation and collapse (Figure 1). Oral amoxicillin and flucloxacillin were started and oral feeding was successfully reestablished over the next 24 hours. He was discharged home after 48 hours, to complete a full 7-day course of oral antibiotics.

  14. Simple technique for in field samples collection in the cases of skin rash illness and subsequent PCR detection of orthopoxviruses and varicella zoster virus.

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    Catherine Dumont

    Full Text Available BACKGROUND: In case of outbreak of rash illness in remote areas, clinically discriminating monkeypox (MPX from severe form of chickenpox and from smallpox remains a concern for first responders. OBJECTIVE: The goal of the study was therefore to use MPX and chickenpox outbreaks in Democratic Republic of Congo (DRC as a test case for establishing a rapid and specific diagnosis in affected remote areas. METHODS: In 2008 and 2009, successive outbreaks of presumed MPX skin rash were reported in Bena Tshiadi, Yangala and Ndesha healthcare districts of the West Kasai province (DRC. Specimens consisting of liquid vesicle dried on filter papers or crusted scabs from healing patients were sampled by first responders. A field analytical facility was deployed nearby in order to carry out a real-time PCR (qPCR assay using genus consensus primers, consensus orthopoxvirus (OPV and smallpox-specific probes spanning over the 14 kD fusion protein encoding gene. A PCR-restriction fragment length polymorphism was used on-site as backup method to confirm the presence of monkeypox virus (MPXV in samples. To complete the differential diagnosis of skin rash, chickenpox was tested in parallel using a commercial qPCR assay. In a post-deployment step, a MPXV-specific pyrosequencing was carried out on all biotinylated amplicons generated on-site in order to confirm the on-site results. RESULTS: Whereas MPXV proved to be the agent causing the rash illness outbreak in the Bena Tshiadi, VZV was the causative agent of the disease in Yangala and Ndesha districts. In addition, each on-site result was later confirmed by MPXV-specific pyrosequencing analysis without any discrepancy. CONCLUSION: This experience of rapid on-site dual use DNA-based differential diagnosis of rash illnesses demonstrates the potential of combining tests specifically identifying bioterrorism agents and agents causing natural outbreaks. This opens the way to rapid on-site DNA-based identification of a

  15. Herpes Zoster Vaccination: Controversies and Common Clinical Questions. (United States)

    Van Epps, Puja; Schmader, Kenneth E; Canaday, David H


    Herpes zoster, clinically referred to as shingles, is an acute, cutaneous viral infection caused by reactivation of the varicella zoster virus, the same virus that causes chickenpox. The incidence of herpes zoster and its complications increase with decline in cell-mediated immunity, including age-associated decline. The most effective management strategy for herpes zoster is prevention of the disease through vaccination in those who are most vulnerable. Despite the demonstrated efficacy in reducing the incidence and severity of herpes zoster, the uptake of vaccine remains low. Here, we will discuss the controversies that surround the live herpes zoster vaccine and address the common clinical questions that arise. We will also discuss the new adjuvanted herpes zoster vaccine currently under investigation.

  16. Differentiation of strains of varicella-zoster virus by changes in neutral lipid metabolism in infected cells

    Energy Technology Data Exchange (ETDEWEB)

    Jerkofsky, M.; De Siervo, A.J.


    Eleven isolates of varicella-zoster virus were tested for their effects on the incorporation of (/sup 14/C)acetate into lipids in infected human embryonic lung cells. By relative percent, all virus isolates demonstrated a shift from polar lipid synthesis to neutral lipid, especially triglyceride, synthesis. By data expressed as counts per minute per microgram of protein, the VZV strains could be separated into two groups: those strains which depressed lipid synthesis and those strains which did not depress, and may even have stimulated, lipid, especially triglyceride, synthesis. These results may be useful in understanding the development of lipid changes seen in children affected with Reye's syndrome following chickenpox.

  17. [Varicella and herpes zoster. Part 1: virology, epidemiology, clinical picture, laboratory diagnostics]. (United States)

    Wittek, Miriam; Doerr, Hans Wilhelm; Allwinn, Regina


    Varicella-zoster virus (VZV), known as one of the eight human herpesviridae, shows a ubiquitous distribution and is the cause for acute exanthema in childhood (chickenpox). VZV is highly infectious, spread by respiratory droplets and direct contact with fluid in vesicles. As a characteristic of the alpha-herpesviridae, VZV establishes latency in the nucleus of the paraspinal cells. Reactivation of VZV (zoster) is possible in all infected persons, but becomes more common with increasing age and a decline of VZV-specific cell-mediated immunity. Immunocompromised patients and older people (> 50 years) have an increased risk for a severe course of disease. The postherpetic neuralgia (PHN), as one of the most common and feared complications, is defined as a neuropathic pain (burning character), which persists for > 6 weeks after onset of disease and needs adequate antiviral and pain treatment.

  18. Varicella Zoster Virus in the Nervous System [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Don Gilden


    Full Text Available Varicella zoster virus (VZV is a ubiquitous, exclusively human alphaherpesvirus. Primary infection usually results in varicella (chickenpox, after which VZV becomes latent in ganglionic neurons along the entire neuraxis. As VZV-specific cell-mediated immunity declines in elderly and immunocompromised individuals, VZV reactivates and causes herpes zoster (shingles, frequently complicated by postherpetic neuralgia. VZV reactivation also produces multiple serious neurological and ocular diseases, such as cranial nerve palsies, meningoencephalitis, myelopathy, and VZV vasculopathy, including giant cell arteritis, with or without associated rash. Herein, we review the clinical, laboratory, imaging, and pathological features of neurological complications of VZV reactivation as well as diagnostic tests to verify VZV infection of the nervous system. Updates on the physical state of VZV DNA and viral gene expression in latently infected ganglia, neuronal, and primate models to study varicella pathogenesis and immunity are presented along with innovations in the immunization of elderly individuals to prevent VZV reactivation.

  19. Live attenuated varicella vaccine use in immunocompromised children and adults. (United States)

    Gershon, A A; Steinberg, S P; Gelb, L


    Live attenuated varicella vaccine has been administered to 307 children with leukemia in remission and to 86 healthy adults. The vaccine was well tolerated and immunogenic. The major side effect in leukemic children receiving maintenance chemotherapy was development of a vaccine-associated rash. Vaccinees in whom a rash developed were potentially somewhat infectious to others about 1 month after immunization. Vaccination was not associated with an increase in the incidence of herpes zoster or in relapse of leukemia. Vaccination provided excellent protection against severe varicella. It was associated with a significant decrease in the attack rate of chickenpox following an intimate exposure to varicella-zoster virus, conferring about 80% protection in leukemic children. The cases of breakthrough varicella that occurred were mild. Thus, the vaccine may either prevent or modify varicella in high-risk individuals. It may also have use for prevention of nosocomial varicella.

  20. [Epidemiology of invasive group A streptococcal infections in developed countries : the Canadian experience with necrotizing fasciitis]. (United States)

    Ovetchkine, Ph; Bidet, Ph; Minodier, Ph; Frère, J; Bingen, E


    In industrialized countries, group A streptococcal infections were a source of concern, mainly due to the occurrence of rheumatic fever and its cardiac complications. At present, the incidence of rheumatic fever is decreasing in these countries, giving way to an increasing occurrence of invasive streptococcal group A infections with high level of morbidity and mortality. Streptococcal necrotizing fasciitis, a specific entity, emerged these last decades, often in association with chickenpox. The introduction of the varicella vaccine in the province of Quebec routine immunization program, was followed by a significant decrease in the number of necrotizing fasciitis or other skin and soft-tissues infections in our pediatric population. However, in our experience at the CHU Sainte-Justine, this immunization program has not been helpful to reduce the overall incidence of invasive group A streptococcal infections. Conversely, an increase in the number of pleuro-pulmonary and osteo-articular infections was observed.

  1. Is ultra-violet radiation the main force shaping molecular evolution of varicella-zoster virus?

    Directory of Open Access Journals (Sweden)

    Escobar-Gutiérrez Alejandro


    Full Text Available Abstract Background Varicella (chickenpox exhibits a characteristic epidemiological pattern which is associated with climate. In general, primary infections in tropical regions are comparatively less frequent among children than in temperate regions. This peculiarity regarding varicella-zoster virus (VZV infection among certain age groups in tropical regions results in increased susceptibility during adulthood in these regions. Moreover, this disease shows a cyclic behavior in which the number of cases increases significantly during winter and spring. This observation further supports the participation of environmental factors in global epidemiology of chickenpox. However, the underlying mechanisms responsible for this distinctive disease behavior are not understood completely. In a recent publication, Philip S. Rice has put forward an interesting hypothesis suggesting that ultra-violet (UV radiation is the major environmental factor driving the molecular evolution of VZV. Discussion While we welcomed the attempt to explain the mechanisms controlling VZV transmission and distribution, we argue that Rice's hypothesis takes lightly the circulation of the so called "temperate VZV genotypes" in tropical regions and, to certain degree, overlooks the predominance of such lineages in certain non-temperate areas. Here, we further discuss and present new information about the overwhelming dominance of temperate VZV genotypes in Mexico regardless of geographical location and climate. Summary UV radiation does not satisfactorily explain the distribution of VZV genotypes in different tropical and temperate regions of Mexico. Additionally, the cyclic behavior of varicella does not shown significant differences between regions with different climates in the country. More studies should be conducted to identify the factors directly involved in viral spreading. A better understanding of the modes of transmissions exploited by VZV and their effect on viral

  2. 水痘-带状疱疹病毒感染的研究现状%The Present Status of Reseach on Varicella-zoster Virus Infection

    Institute of Scientific and Technical Information of China (English)

    俞蕙; 朱启镕


    水痘是儿童常见的一种急性、高传染性的呼吸道传染病,带状疱疹是患水痘后潜伏病毒的再激活所致,其病原为水痘-带状疱疹病毒(VZV),即人类疱疹病毒3型。原发感染可引起不同严重程度的典型疾病,健康儿童感染VZV后多数症状轻微,预后良好。但在某些特殊人群,如免疫功能缺陷及使用免疫抑制剂治疗的儿童,会导致严重后果,甚至死亡。成人感染VZV后症状也甚为严重。对VZV的分子生物学特征、流行病学、实验室诊断、治疗及预防对策等做了详细阐述。%Chickenpox is an acute and highly infectious respiratory disease commonly seen in children.Varicela-zoster often results from the activation of latent virus in chickenpox called varicella-zoster virus(VZV)or called human herpesvirus type 3. Primary infection of VZV may induce typical disease of various severity and most healthy children infected with VZV have mild symptoms and good prognosis.But VZV infection,if occurs in special population such as persons of immune inhibition treatment will induce serious consequence or even death and it is as same serious as in adults.A detailed illustration of molecular biology,epidemiology,laboratory diagnosis,treatment and preventive strategy of the VZV were given.

  3. Varicella-zoster virus: pathogenesis, incidence patterns and vaccination programs. (United States)

    Gabutti, Giovanni; Franchi, Michele; Maniscalco, Licia; Stefanati, Armando


    Varicella or chickenpox is a common and highly contagious exanthematic disease caused by the varicella-zoster virus (VZV) that during primary infection has the ability to establish latency. VZV reactivation, even decades after primary infection, causes herpes zoster. In healthy immunocompetent subjects, children in particular, varicella results in mild to moderate illness and for this reason, regardless its high morbidity, it is not considered a public health priority. Varicella still represents the most widespread vaccine preventable childhood infectious disease in industrialized countries; due to its relevant burden on healthcare resources several countries has introduced varicella vaccination into the recommended routine childhood national immunization schedule. Nowadays, live attenuated monovalent and combined MMRV vaccines are licensed worldwide. The use of several millions of doses has demonstrated the excellent safety and efficacy level of varicella vaccines as well as of combined MMRV vaccines. Universal vaccination adopted in many countries with a two-dose strategy has allowed to significantly reducing morbidity and mortality of this infectious disease. Anyway, an ample international debate is ongoing on the time range to be used between the two doses, and on the safety issues related to the use as first-dose of MMRV vaccine. Taking into account the availability of a zoster vaccine in subjects older than 50 years of age, it will be relevant to clarify if an impact on exogenous boosters and on the epidemiology of herpes zoster can occur after the adoption of extensive varicella immunization.

  4. Perceived vaccination status in ecotourists and risks of anthropozoonoses. (United States)

    Muehlenbein, Michael P; Martinez, Leigh Ann; Lemke, Andrea A; Ambu, Laurentius; Nathan, Senthilvel; Alsisto, Sylvia; Andau, Patrick; Sakong, Rosman


    Anthropozoonotic (human to nonhuman animal) transmission of infectious disease poses a significant threat to wildlife. A large proportion of travelers to tropical regions are not protected against vaccine-preventable illnesses, and a majority of these travelers demonstrate poor recall of actual vaccination status. Here we characterize self-perceived vaccination status among a large sample of ecotourists at the Sepilok Orangutan Rehabilitation Centre, Sabah, Malaysia. Despite their recognized travel itinerary to view endangered animals, tourists at wildlife sanctuaries are not adequately protected against vaccine-preventable illnesses. Of 633 surveys, over half reported being currently vaccinated against tuberculosis, hepatitis A, hepatitis B, polio, and measles. Fewer participants reported current vaccination status for influenza, rabies, and chickenpox. Despite the fact that the majority of visitors to Sepilok are from temperate regions where influenza is relatively more prevalent, 67.1% of those surveyed with medical-related occupations reported not being currently vaccinated for influenza. Ecotourists concerned about environmental protection are themselves largely unaware of their potential contribution to the spread of diseases to animals. The risks of negatively affecting animal populations must be communicated to all concerned parties, and this may begin by urging travelers to examine their actual vaccination status, particularly as the ecotourism industry continues its rapid expansion, and is seen increasingly as a possible tool to save great ape populations from extinction.

  5. Advances in the understanding of the pathogenesis and epidemiology of herpes zoster (United States)

    Gershon, Anne A.; Gershon, Michael D.; Breuer, Judith; Levin, Myron J.; Oaklander, Anne Louise; Griffiths, Paul D.


    SUMMARY The primary varicella zoster virus (VZV) infection results in chickenpox (varicella), which is transmitted via the airborne route. VZV is highly infectious, but in the USA the incidence of varicella has been reduced by 76–87% as a result of the varicella vaccine. The virus establishes latency in the dorsal root ganglia during varicella and, when reactivated, travels along the sensory nerve axons to cause shingles (herpes zoster [HZ]). There are over 1 million cases of HZ in the USA each year, with an estimated lifetime attack rate of 30%. The incidence of HZ, which causes significant morbidity, increases with age and reaches approximately 10 cases per 1,000 patient-years by age 80. Cell-mediated immunity (CMI) is known to decline with age as part of immunosenescence, and decreased CMI is associated with reactivation of VZV. This article provides an overview of our emerging understanding of the epidemiology and pathogenesis of varicella and HZ, in addition to exploring the current theories on latency and reactivation. Understanding the risk factors for developing HZ and the complications associated with infection, particularly in older people, is important for prompt diagnosis and management of HZ in primary care, and they are therefore also reviewed. PMID:20510263


    Velenciuc, I; Minea, Raluca; Duceac, Letiţia; Vlad, T


    The present paper aims, exploring the history of Renaissance medicine, to evoke the figure and work of the priest, surgeon and anatomist, Guido Guidi (Vidus Vidius) (1509-1569). The XVIth century is considered a period marked by artistic and scientific effervescence in the western part of Europe and Guido Guidi was a first order personality, grandson of Domenico Ghirlandaio and friend of Benvenuto Cellini. He was appointed by the King Francis I the first professor of anatomy and surgery at the newly founded College de France. On demand of the King, he wrote Chirurgia j Graeco in Latinum conversa Vido Vidio Florentino interprete, cum nonnullis eiusdem Vidii comentariis (1544), a beautifully illustrated original surgery book that became for the following two centuries the main source in teaching surgery. Our study realized a detailed assessment of the book and especially of its illustrations belonging to Francesco Salviati. Exploring the life of Guido Guidi, we were also able to point out other significant contributions in the field of anatomy and clinical medicine as De anatome the first book where are presented disarticulated, the bones of the skull base and also the discovery of the chickenpox. Some surgical personalities attributed to him both the elaboration of the term appendix vermiformis and the first description of an aneurysm, he treated with the help of Fallopio. Although forgotten today, Guido Guidi was a leading figure of the Renais sance medicine both in France and Italy.

  7. Diagnosis and management of herpes zoster by the family and community physician

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    Pedro Alexandre Barreto Coelho


    Full Text Available The herpes virus that causes varicella (chickenpox persists in a latent form in the nervous system and can reactivate and propagate through nerve roots, manifesting years later through painful skin lesions, a condition called herpes zoster. The diagnosis is primarily clinical, but it is important to make a differential diagnosis with impetigo, contact dermatitis, dermatitis herpetiformis and also herpes simplex itself. After the diagnosis is confirmed, treatment should be initiated within the first 72 hours after onset of the rash and it is based upon antiviral therapy. Valacyclovir and famciclovir are more effective when compared to acyclovir. The most common complication of herpes zoster is post-herpetic neuralgia, usually managed with tricyclic antidepressants, anticonvulsants, topical lidocaine or capsaicin. Recently, a live attenuated vaccine against herpes zoster was introduced in Brazil, with the same components as the vaccine against varicella, but in a greater concentration. However, it still has a high cost and is not available in the public health system.

  8. High-resolution CT findings of varicella-zoster pneumonia

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    Choo, Hye Jeung; Kim, Kun Il [Busan National Univ. Hospital, Busan (Korea, Republic of); Lee, Ki Nam [College of Medicine, Donga Univ., Busan (Korea, Republic of)


    To describe the high-resolution CT findings of varicella-zoster pneumonia. Seven adult patients with clinically and serologically diagnosed varicella-zoster pneumonia underwent HRCT scanning. One had undergone a kidney transplant, and the others were immunocompetent. The HRCT findings were retrospectively analyzed by two radiologists in terms of the presence of a nodule, pneumonia consolidation, ground-glass attenuation and pleural effusion, and with regard to the number, size and distribution of nodules. HRCT findings of varicella pneumonia included nodule (n=7), consolidation (n=3), diffuse ground-glass attenuation (n=1) and pleural effusion (n=1). Nodules were mostly 2-10 mm in size, and multiple (n=6), and zonal predominancy was not apparent. One case in which HRCT demonstrated diffuse ground-glass opacity and slight bilateral pleural effusion involved a patient in whom complications of acute respiratory distress syndrome occured. When HRCT demonstrates the presence of nodules 2-10 mm in size multiple nodules, or nodule surrounded by ground-glass attenuation, or the coalescence of nodules and consolidation is observed in adults with chickenpox, the varicella-zoster pneumonia should be included in the differential diagnosis.

  9. Clinical and Etiological Characteristics of Atypical Hand-Foot-and-Mouth Disease in Children from Chongqing, China: A Retrospective Study

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    Xiang Yan


    Full Text Available Background. Hand-foot-and-mouth disease (HFMD is a disease that had similar manifestations to chickenpox, impetigo, and measles, which is easy to misdiagnose and subsequently causes delayed therapy and subsequent epidemic. To date, no study has been conducted to report the clinical and epidemiological characteristics of atypical HFMD. Methods. 64 children with atypical HFMD out of 887 HFMD children were recruited, stool was collected, and viral VP1 was detected. Results. The atypical HFMD accounted for 7.2% of total HFMD in the same period (64/887 and there were two peaks in its prevalence in nonepidemic seasons. Ten children (15.6% had manifestations of neurologic involvement, of whom 4 (6.3% were diagnosed with severe HFMD and 1 with critically severe HFMD, but all recovered smoothly. Onychomadesis and desquamation were found in 14 patients (21.9% and 15 patients (23.4%, respectively. The most common pathogen was coxsackievirus A6 (CV-A6 which accounted for 67.2%, followed by nontypable enterovirus (26.6%, enterovirus 71 (EV-A71 (4.7%, and coxsackievirus A16 (A16 (1.5%. Conclusions. Atypical HFMD has seasonal prevalence. The manifestations of neurologic involvement in atypical HFMD are mild and usually have a good prognosis. CV-A6 is a major pathogen causing atypical HFMD, but not a major pathogen in Chongqing, China.

  10. Infection and childhood leukemia: review of evidence

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    Raquel da Rocha Paiva Maia


    Full Text Available OBJECTIVE : To analyze studies that evaluated the role of infections as well as indirect measures of exposure to infection in the risk of childhood leukemia, particularly acute lymphoblastic leukemia. METHODS : A search in Medline, Lilacs, and SciELO scientific publication databases initially using the descriptors “childhood leukemia” and “infection” and later searching for the words “childhood leukemia” and “maternal infection or disease” or “breastfeeding” or “daycare attendance” or “vaccination” resulted in 62 publications that met the following inclusion criteria: subject aged ≤ 15 years; specific analysis of cases diagnosed with acute lymphoblastic leukemia or total leukemia; exposure assessment of mothers’ or infants’ to infections (or proxy of infection, and risk of leukemia. RESULTS : Overall, 23 studies that assessed infections in children support the hypothesis that occurrence of infection during early childhood reduces the risk of leukemia, but there are disagreements within and between studies. The evaluation of exposure to infection by indirect measures showed evidence of reduced risk of leukemia associated mainly with daycare attendance. More than 50.0% of the 16 studies that assessed maternal exposure to infection observed increased risk of leukemia associated with episodes of influenza, pneumonia, chickenpox, herpes zoster, lower genital tract infection, skin disease, sexually transmitted diseases, Epstein-Barr virus, and Helicobacter pylori . CONCLUSIONS : Although no specific infectious agent has been identified, scientific evidence suggests that exposure to infections has some effect on childhood leukemia etiology.

  11. Necrotizing fasciitis with group A Streptococci and Eggerthella lenta as a complication of Varicella in a child – case presentation –

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    Claudia Cambrea Simona


    Full Text Available Necrotizing fasciitis is a life threatening condition that can be quickly spread through the flesh surrounding the muscle. The disease can be polymicrobial, or caused by group A beta hemolytic Streptococci, or by Clostridium spp. We present a case of a 7 years old girl, which was hospitalized in Children Infectious Diseases Department in a 7th day of chickenpox (hematic crusts all over the body, high fever, asthenia, vomiting, oligoanuria, and tumefaction, pain and functio lessa in the right thigh. In a very short time in the right thigh swelling, edema and congestion have increased gradually, and in the third highest middle thigh the ecchymotic areas appeared evolving towards bubbles and blisters which included the right thigh and calf. After excluding the diagnosis of thrombophlebitis was raised suspicion of necrotizing fasciitis. CT pelvic scan evidenced pelvic asymmetry by maximus and medium right gluteal muscles swelling with important inflammatory infiltrate extended laterally in the subcutaneous adipose tissue. In blood culture was isolated Eggerthella lenta, and from throat swab was isolated group A Streptococci. Treatment consists of a combination of antibiotics associated with intravenous immunoglobulin administration. Despite medical treatment evolution worsened and required transfer in a pediatric surgery department where emergent surgical debridement associated with intensive antibiotic therapy was done. After this intervention evolution was slowly favorable without major limb dysfunction. Polymicrobial necrotizing fasciitis is a severe disease, which if recognized early can have a

  12. Sero-Prevalence of Antibodies against Varicella Zoster Virus in Children under Seven-Years Old in 2012 in Tehran, Iran.

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    Yasaman Vojgani


    Full Text Available Varicella zoster virus (VZV is a member of herpes family viruses, which causes varicella (chickenpox after primary infection and herpes zoster (shingles because of latent virus reactivation from dorsal root ganglia. Generally, prevalence of varicella antibodies increases with age. We aimed to compare the prevalence of anti-VZV antibody in children under seven years old, in order to obtain a preliminarily picture of general presence of these antibodies to design an immunization plan.In this cross-sectional study, performed from September 2011 to September 2012 in Tehran, Iran, 267 serum samples including sera from 7 month old infants, n= 87; 18 month old children, n= 86; and 6 year old children, n= 94 were assessed for the presence of specific IgG antibodies against VZV, using ELISA technique.4.6% of 7 month, 12.8% of 18 month and 21.3% of 6-year-old children were seropositive. No relation was found between demographic variables (e.g. age and birth weight and seropositivity in these age groups. VZV antibodies increased with age. Serum levels of varicella antibodies were elevated in 18 months old compared to 7 months old children, significantly (P < 0.001.In view of the significant elevation of VZV antibodies in children from 7 months to 18 months of age and rate of seronegative children, our results support the necessity of varicella immunization between 7 and 18 months of age in order to prevent viral infection.

  13. Varicella Zoster Virus (VZV-Human Neuron Interaction

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    Don Gilden


    Full Text Available Varicella zoster virus (VZV is a highly neurotropic, exclusively human herpesvirus. Primary infection causes varicella (chickenpox, wherein VZV replicates in multiple organs, particularly the skin. Widespread infection in vivo is confirmed by the ability of VZV to kill tissue culture cells in vitro derived from any organ. After varicella, VZV becomes latent in ganglionic neurons along the entire neuraxis. During latency, virus DNA replication stops, transcription is restricted, and no progeny virions are produced, indicating a unique virus-cell (neuron relationship. VZV reactivation produces zoster (shingles, often complicated by serious neurological and ocular disorders. The molecular trigger(s for reactivation, and thus the identity of a potential target to prevent it, remains unknown due to an incomplete understanding of the VZV-neuron interaction. While no in vitro system has yet recapitulated the findings in latently infected ganglia, recent studies show that VZV infection of human neurons in SCID mice and of human stem cells, including induced human pluripotent stem cells and normal human neural progenitor tissue-like assemblies, can be established in the absence of a cytopathic effect. Usefulness of these systems in discovering the mechanisms underlying reactivation awaits analyses of VZV-infected, highly pure (>90%, terminally differentiated human neurons capable of prolonged survival in vitro.

  14. RNA-seq analysis of host and viral gene expression highlights interaction between varicella zoster virus and keratinocyte differentiation.

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    Meleri Jones


    Full Text Available Varicella zoster virus (VZV is the etiological agent of chickenpox and shingles, diseases characterized by epidermal skin blistering. Using a calcium-induced keratinocyte differentiation model we investigated the interaction between epidermal differentiation and VZV infection. RNA-seq analysis showed that VZV infection has a profound effect on differentiating keratinocytes, altering the normal process of epidermal gene expression to generate a signature that resembles patterns of gene expression seen in both heritable and acquired skin-blistering disorders. Further investigation by real-time PCR, protein analysis and electron microscopy revealed that VZV specifically reduced expression of specific suprabasal cytokeratins and desmosomal proteins, leading to disruption of epidermal structure and function. These changes were accompanied by an upregulation of kallikreins and serine proteases. Taken together VZV infection promotes blistering and desquamation of the epidermis, both of which are necessary to the viral spread and pathogenesis. At the same time, analysis of the viral transcriptome provided evidence that VZV gene expression was significantly increased following calcium treatment of keratinocytes. Using reporter viruses and immunohistochemistry we confirmed that VZV gene and protein expression in skin is linked with cellular differentiation. These studies highlight the intimate host-pathogen interaction following VZV infection of skin and provide insight into the mechanisms by which VZV remodels the epidermal environment to promote its own replication and spread.

  15. Animal Models of Varicella Zoster Virus Infection

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    Ilhem Messaoudi


    Full Text Available Primary infection with varicella zoster virus (VZV results in varicella (chickenpox followed by the establishment of latency in sensory ganglia. Declining T cell immunity due to aging or immune suppressive treatments can lead to VZV reactivation and the development of herpes zoster (HZ, shingles. HZ is often associated with significant morbidity and occasionally mortality in elderly and immune compromised patients. There are currently two FDA-approved vaccines for the prevention of VZV: Varivax® (for varicella and Zostavax® (for HZ. Both vaccines contain the live-attenuated Oka strain of VZV. Although highly immunogenic, a two-dose regimen is required to achieve a 99% seroconversion rate. Zostavax vaccination reduces the incidence of HZ by 51% within a 3-year period, but a significant reduction in vaccine-induced immunity is observed within the first year after vaccination. Developing more efficacious vaccines and therapeutics requires a better understanding of the host response to VZV. These studies have been hampered by the scarcity of animal models that recapitulate all aspects of VZV infections in humans. In this review, we describe different animal models of VZV infection as well as an alternative animal model that leverages the infection of Old World macaques with the highly related simian varicella virus (SVV and discuss their contributions to our understanding of pathogenesis and immunity during VZV infection.

  16. Thomas Huckle Weller MD: Nobel Laureate and research pioneer in poliomyelitis, varicella-zoster virus, cytomegalovirus, rubella, and other infectious diseases. (United States)

    Ligon, B Lee


    In 1954, the Nobel Prize for Medicine was awarded to Drs John Enders, Thomas Weller, and Frederick Robbins for their watershed discovery that growth of poliomyelitis virus occurred in cultures of cells of extraneural origin, first reported in 1949. Their demonstration in 1949 that the Lansing type II strain of poliomyelitis could be grown in cultures of human embryonic tissue set into motion a race to develop a vaccine for the disease that had crippled countless thousands of individuals. The discovery and subsequent recognition were only the beginning of a prolific career for Thomas Huckle Weller, who made numerous contributions to the field of virology, including isolating the varicella-zoster virus (VZV) from cases of chickenpox and zoster, providing suggestive evidence that the same virus is responsible for both diseases; isolating the human cytomegalovirus (CMV) for the first time in tissue culture and suggesting the descriptive name now used for it; establishing Coxsackie viruses as the cause of epidemic pleurodynia: and first isolating rubella virus, the cause of German measles. This article presents a brief biography of Dr Thomas Huckle Weller, one of the field's most important figures, with primary focuses on his work on poliomyelitis, varicella-zoster virus, rubella virus, and cytomegalovirus.

  17. Varicella vaccine for immunocompromised children: results of collaborative studies in the United States and Canada. (United States)

    LaRussa, P; Steinberg, S; Gershon, A A


    Varicella vaccine in immunocompromised children was clinically evaluated in 575 US and Canadian children with leukemia in remission by the Varicella Vaccine Collaborative Study. Most children had chemotherapy stopped 1 week before and 1 week after immunization. Steroids were stopped for 3 weeks (1 week before to 2 weeks after vaccination). Varicella vaccine was safe, immunogenic, and effective in leukemic children at risk for serious disease or death from chickenpox. The major side effect was mild rash in 50% approximately 1 month after immunization. About 40% of children who developed rash were treated with acyclovir. Vaccine efficacy was judged by the degree of protection after a household exposure to varicella; of 123 exposed children, 17 (14%) developed a mild form of varicella. The vaccine protected completely against severe varicella. Leukemic vaccines were less likely to develop zoster than were comparable children with leukemia who had wild type varicella. Thus, varicella vaccine, administered carefully with close follow-up, is extremely beneficial for leukemic children.

  18. Seroprevalence of hepatitis A virus and varicella zoster antibodies in a Javanese community (Yogyakarta, Indonesia). (United States)

    Juffrie, M; Graham, R R; Tan, R I; Widjaja, S; Mulyadi, S; Weil, J; Bock, H L


    Hepatitis A virus (HAV) cause an acute inflammation of the liver. Varicella-zoster virus (VZV) cause chickenpox (varicella) and herpes zoster. Effective vaccines against hepatitis A and varicella are available for children, adolescents and adults. In order to implement an appropriate vaccination policy, a baseline to assess the potential benefits and sections of the population who would benefit most are required. We investigated seroprevalence of hepatitis A virus and varicella zoster antibodies in a Javanese community. A total of 1,103 subjects were studied. The 600 subjects aged 4 to 9 years were sampled between 23 October and 2 November, 1995. The other subjects were sampled between 12 October and 1 November, 1996. The overall prevalence of anti-HAV in cohort was 28.7%. Anti-HAV seroprevalence rates were below 30% until the age of 15 and below 40% until the age of 25. The anti-varicella seroprevalence showed only in two thirds of seropositive population at the age of 15. The results of the study have implications for vaccination strategies for both hepatitis A and varicella zoster.

  19. LGBT health and vaccinations: Findings from a community health survey of Lexington-Fayette County, Kentucky, USA. (United States)

    Jones, Jeff; Poole, Asheley; Lasley-Bibbs, Vivian; Johnson, Mark


    Data on adult immunization coverage at the state level and for LGBT Americans in particular are sparse. This study reports the results of a 2012 Lexington-Fayette County, Kentucky, community health assessment's results asking about eight adult vaccinations among 218 lesbian, gay, bisexual, and transgendered (LGBT) respondents. Researchers collected data using an online survey distributed through LGBT social media, posters, and LGBT print media. The LGBT sample largely matches the demographics of the county as a whole except this group reports higher level of education and fewer uninsured individuals. Among LGBT respondents, immunization prevalence reaches 68.0% (annual Influenza), 65.7% (Hepatitis B), 58.8% (Chickenpox/Varicella), 55.9% (Hepatitis A), 41.2% (Smallpox), and 25.8% (Pneumonia). Among respondents who are currently within the recommended 19-26 years age range for the Human Papillomavirus (HPV) vaccine, the LGBT females are less likely to report receiving the vaccine (15.4%) compared to the national coverage percentage of 34.5%. Males, however, are more likely to have received the vaccine (10.3%) than the national percentage of 2.3%. The small number of LGBT seniors in the study report a much higher prevalence of the Shingles (Herpes Zoster) vaccines than for U.S. seniors 60 and older (71.4% compared to 20.1% nationally). LGBT respondents report higher percentages of adult vaccination.

  20. Herpes Zoster in Healthy Children: A Retrospective Study

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    Birgül Tepe


    Full Text Available Objective: Herpes zoster is an acute dermatomal viral infection caused by the reactivation of varicella zoster virus. While it is commonly seen among elderly and immunocompromised individuals, it is rare in healthy children. The aim of this study was to evaluate the clinical features, treatment and complications of healthy children with herpes zoster. Methods: Thirty one patients aged between 0-16 years who were admitted to our clinic with the diagnosis of herpes zoster, between January 2014 and December 2014, were evaluated retrospectively for age, gender, month of admission, complaint, history of chickenpox infection or varicella vaccination, triggering factors, dermatomal involvement, complications and treatment. Results: Among 31 patients with diagnosis of herpes zoster, 19 were boys (61.3% and 12 were girls (38.7%. The mean of age was 9.12±4.4 years. Twenty patients had thoracic (64.5%, six had lumbar (19.4% and five had cervical involvements (16.2%. The most frequent symptoms were pruritus and pain, respectively. Six patients were administered topical treatment and 25 patients were treated with both systemic and topical treatments. Complication was not observed. Conclusion: Herpes zoster is also being encountered increasingly in healthy children nowadays. It is benign and generally no complications are observed. Incidence can vary because of geographic and socioeconomic differences like vaccination programs.

  1. Seroprevalence of varicella zoster virus infections in Colombo District, Sri Lanka

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    Liyanage NPM


    Full Text Available Background: Although Varicella Zoster virus (VZV infections occur worldwide, the epidemiology is remarkably different in tropical and temperate climates. VZV infections result in significant morbidity and mortality among adults in Sri Lanka. Aims : For future VZV vaccination strategies, we set to determine the age-specific seroprevalence rate of VZV infections in Colombo, Sri Lanka. Materials and methods : The study was carried out from 1999 to 2000. Multi-stage cluster sampling technique was used to collect 913 blood samples, which were tested for the presence of VZV-specific IgG antibodies. Results :0 VZV seroprevalence rates were markedly lower in all age groups when compared to temperate climates. The seroprevalence rates increased with age in both the rural and urban populations. Of those aged 60 years, only 50% in the rural population and 78.9% in the urban population were immune to VZV. Seroprevalence rates of VZV infections were significantly different between the urban and rural populations (P< 0.001, with VZV-specific IgG antibodies detected in 47.5% in the urban population and 27.9% in the rural population. It was found that 56.2% (131 of females of childbearing age were nonimmune to VZV. Conclusions : These findings highlight the need for a VZV vaccination program, which is likely to have a huge impact on the incidence of chickenpox and its associated morbidity and mortality.

  2. Streptococcus pyogenes and re-emergence of scarlet fever as a public health problem. (United States)

    Wong, Samson Sy; Yuen, Kwok-Yung


    Explosive outbreaks of infectious diseases occasionally occur without immediately obvious epidemiological or microbiological explanations. Plague, cholera and Streptococcus pyogenes infection are some of the epidemic-prone bacterial infections. Besides epidemiological and conventional microbiological methods, the next-generation gene sequencing technology permits prompt detection of genomic and transcriptomic profiles associated with invasive phenotypes. Horizontal gene transfer due to mobile genetic elements carrying virulence factors and antimicrobial resistance, or mutations associated with the two component CovRS operon are important bacterial factors conferring survival advantage or invasiveness. The high incidence of scarlet fever in children less than 10 years old suggests that the lack of protective immunity is an important host factor. A high population density, overcrowded living environment and a low yearly rainfall are environmental factors contributing to outbreak development. Inappropriate antibiotic use is not only ineffective for treatment, but may actually drive an epidemic caused by drug-resistant strains and worsen patient outcomes by increasing the bacterial density at the site of infection and inducing toxin production. Surveillance of severe S. pyogenes infection is important because it can complicate concurrent chickenpox and influenza. Concomitant outbreaks of these two latter infections with a highly virulent and drug-resistant S. pyogenes strain can be disastrous.

  3. Outcome of dermal grafting in the management of atrophic facial scars

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    Kanathur Shilpa


    Full Text Available Background: Scars over the face are cosmetically and psychologically disturbing. Various techniques have been described and are being practiced in the management of these scars. Aims and Objectives: This study was undertaken to study the safety, effectiveness of using dermal grafts as fillers in the management of facial scars due to acne, chickenpox, trauma or any others. Materials and Methods: Fifteen patients with atrophic facial scars of varied aetiology and willing for surgery were considered for dermal graft technique. After pre-operative workup, subcision was done 2 weeks before planned surgery. Depending on the type of scar, grafts were inserted using pocket or road railing techniques. Scar improvement was assessed based on patient satisfaction. Results: Linear scars showed excellent improvement. Acne, varicella and traumatic scars also showed good improvement. However, two patients did not appreciate improvement due to marked surface irregularities as the scars were elevated. They were further subjected to LASER and chemical peel resurfacing. Conclusion: Dermal grafting can be used in the management of any round to oval facial scar which is soft, prominent and at least 4-5 mm across; linear scars at least 2-3 mm across and 3-4 cm in length. However, scars with prominent surface irregularities need further resurfacing techniques along with dermal grafting. Limitations: Limitations of the study include small sample size, and only subjective assessment of the scar has been taken into consideration to assess the outcome.

  4. [Infections in the child with acute leukemia]. (United States)

    Carrillo, J M; Jiménez, E; Jiménez, R


    One hundred and twenty-five febrile episodes in 82 children with acute leukemia were studied; 46% of the patients were from urban and 54% from rural areas. The origin of the fever was identified in 91% of the episodes, prevailing pneumonia, septicemia, chickenpox and herpes zoster. The etiological agent was identified in 46% of the cases. A viral predominance was evident, and among them varicela-zoster, following in importance gram-negative bacteria. Histoplasma capsulatum and Pneumocystis carinii were isolated in two occassions each. Sepsis was found more frequently in children with active leukemia than in those in remission (p less than 0.001). Forty-four febrile episodes occurred in patients with less than 1,000 neutrophils/ul. The daily-risk rate of infection was higher in children fom rural than in those from urban areas (p less than 0.001). After clinical and laboratory studies, methicillin and gentamicin were used, in addition to carbenicillin or trimethoprim-sulfamethoxazole is selected cases. This treatment was effective in 86% of the cases. Twelve (15%) children died, 6 of whom were in remission at that moment.

  5. Simian varicella virus infection of rhesus macaques recapitulates essential features of varicella zoster virus infection in humans.

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    Ilhem Messaoudi


    Full Text Available Simian varicella virus (SVV, the etiologic agent of naturally occurring varicella in primates, is genetically and antigenically closely related to human varicella zoster virus (VZV. Early attempts to develop a model of VZV pathogenesis and latency in nonhuman primates (NHP resulted in persistent infection. More recent models successfully produced latency; however, only a minority of monkeys became viremic and seroconverted. Thus, previous NHP models were not ideally suited to analyze the immune response to SVV during acute infection and the transition to latency. Here, we show for the first time that intrabronchial inoculation of rhesus macaques with SVV closely mimics naturally occurring varicella (chickenpox in humans. Infected monkeys developed varicella and viremia that resolved 21 days after infection. Months later, viral DNA was detected only in ganglia and not in non-ganglionic tissues. Like VZV latency in human ganglia, transcripts corresponding to SVV ORFs 21, 62, 63 and 66, but not ORF 40, were detected by RT-PCR. In addition, as described for VZV, SVV ORF 63 protein was detected in the cytoplasm of neurons in latently infected monkey ganglia by immunohistochemistry. We also present the first in depth analysis of the immune response to SVV. Infected animals produced a strong humoral and cell-mediated immune response to SVV, as assessed by immunohistology, serology and flow cytometry. Intrabronchial inoculation of rhesus macaques with SVV provides a novel model to analyze viral and immunological mechanisms of VZV latency and reactivation.

  6. Sequencing and characterization of Varicella-Zoster virus vaccine strain SuduVax

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    Kim Jong


    Full Text Available Abstract Background Varicella-zoster virus (VZV causes chickenpox in children and shingles in older people. Currently, live attenuated vaccines based on the Oka strain are available worldwide. In Korea, an attenuated VZV vaccine has been developed from a Korean isolate and has been commercially available since 1994. Despite this long history of use, the mechanism for the attenuation of the vaccine strain is still elusive. We attempted to understand the molecular basis of attenuation mechanism by full genome sequencing and comparative genomic analyses of the Korean vaccine strain SuduVax. Results SuduVax was found to contain a genome that was 124,759 bp and possessed 74 open reading frames (ORFs. SuduVax was genetically most close to Oka strains and these Korean-Japanese strains formed a strong clade in phylogenetic trees. SuduVax, similar to the Oka vaccine strains, underwent T- > C substitution at the stop codon of ORF0, resulting in a read-through mutation to code for an extended form of ORF0 protein. SuduVax also shared certain deletion and insertion mutations in ORFs 17, 29, 56 and 60 with Oka vaccine strains and some clinical strains. Conclusions The Korean VZV vaccine strain SuduVax is genetically similar to the Oka vaccine strains. Further comparative genomic and bioinformatics analyses will help to elucidate the molecular basis of the attenuation of the VZV vaccine strains.

  7. Susceptibility to varicella zoster virus infection in health care workers.

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    Gallagher, J


    Varicella zoster virus (VZV) is an occupational hazard for a percentage of health care staff. Nine hundred and seventy staff members attending the Occupational Health Department at Cork University Hospital took part in the survey. A latex agglutination assay was used to determine the health care workers immune status to VZV. Of the 970 workers tested, 928 (95.7%) were immune to VZV. The sensitivity, specificity and predictive value of an enquiry regarding a history of chicken-pox was determined on a sample of 206 health care workers. The positive predictive value was 95% (119\\/125) and the negative predictive value was 11% (4\\/35). The sensitivity of the enquiry was 79% (119\\/150), the specificity was 40% (4\\/10), reducing to 61% (119\\/195) and 36% (4\\/11) respectively when individuals with uncertain histories were included in the calculations. The advantages and disadvantages of selective staff screening are discussed. In the authors\\' opinion all health care workers involved in the clinical care of patients should be screened by serology for past VZV infection before taking up duty and those who are susceptible to VZV should be made aware of the risks and health effects associated with VZV if contracted.

  8. Chemical reconstruction of skin scars therapy using 100% trichloroacetic acid in the treatment of atrophic facial post varicella scars: A pilot study

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    Nidheesh Agarwal


    Full Text Available Context: Chickenpox (varicella is a common viral disease caused by Varicella zoster virus. Facial atrophic scars after varicella infection are not uncommon and pose a cosmetic problem. Like atrophic scars of other aetiologies, they are a difficult condition to treat. There are not enough references in the literature regarding efficient treatment of post varicella scars. High strength Trichloroacetic acid (TCA, which is known to cause dermal collagen remodelling, was used to treat varicella scars in the present study. Aims: The study was undertaken to assess the efficiency of Chemical Reconstruction of Skin Scars (CROSS technique using 100% TCA in the treatment of atrophic facial post varicella scars. Settings and Design: Open label, pilot study. Materials and Methods: A total of 16 patients with atrophic facial post varicella scars were treated by focal application of 100% TCA solution by pressing down upon the scar surface by a toothpick (CROSS technique. Total 4 sittings were given at 2 weekly intervals and the results evaluated after 3 months of follow-up. Statistical analysis was carried out using Fischer′s exact t-test. Results: All of the 13 patients who completed the study showed good clinical improvement, with 69% patients grading the response as excellent (>75% improvement, whereas the rest 31% patients reporting good (51-75% improvement. No significant complications were seen in any patient. Conclusions: CROSS technique using 100% TCA is a safe, cheap and effective therapy for the treatment of post varicella scars.

  9. Quantitative Measurement of Varicella-Zoster Virus Infection by Semiautomated Flow Cytometry▿ (United States)

    Gates, Irina V.; Zhang, Yuhua; Shambaugh, Cindy; Bauman, Meredith A.; Tan, Charles; Bodmer, Jean-Luc


    Varicella-zoster virus (VZV; human herpesvirus 3) is the etiological cause of chickenpox and, upon reactivation from latency, zoster. Currently, vaccines are available to prevent both diseases effectively. A critical requirement for the manufacturing of safe and potent vaccines is the measurement of the biological activity to ensure proper dosing and efficacy, while minimizing potentially harmful secondary effects induced by immunization. In the case of live virus-containing vaccines, such as VZV-containing vaccines, biological activity is determined using an infectivity assay in a susceptible cellular host in vitro. Infectivity measurements generally rely on the enumeration of plaques by visual inspection of an infected cell monolayer. These plaque assays are generally very tedious and labor intensive and have modest throughput and high associated variability. In this study, we have developed a flow cytometry assay to measure the infectivity of the attenuated vaccine strain (vOka/Merck) of VZV in MRC-5 cells with improved throughput. The assay is performed in 96-well tissue culture microtiter plates and is based on the detection and quantification of infected cells expressing VZV glycoproteins on their surfaces. Multiple assay parameters have been investigated, including specificity, limit of detection, limit of quantification, range of linear response, signal-to-noise ratio, and precision. This novel assay appears to be in good concordance with the classical plaque assay results and therefore provides a viable, higher-throughput alternative to the plaque assay. PMID:19201967

  10. Quantitative measurement of varicella-zoster virus infection by semiautomated flow cytometry. (United States)

    Gates, Irina V; Zhang, Yuhua; Shambaugh, Cindy; Bauman, Meredith A; Tan, Charles; Bodmer, Jean-Luc


    Varicella-zoster virus (VZV; human herpesvirus 3) is the etiological cause of chickenpox and, upon reactivation from latency, zoster. Currently, vaccines are available to prevent both diseases effectively. A critical requirement for the manufacturing of safe and potent vaccines is the measurement of the biological activity to ensure proper dosing and efficacy, while minimizing potentially harmful secondary effects induced by immunization. In the case of live virus-containing vaccines, such as VZV-containing vaccines, biological activity is determined using an infectivity assay in a susceptible cellular host in vitro. Infectivity measurements generally rely on the enumeration of plaques by visual inspection of an infected cell monolayer. These plaque assays are generally very tedious and labor intensive and have modest throughput and high associated variability. In this study, we have developed a flow cytometry assay to measure the infectivity of the attenuated vaccine strain (vOka/Merck) of VZV in MRC-5 cells with improved throughput. The assay is performed in 96-well tissue culture microtiter plates and is based on the detection and quantification of infected cells expressing VZV glycoproteins on their surfaces. Multiple assay parameters have been investigated, including specificity, limit of detection, limit of quantification, range of linear response, signal-to-noise ratio, and precision. This novel assay appears to be in good concordance with the classical plaque assay results and therefore provides a viable, higher-throughput alternative to the plaque assay.

  11. Antibacterial and Antioxidant Properties of the Methanolic Extract of the Stem Bark of Pteleopsis hylodendron (Combretaceae

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    Aristide Laurel Mokale Kognou


    Full Text Available Pteleopsis hylodendron (Combretaceae is used in Cameroon and West Africa folk medicine for the treatment of various microbial infections (measles, chickenpox, and sexually transmitted diseases. The antibacterial properties of the methanolic extract and fractions from stem bark of Pteleopsis hylodendron were tested against three Gram-positive bacteria and eight Gram-negative bacteria using Agar-well diffusion and Broth microdilution methods. Antioxidant activities of the crude extract and fractions were investigated by DPPH radical scavenging activity and β-carotene-linoleic acid assays. The methanolic extract and some fractions exhibited antibacterial activities that varied between the bacterial species (ID = 0.00–25.00 mm; MIC = 781–12500 μg/mL and 0.24–1000 μg/mL. The activity of the crude extract is, however, very weak compared to the reference antibiotics (MIC = 0.125–128 μg/mL. Two fractions (FE and FF showed significant activity (MIC = 0.97 μg/mL while S. aureus ATCC 25922 was almost resistant to all the tested fractions. In addition, the crude extract and some fractions showed good antioxidant potential with inhibition values ranging from 17.53 to 98.79%. These results provide promising baseline information for the potential use of this plant as well as some of the fractions in the treatment of infectious diseases and oxidative stress.

  12. Analysis of single nucleotide polymorphism among Varicella-Zoster Virus and identification of vaccine-specific sites. (United States)

    Jeon, Jeong Seon; Won, Youn Hee; Kim, In Kyo; Ahn, Jin Hyun; Shin, Ok Sarah; Kim, Jung Hwan; Lee, Chan Hee


    Varicella-zoster virus (VZV) is a causative agent for chickenpox and zoster. Live attenuated vaccines have been developed based on Oka and MAV/06 strains. In order to understand the molecular mechanisms of attenuation, complete genome sequences of vaccine and wild-type strains were compared and single nucleotide polymorphism (SNP) was analyzed. ORF22 and ORF62 contained the highest number of SNPs. The detailed analysis of the SNPs suggested 24 potential vaccine-specific sites. All the mutational events found in vaccine-specific sites were transitional, and most of them were substitution of AT to GC pair. Interestingly, 18 of the vaccine-specific sites of the vaccine strains appeared to be genetically heterogeneous. The probability of a single genome of vaccine strain to contain all 24 vaccine-type sequences was calculated to be less than 4%. The average codon adaptation index (CAI) value of the vaccine strains was significantly lower than the CAI value of the clinical strains.

  13. Using stated preference discrete choice modelling to evaluate the introduction of varicella vaccination. (United States)

    Hall, Jane; Kenny, Patricia; King, Madeleine; Louviere, Jordan; Viney, Rosalie; Yeoh, Angela


    Applications of stated preference discrete choice modelling (SPDCM) in health economics have been used to estimate consumer willingness to pay and to broaden the range of consequences considered in economic evaluation. This paper demonstrates how SPDCM can be used to predict participation rates, using the case of varicella (chickenpox) vaccination. Varicella vaccination may be cost effective compared to other public health programs, but this conclusion is sensitive to the proportion of the target population immunised. A choice experiment was conducted on a sample of Australian parents to predict uptake across a range of hypothetical programs. Immunisation rates would be increased by providing immunisation at no cost, by requiring it for school entry, by increasing immunisation rates in the community and decreasing the incidence of mild and severe side effects. There were two significant interactions; price modified the effect of both support from authorities and severe side effects. Country of birth was the only significant demographic characteristic. Depending on aspects of the immunisation program, the immunisation rates of children with Australian-born parents varied from 9% to 99% while for the children with parents born outside Australia they varied from 40% to 99%. This demonstrates how SPDCM can be used to understand the levels of attributes that will induce a change in the decision to immunise, the modification of the effect of one attribute by another, and subgroups in the population. Such insights can contribute to the optimal design and targeting of health programs.

  14. Postherpetic neuralgia: epidemiology, pathophysiology, and pain management pharmacology

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    Mallick-Searle T


    Full Text Available Theresa Mallick-Searle,1 Brett Snodgrass,2 Jeannine M Brant,3 1Pain Management Center, Stanford Health Care, Redwood City, CA, 2LifeLinc Pain Centers, Cordova, TN, 3Billings Clinic, Billings, MT, USA Abstract: Herpes zoster, also known as shingles, is a distinctive clinical condition caused by the reactivation of latent varicella zoster (chickenpox virus following an initial infection. Approximately 1 million cases of herpes zoster occur annually in the US, and one in every three people develops herpes zoster during their lifetime. Postherpetic neuralgia is a neuropathic pain syndrome characterized by pain that persists for months to years after resolution of the herpes zoster rash. It stems from damage to peripheral and central neurons that may be a byproduct of the immune/inflammatory response accompanying varicella zoster virus reactivation. Patients with postherpetic neuralgia report decreased quality of life and interference with activities of daily living. Approaches to management of postherpetic neuralgia include preventing herpes zoster through vaccination and/or antiviral treatment, and administering specific medications to treat pain. Current guidelines recommend treatment of postherpetic neuralgia in a hierarchical manner, with calcium channel α2-δ ligands (gabapentin and pregabalin, tricyclic antidepressants (amitriptyline, nortriptyline, or desipramine, or topical lidocaine patches as first-line drugs. The safety and tolerability of pharmacologic therapies for pain are important issues to consider as postherpetic neuralgia affects primarily an older population. Patients should be educated on appropriate dosing, titration if applicable, the importance of adherence to treatment for optimal effectiveness, and possible side effects. Health-care professionals play a key role in helping to ameliorate the pain caused by postherpetic neuralgia through early recognition and diligent assessment of the problem; recommending evidence

  15. Seroprevalence of cytomegalovirus, Epstein Barr virus and varicella zoster virus among pregnant women in Bradford: a cohort study.

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    Lucy Pembrey

    Full Text Available OBJECTIVE: To estimate the seroprevalence of cytomegalovirus (CMV, Epstein Barr virus (EBV and varicella zoster virus (VZV among pregnant women in Bradford by ethnic group and country of birth. METHODS: A stratified random sample of 949 pregnant women enrolled in the Born in Bradford birth cohort was selected to ensure sufficient numbers of White UK born women, Asian UK born women and Asian women born in Asia. Serum samples taken at 24-28 weeks' gestation were tested for CMV IgG, EBV IgG and VZV IgG. Each woman completed a questionnaire which included socio-demographic information. RESULTS: CMV seroprevalence was 49% among the White British women, 89% among South Asian UK born women and 98% among South Asian women born in South Asia. These differences remained after adjusting for socio-demographic factors. In contrast, VZV seroprevalence was 95% among women born in the UK but significantly lower at 90% among South Asian women born in Asia. EBV seroprevalence was 94% overall and did not vary by ethnic group/country of birth. CONCLUSIONS: Although about half of White British women are at risk of primary CMV infection in pregnancy and the associated increased risk of congenital infection, most congenital CMV infections are likely to be in children born to South Asian women with non-primary infection during pregnancy. South Asian women born in South Asia are at risk of VZV infection during pregnancy which could produce congenital varicella syndrome or perinatal chickenpox. Differences in CMV and VZV seroprevalence by ethnic group and country of birth must be taken into account when universal immunisation against these viruses is contemplated.

  16. Postherpetic neuralgia: Therapeutic and prophylactic aspects and pregabalin therapy

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    E.G. Mendelevich


    Full Text Available Postherpetic neuralgia (PHN is one of the most common and persistent chronic pain syndromes caused by chickenpox virus affecting the peripheral and central nervous systems. PHN is a typical neuropathic pain resulting from injury or dysfunction of the somatosensory system whose development involves a few mechanisms. Elderly people are more prone to PHN, which is associated with the weakened immune system. Treatment of shingles cannot completely prevent subsequent neuralgia; however, some drugs can reduce its manifestations. The diagnosis of PHN is largely based on the duration of pain after rash onset. However, it is difficult to estimate the real rate of PHN development because there is neither consensus of opinion on this issue nor common criteria for pat duration (1 to 6 months, as shown by different data. The significant factors that may predispose to PHN are older age, female gender, and acute herpes zoster indicators, such as pain intensity, the severity of herpetic rash and infectious manifestations. Pain syndrome in PHN can reach a high intensity level, accompanied by the development of chronic fatigue, depression, and loss of social skills. There are several types of pain in PHN: constant, paroxysmal and allodynia, which are due to different pathophysiological mechanisms. Variability in the clinical manifestations of PHN may underlie the inadequate efficacy of one or other drug. The treatment of PHN poses definite difficulties. About 40-50% of patients continue to suffer from pain despite the fact that the multitude of currently available therapies is performed. Pregabalin, whose high efficacy and advantages in the treatment of pain in PHN are demonstrated in numerous studies, is one of the most effective first-line drugs for PHN. In-depth analysis suggests that inadequately low doses of pregabalin are frequently used in the treatment of PHN, which may lead to an insufficient analgesic effect.

  17. 3D reconstruction of VZV infected cell nuclei and PML nuclear cages by serial section array scanning electron microscopy and electron tomography.

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    Mike Reichelt

    Full Text Available Varicella-zoster virus (VZV is a human alphaherpesvirus that causes varicella (chickenpox and herpes zoster (shingles. Like all herpesviruses, the VZV DNA genome is replicated in the nucleus and packaged into nucleocapsids that must egress across the nuclear membrane for incorporation into virus particles in the cytoplasm. Our recent work showed that VZV nucleocapsids are sequestered in nuclear cages formed from promyelocytic leukemia protein (PML in vitro and in human dorsal root ganglia and skin xenografts in vivo. We sought a method to determine the three-dimensional (3D distribution of nucleocapsids in the nuclei of herpesvirus-infected cells as well as the 3D shape, volume and ultrastructure of these unique PML subnuclear domains. Here we report the development of a novel 3D imaging and reconstruction strategy that we term Serial Section Array-Scanning Electron Microscopy (SSA-SEM and its application to the analysis of VZV-infected cells and these nuclear PML cages. We show that SSA-SEM permits large volume imaging and 3D reconstruction at a resolution sufficient to localize, count and distinguish different types of VZV nucleocapsids and to visualize complete PML cages. This method allowed a quantitative determination of how many nucleocapsids can be sequestered within individual PML cages (sequestration capacity, what proportion of nucleocapsids are entrapped in single nuclei (sequestration efficiency and revealed the ultrastructural detail of the PML cages. More than 98% of all nucleocapsids in reconstructed nuclear volumes were contained in PML cages and single PML cages sequestered up to 2,780 nucleocapsids, which were shown by electron tomography to be embedded and cross-linked by an filamentous electron-dense meshwork within these unique subnuclear domains. This SSA-SEM analysis extends our recent characterization of PML cages and provides a proof of concept for this new strategy to investigate events during virion assembly at the

  18. Epidemiological investigation of mixed outbreaks of measles/varicella in hilly villages of district Kangra, Himachal Pradesh, India

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    Full Text Available Background On 26th September 2006, a local health worker informed us about sudden increased number of cases of fever and rash in three villages of district Kangra. We investigated the suspected outbreak to confirm diagnosis and recommendation to prevent and control.Methods A case of measles was defined as occurrence of fever with rash in a child between six months to 17 years of age, from 26th September to 2nd week of January, 2007. The information on age, sex, symptoms, signs, date of onset, residence, traveling history treatment taken and assessment of cold chain system was collected. The outbreak was described by place, time and person characteristics. We also conducted a retrospective cohort study among children between 10 months and 15 years of age to estimate the vaccine efficacy. We confirmed diagnosis clinically, epidemiologically and serologically. Results We identified 29/35 measles and 6/35 were confirmed as epidemiologically linked unvaccinated chickenpox case patients. The overall attack rate (AR was 8.13%; maximally in the age group of 11-17 years ranging in between 17-35%. Sex specific AR was more (17% in females. There was neither any death nor any serious complications. The proportion of the children vaccinated was 95% for measles but nil for varicella. Of 35 case-patients, 27 (78% were vaccinated for measles only with no vitamin A supplementation (relative risk: 5.3; 95% confidence interval: 1.90 – 14.77. The measles vaccine efficacy was estimated to be 82%. 3/3 case-patients for measles IgM antibodies and 2/3 nasopharyngeal swabs were tested positive by PCR and D4 measles strain genotyped.Conclusion Measles/varicella outbreaks were confirmed. We recommended varicella vaccination, second dose opportunity for measles and vitamin A supplementation to all cases in affected areas.

  19. Forecasting fluctuating outbreaks in seasonally driven epidemics (United States)

    Stone, Lewi


    Seasonality is a driving force that has major impact on the spatio-temporal dynamics of natural systems and their populations. This is especially true for the transmission of common infectious diseases such as influenza, measles, chickenpox, and pertussis. Here we gain new insights into the nonlinear dynamics of recurrent diseases through the analysis of the classical seasonally forced SIR epidemic model. Despite many efforts over the last decades, it has been difficult to gain general analytical insights because of the complex synchronization effects that can evolve between the external forcing and the model's natural oscillations. The analysis advanced here attempts to make progress in this direction by focusing on the dynamics of ``skips'' where we identify and predict years in which the epidemic is absent rather than outbreak years. Skipping events are intrinsic to the forced SIR model when parameterised in the chaotic regime. In fact, it is difficult if not impossible to locate realistic chaotic parameter regimes in which outbreaks occur regularly each year. This contrasts with the well known Rossler oscillator whose outbreaks recur regularly but whose amplitude vary chaotically in time (Uniform Phase Chaotic Amplitude oscillations). The goal of the present study is to develop a ``language of skips'' that makes it possible to predict under what conditions the next outbreak is likely to occur, and how many ``skips'' might be expected after any given outbreak. We identify a new threshold effect and give clear analytical conditions that allow accurate predictions. Moreover, the time of occurrence (i.e., phase) of an outbreak proves to be a useful new parameter that carries important epidemiological information. In forced systems, seasonal changes can prevent late-initiating outbreaks (i.e., having high phase) from running to completion. These principles yield forecasting tools that should have relevance for the study of newly emerging and reemerging diseases.

  20. Microbiology laboratory and the management of mother-child varicella-zoster virus infection (United States)

    De Paschale, Massimo; Clerici, Pierangelo


    Varicella-zoster virus, which is responsible for varicella (chickenpox) and herpes zoster (shingles), is ubiquitous and causes an acute infection among children, especially those aged less than six years. As 90% of adults have had varicella in childhood, it is unusual to encounter an infected pregnant woman but, if the disease does appear, it can lead to complications for both the mother and fetus or newborn. The major maternal complications include pneumonia, which can lead to death if not treated. If the virus passes to the fetus, congenital varicella syndrome, neonatal varicella (particularly serious if maternal rash appears in the days immediately before or after childbirth) or herpes zoster in the early years of life may occur depending on the time of infection. A Microbiology laboratory can help in the diagnosis and management of mother-child infection at four main times: (1) when a pregnant woman has been exposed to varicella or herpes zoster, a prompt search for specific antibodies can determine whether she is susceptible to, or protected against infection; (2) when a pregnant woman develops clinical symptoms consistent with varicella, the diagnosis is usually clinical, but a laboratory can be crucial if the symptoms are doubtful or otherwise unclear (atypical patterns in immunocompromised subjects, patients with post-vaccination varicella, or subjects who have received immunoglobulins), or if there is a need for a differential diagnosis between varicella and other types of dermatoses with vesicle formation; (3) when a prenatal diagnosis of uterine infection is required in order to detect cases of congenital varicella syndrome after the onset of varicella in the mother; and (4) when the baby is born and it is necessary to confirm a diagnosis of varicella (and its complications), make a differential diagnosis between varicella and other diseases with similar symptoms, or confirm a causal relationship between maternal varicella and malformations in a newborn

  1. Postherpetic neuralgia: epidemiology, pathophysiology, and pain management pharmacology (United States)

    Mallick-Searle, Theresa; Snodgrass, Brett; Brant, Jeannine M


    Herpes zoster, also known as shingles, is a distinctive clinical condition caused by the reactivation of latent varicella zoster (chickenpox) virus following an initial infection. Approximately 1 million cases of herpes zoster occur annually in the US, and one in every three people develops herpes zoster during their lifetime. Postherpetic neuralgia is a neuropathic pain syndrome characterized by pain that persists for months to years after resolution of the herpes zoster rash. It stems from damage to peripheral and central neurons that may be a byproduct of the immune/inflammatory response accompanying varicella zoster virus reactivation. Patients with postherpetic neuralgia report decreased quality of life and interference with activities of daily living. Approaches to management of postherpetic neuralgia include preventing herpes zoster through vaccination and/or antiviral treatment, and administering specific medications to treat pain. Current guidelines recommend treatment of postherpetic neuralgia in a hierarchical manner, with calcium channel α2-δ ligands (gabapentin and pregabalin), tricyclic antidepressants (amitriptyline, nortriptyline, or desipramine), or topical lidocaine patches as first-line drugs. The safety and tolerability of pharmacologic therapies for pain are important issues to consider as postherpetic neuralgia affects primarily an older population. Patients should be educated on appropriate dosing, titration if applicable, the importance of adherence to treatment for optimal effectiveness, and possible side effects. Health-care professionals play a key role in helping to ameliorate the pain caused by postherpetic neuralgia through early recognition and diligent assessment of the problem; recommending evidence-based treatments; and monitoring treatment adherence, adverse events, responses, and expectations. Nurse practitioners are especially crucial in establishing communication with patients and encouraging the initiation of appropriate

  2. Varicella and Herpes Zoster in Madrid, based on the Sentinel General Practitioner Network: 1997–2004

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    Gutiérrez-Rodríguez Ángeles


    Full Text Available Abstract Background Varicella (chickenpox is the primary disease caused by varicella-zoster virus. It is extremely contagious and is frequent in children. Indeed, in the absence of vaccination, a high proportion of the population is liable to contract it. Herpes zoster -more frequent among adults- is caused by reactivation of the latent virus. The objective of this study is to describe the status of and time trend for varicella and herpes zoster in the Madrid Autonomous Region prior to the introduction of the vaccine to the general population. Methods Data source: individualised varicella and herpes zoster case records kept by the Madrid Autonomous Region Sentinel General Practitioner Network for the period 1997–2004. Cumulative incidences, crude and standardised incidence rates, and age-specific rates of varicella and herpes zoster were calculated for each year. Kendall's Tau-b correlation coefficient was calculated to evaluate whether incidence displayed a time trend. Spectral density in the time series of weekly incidences was estimated using a periodogram. Results Standardised annual varicella incidence rates ranged from 742.5 (95% CI: 687.2 – 797.7 to 1239.6 (95% CI: 1164.5 – 1313.4 cases per 100 000 person-years. Most cases affected children, though complications were more frequent in adults. Varicella incidence displayed an annual periodicity but no trend over time. Most herpes zoster cases occurred at advanced ages, with incidence registering a rising annual trend but no seasonality factor. Conclusion In the absence of vaccination, no significant changes in varicella incidence were in evidence recent years, though these were observed in the incidence of herpes zoster. Sentinel general practitioner networks are a valid instrument for surveillance of diseases such as varicella. Further varicella vaccination-coverage and vaccine-efficacy studies are called for.

  3. Attitudinal variables and a possible mediating mechanism for vaccination practice in health care workers of a local hospital in L'Aquila (Italy) (United States)

    Scatigna, Maria; Fabiani, Leila; Micolucci, Giovanna; Santilli, Flavio; Mormile, Pasquale; Giuliani, Anna Rita


    ABSTRACT Active immunization is an important concern for health care workers (HCWs) susceptible subjects and potential sources of infection for patients. However, the vaccine coverage for vaccine preventable diseases (VPDs) is below recommended standards. The aims of the study were to estimate the hospitals' HCWs' susceptibility and vaccination coverage rates for VPDs and to analyze the role of HCWs' attitudes and knowledge as determinants of the immunization practices. A cross-sectional study enrolled 334 HCWs (physicians, nurses, others) at local hospital in L'Aquila (Italy). By means of an anonymous questionnaire, self-report data about history of disease and active vaccination for seasonal influenza, chickenpox, measles-mumps-rubella and hepatitis B were collected, as well as attitudes and knowledge about vaccination in HCWs. The employees showed high levels of susceptibility and insufficient vaccination coverage rates, particularly for influenza. Specific trends were detected for different VPDs across age strata and professional categories, not always consistent with literature. Overall, the level of knowledge about recommended vaccination for HCWs was low, in all categories. The active immunization status against influenza was found the most clearly associated with difference levels in 3 psychometric variables: personal responsibility, beliefs on usefulness and beliefs on risk of vaccination. A mediation mechanism was analyzed between these constructs, and an interesting indirect effect was highlighted for beliefs that could enhance the advantage of increased responsibility for HCWs. Further effort in research is needed to evaluate the black-box of longitudinal intervention studies (education, environmental changes, policies), to improve HCWs immunization. PMID:27624736

  4. 3D Reconstruction of VZV Infected Cell Nuclei and PML Nuclear Cages by Serial Section Array Scanning Electron Microscopy and Electron Tomography (United States)

    Reichelt, Mike; Joubert, Lydia; Perrino, John; Koh, Ai Leen; Phanwar, Ibanri; Arvin, Ann M.


    Varicella-zoster virus (VZV) is a human alphaherpesvirus that causes varicella (chickenpox) and herpes zoster (shingles). Like all herpesviruses, the VZV DNA genome is replicated in the nucleus and packaged into nucleocapsids that must egress across the nuclear membrane for incorporation into virus particles in the cytoplasm. Our recent work showed that VZV nucleocapsids are sequestered in nuclear cages formed from promyelocytic leukemia protein (PML) in vitro and in human dorsal root ganglia and skin xenografts in vivo. We sought a method to determine the three-dimensional (3D) distribution of nucleocapsids in the nuclei of herpesvirus-infected cells as well as the 3D shape, volume and ultrastructure of these unique PML subnuclear domains. Here we report the development of a novel 3D imaging and reconstruction strategy that we term Serial Section Array-Scanning Electron Microscopy (SSA-SEM) and its application to the analysis of VZV-infected cells and these nuclear PML cages. We show that SSA-SEM permits large volume imaging and 3D reconstruction at a resolution sufficient to localize, count and distinguish different types of VZV nucleocapsids and to visualize complete PML cages. This method allowed a quantitative determination of how many nucleocapsids can be sequestered within individual PML cages (sequestration capacity), what proportion of nucleocapsids are entrapped in single nuclei (sequestration efficiency) and revealed the ultrastructural detail of the PML cages. More than 98% of all nucleocapsids in reconstructed nuclear volumes were contained in PML cages and single PML cages sequestered up to 2,780 nucleocapsids, which were shown by electron tomography to be embedded and cross-linked by an filamentous electron-dense meshwork within these unique subnuclear domains. This SSA-SEM analysis extends our recent characterization of PML cages and provides a proof of concept for this new strategy to investigate events during virion assembly at the single cell

  5. CD4 T cell immunity is critical for the control of simian varicella virus infection in a nonhuman primate model of VZV infection.

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    Kristen Haberthur


    Full Text Available Primary infection with varicella zoster virus (VZV results in varicella (more commonly known as chickenpox after which VZV establishes latency in sensory ganglia. VZV can reactivate to cause herpes zoster (shingles, a debilitating disease that affects one million individuals in the US alone annually. Current vaccines against varicella (Varivax and herpes zoster (Zostavax are not 100% efficacious. Specifically, studies have shown that 1 dose of varivax can lead to breakthrough varicella, albeit rarely, in children and a 2-dose regimen is now recommended. Similarly, although Zostavax results in a 50% reduction in HZ cases, a significant number of recipients remain at risk. To design more efficacious vaccines, we need a better understanding of the immune response to VZV. Clinical observations suggest that T cell immunity plays a more critical role in the protection against VZV primary infection and reactivation. However, no studies to date have directly tested this hypothesis due to the scarcity of animal models that recapitulate the immune response to VZV. We have recently shown that SVV infection of rhesus macaques models the hallmarks of primary VZV infection in children. In this study, we used this model to experimentally determine the role of CD4, CD8 and B cell responses in the resolution of primary SVV infection in unvaccinated animals. Data presented in this manuscript show that while CD20 depletion leads to a significant delay and decrease in the antibody response to SVV, loss of B cells does not alter the severity of varicella or the kinetics/magnitude of the T cell response. Loss of CD8 T cells resulted in slightly higher viral loads and prolonged viremia. In contrast, CD4 depletion led to higher viral loads, prolonged viremia and disseminated varicella. CD4 depleted animals also had delayed and reduced antibody and CD8 T cell responses. These results are similar to clinical observations that children with agammaglobulinemia have

  6. Fractional lasers in dermatology - Current status and recommendations

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    Apratim Goel


    Full Text Available Introduction: Fractional laser technology is a new emerging technology to improve scars, fine lines, dyspigmentation, striae and wrinkles. The technique is easy, safe to use and has been used effectively for several clinical and cosmetic indications in Indian skin. Devices: Different fractional laser machines, with different wavelengths, both ablative and non-ablative, are now available in India. A detailed understanding of the device being used is recommended. Indications: Common indications include resurfacing for acne, chickenpox and surgical scars, periorbital and perioral wrinkles, photoageing changes, facial dyschromias. The use of fractional lasers in stretch marks, melasma and other pigmentary conditions, dermatological conditions such as granuloma annulare has been reported. But further data are needed before adopting them for routine use in such conditions. Physician qualification: Any qualified dermatologist may administer fractional laser treatment. He/ she should possess a Master′s degree or diploma in dermatology and should have had specific hands-on training in lasers, either during postgraduation or later at a facility which routinely performs laser procedures under a competent dermatologist or plastic surgeon with experience and training in using lasers. Since parameters may vary with different systems, specific training tailored towards the concerned device at either the manufacturer′s facility or at another center using the machine is recommended. Facility: Fractional lasers can be used in the dermatologist′s minor procedure room for the above indications. Preoperative counseling and Informed consent: Detailed counseling with respect to the treatment, desired effects and possible postoperative complications should be provided to the patient. The patient should be provided brochures to study and also adequate opportunity to seek information. A detailed consent form needs to be completed by the patient. Consent form should

  7. Incidence of Latent Virus Shedding during Space Flight (United States)

    Mehta, Satish K.; Cohrs, Randall J.; Gilden, Donald H.; Tyring, Stephen K.; Ott, C. Mark; Pierson, Duane L.


    Measurements of immune parameters of both cellular and innate immunity indicate alterations in immune function in astronauts. Immune changes are due to stress and perhaps other factors associated with launch, flight, and landing phases. Medical relevance of observed changes is not known. The reactivation of latent viruses has been identified as an important in vivo indicator of clinically relevant immune changes. The polymerase chain reaction (PCR) was used to detect the presence of specific viral DNA in body fluids. Initial studies demonstrated Epstein-Barr virus (EBV) reactivation during all 3 mission phases. EBV is shed in saliva following reactivation from B-cells. Incidence of EBV in saliva was higher than control subjects during all 3 mission phases. However, quantitative PCR revealed 10-fold higher levels of EBV DNA present in saliva collected during flight than found in pre- and post flight specimens. To determine if other latent viruses showed similar effects, cytomegalovirus (CMV), another herpes virus, shed in urine following reactivation was studied. A very low incidence (less than 2%) of CMV in urine is found in healthy, lowstressed individuals. However, 25-50% of astronauts shed CMV in their urine before, during, or after flight. Our studies are now focused on varicella-zoster virus (VZV), the etiological agent of chicken-pox during childhood and shingles later in life. We demonstrated reactivation of VZV and shedding of the virus during and after spaceflight in saliva of astronauts with no sign of active infection or symptoms. The maximum shedding of VZV occurred during the flight phase and diminishes rapidly during the first five days after landing. We have utilized the same PCR assay for VZV in a clinical study of shingles patients. Generally, shingles patients shed much more VZV in saliva than astronauts. However, the VZV levels in astronauts overlap with the lower range of VZV numbers in shingles patients. Saliva from shingles patients and

  8. [Chronic and vaccine-preventable diseases in children and adolescents in Germany: results of the KiGGS study: first follow up (KiGGS wave 1)]. (United States)

    Neuhauser, H; Poethko-Müller, C


    The German Health Interview and Examination Survey for Children and Adolescents (KiGGS) 2003-2006 is the first nationwide comprehensive study on the health of children and adolescents living in Germany. The KiGGS first interview follow-up is a telephone interview study that collected, among other things, data on a number of chronic and vaccine-preventable diseases in 2009-2012 and is a combined cross-sectional and longitudinal study based on a population registry sample from the 167 KiGGS study points. The analysis is based on 12,368 respondents (7913 KiGGS follow-up participants aged 7-17 years, response 72 % and 4455 newly recruited 0- to 6-year-olds, response 42 %). Based on parent reports the lifetime prevalence of both chickenpox and pertussis has decreased in the population targeted by recently changed vaccination recommendations. For measles the prevalence remained unsatisfactorily high in each investigated age group. Of the children and adolescents aged 0-17 years 16 % (95 % confidence interval CI 15.2-17.0 %) had a long-standing chronic health condition according to the parents. Of these, however, only one in five was affected in their routine daily activities. The lifetime prevalence in 7- to 17-year-olds was 1.2 % (0.9-1.6) for epilepsy (0.4 % for the past 12 months), 5.0 % (4.4-5.7) for migraine, 0.2 % (0.1-0.3) for diabetes and in 0 to 6-year-olds 2.0 % (1.5-2.6) for heart conditions and 3.1 % (2.5-3.8) for febrile seizures with a -prevalence in 0 to 2-year-olds which are most affected of 1.0 % (0.6-1.6) in the past 12 months. The vast majority of children and adolescents in Germany are in good or very good health as suggested by other results reported in this issue; however, chronic conditions are not rare and need continuous monitoring. These results confirm that implementation of the vaccination recommendations of the German Standing Committee on Vaccination (STIKO) can lead to effective prevention of infectious diseases in Germany.

  9. Immediate and longer term impact of the varicella shortage on children 18 and 24 months of age in a community population

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    Zimmerman Rick


    Full Text Available Abstract Background Little is known about the impact of the recent varicella vaccine shortage. To assess the temporal trend in varicella vaccine administration before 18 and 24 months of age in a community cohort of children prior to, during and after the recent varicella vaccine shortage. And to compare the temporal trends in varicella vaccinations to trends of an older, more widely accepted vaccine, the MMR. Methods Community population-based birth cohorts were identified who were eligible for the varicella vaccination before, during and after the 2001 to 2002 varicella vaccine shortage. Only children (84% of all who remained in the community through their second birthday were included. For each child in the cohort, the medical records and immunization registry records from both medical facilities in the county were reviewed to identify the dates and sites for all varicella immunizations given. In addition to varicella immunizations, the dates of all MMR vaccinations were recorded. Additional data abstracted included the child's birth date, gender and dates of any recognized cases of chickenpox up through age 24 months. Results Of the 2,512 children in the birth cohorts, 50.8% were boys. In the three cohorts combined, 81.1% of the boys and 79.3% of the girls (p = 0.30 received the varicella vaccine by age 24 months. The pre-shortage community rate of varicella immunization was 79.7% by 24 months of age. During the varicella vaccine shortage, the rate of varicella immunization by 24 months fell to 77.2%. Only 6 additional children received a "catch-up" immunization by 36 months of age. In the post shortage period the community 24-month immunization rate rebounded to a level higher than the pre-shortage rate 84.0%. During the almost three years of observation, the MMR immunization rate by age 24 months was constant (87%. Conclusion The varicella shortage was associated with an immediate drop in the 24-month varicella immunizations rate but

  10. Role of ventilation in airborne transmission of infectious agents in the built environment - a multidisciplinary systematic review. (United States)

    Li, Y; Leung, G M; Tang, J W; Yang, X; Chao, C Y H; Lin, J Z; Lu, J W; Nielsen, P V; Niu, J; Qian, H; Sleigh, A C; Su, H-J J; Sundell, J; Wong, T W; Yuen, P L


    There have been few recent studies demonstrating a definitive association between the transmission of airborne infections and the ventilation of buildings. The severe acute respiratory syndrome (SARS) epidemic in 2003 and current concerns about the risk of an avian influenza (H5N1) pandemic, have made a review of this area timely. We searched the major literature databases between 1960 and 2005, and then screened titles and abstracts, and finally selected 40 original studies based on a set of criteria. We established a review panel comprising medical and engineering experts in the fields of microbiology, medicine, epidemiology, indoor air quality, building ventilation, etc. Most panel members had experience with research into the 2003 SARS epidemic. The panel systematically assessed 40 original studies through both individual assessment and a 2-day face-to-face consensus meeting. Ten of 40 studies reviewed were considered to be conclusive with regard to the association between building ventilation and the transmission of airborne infection. There is strong and sufficient evidence to demonstrate the association between ventilation, air movements in buildings and the transmission/spread of infectious diseases such as measles, tuberculosis, chickenpox, influenza, smallpox and SARS. There is insufficient data to specify and quantify the minimum ventilation requirements in hospitals, schools, offices, homes and isolation rooms in relation to spread of infectious diseases via the airborne route. PRACTICAL IMPLICATION: The strong and sufficient evidence of the association between ventilation, the control of airflow direction in buildings, and the transmission and spread of infectious diseases supports the use of negatively pressurized isolation rooms for patients with these diseases in hospitals, in addition to the use of other engineering control methods. However, the lack of sufficient data on the specification and quantification of the minimum ventilation requirements

  11. Subclinical Shed of Infectious Varicella zoster Virus in Astronauts (United States)

    Cohrs, Randall J.; Mehta, Satish K.; Schmid, D. Scott; Gilden, Donald H.; Pierson, Duane L.


    Aerosol borne varicella zoster virus (VZV) enters the nasopharynx and replicates in tonsillar T-cells, resulting in viremia and varicella (chickenpox). Virus then becomes latent in cranial nerve, dorsal root and autonomic nervous system ganglia along the entire neuraxis (1). Decades later, as cell-mediated immunity to VZV declines (4), latent VZV can reactivate to produce zoster (shingles). Infectious VZV is present in patients with varicella or zoster, but shed of infectious virus in the absence of disease has not been shown. We previously detected VZV DNA in saliva of astronauts during and shortly after spaceflight, suggesting stress induced subclinical virus reactivation (3). We show here that VZV DNA as well as infectious virus in present in astronaut saliva. VZV DNA was detected in saliva during and after a 13-day spaceflight in 2 of 3 astronauts (Fig. panel A). Ten days before liftoff, there was a rise in serum anti-VZV antibody in subjects 1 and 2, consistent with virus reactivation. In subject 3, VZV DNA was not detected in saliva, and there was no rise in anti-VZV antibody titer. Subject 3 may have been protected from virus reactivation by having zoster boost in cell-medicated immunity to VZV (2). No VZV DNA was detected in astronaut saliva months before spaceflight, or in saliva of 10 age/sex-matched healthy control subjects sampled on alternate days for 3 weeks (88 saliva samples). Saliva taken 2-6 days after landing from all 3 subjects was cultured on human fetal lung cells (Fig. panel B). Infectious VZV was recovered from saliva of subjects 1 and 2 on the second day after landing. Virus specificity was confirmed by antibody staining and DNA analysis which showed it to be VZV of European descent, common in the US (5). Further, both antibody staining and DNA PCR demonstrated that no HSV-1 was detected in any infected culture. This is the first report of infectious VZV shedding in the absence of clinical disease. Spaceflight presents a uniquely stressful

  12. 北京市西城区中小学2004-2009年度传染病发病状况%Prevalence of infectious diseases in elementary schools in Xicheng District in Beijing, 2004-2009

    Institute of Scientific and Technical Information of China (English)

    孙静; 王彦华; 王俊丽; 张亚娟


    目的 了解北京市西城区中小学生2004-2009学年度传染病发病状况,为学校传染病防控工作提供科学依据.方法 利用北京市西城区2004-2009学年度中小学生传染病统计报表,分析不同学段、不同年度各种传染病发病情况.结果 西城区2004-2009学年度学生共363 749名,传染病总数为2 141例,发病率为5.89‰,其中呼吸道传染病2 027例,发病率为5.57‰;消化道传染病114例,发病率为0.31‰.各学段学生水痘和痢疾的发病率均占首位,分别为4.15‰和0.31‰.传染病发病率小学生、初中生、高中生,分别为10.06‰,3.45‰和2.77‰,差异有统计学意义.结论 学校传染病监测工作中呼吸道传染病防控是重点,尤其要加强小学传染病防控工作.%Objective To analyze the prevalence of infectious disease among primary and middle school students of Beijing Xicheng district in 2004-2009, and to provide the scientific basis for the work of infectious disease prevention and control in school. Methods Based on the statistical data of infectious disease in primary and middle school students of Beijing Xicheng district in 2004-2009 year, the prevalence of infectious diseases in different section and academic year were analyzed. Results The prevalence of respiratory infectious diseases) 5.57%c) was higher than that of gastrointestinal tract(0.31 %c). Students of elementary school had the highest prevalence of chickenpox and dysentery, which also accounted for the highest incidence in students of each study section. The prevalence of infectious disease were elementary school, junior high school and high school arranged in higher to lower order (P<0.01), which was 10.06%o, 3.45%e and 2.77%o respectively. Conclusion There are lots of room to improve in monitoring and control of infectious disease in schools, among which the prevention and control of respiratory infectious diseases is of most importance. The prevention and control work infectious

  13. Mortalidade de crianças usuárias de creches no Município de São Paulo Mortality among children enrolled in public day care centers in Brazil

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    Eneida S Ramos Vico


    children occurred before completing six months in the day care center, with a concentration of 36.3% during the first three months. The majority of the deaths occurred during the winter and autumn seasons: 31.8% and 29.6%, respectively. The main underlying causes of death were infections: pneumonia (29.6%, meningococcal disease (13.0%, non-meningococcal meningitis (8.5%, gastroenteritis (7.6% and chickenpox (5.4%. External causes were responsible for 13.5% of the deaths and included falls, being run over, drowning, burns and physical aggression. CONCLUSIONS: The study indicated that younger children (0-3 years were the most vulnerable group and that the majority of deaths derived from avoidable causes, some of which preventable by vaccination nowadays.

  14. Analysis on epidemiological characteristics of public health emergencies of communicable diseases in cross border area of Yunnan Province from 2009-2013%2009-2013年云南省边境地区传染病类突发公共卫生事件流行特征分析

    Institute of Scientific and Technical Information of China (English)

    邬志薇; 戚艳波; 林燕; 李琼芬


    ,which respectively accounted for 3.64%,41.82%,30.00% and 24.54%.The peak seasons appeared March to May and September to December,most of cases were respiratory infectious diseases,such as chickenpox,and the events mainly occurred in schools.There were 6 foreign imported events,and all were from Burma.[Conclusion] Imported communicable disease events,especially public health emergencies of category A communicable diseases,are the key point and difficulty of disease prevention and control in cross border area of Yunnan Province.

  15. A systematic review of 36 patients diagnosed with acute disseminated encephalomyelitis%急性播散性脑脊髓炎36例临床特点分析

    Institute of Scientific and Technical Information of China (English)

    孙晓红; 陈海


    目的 阐明急性播散性脑脊髓炎(ADEM)的临床特点及诊治方法.方法 分析宣武医院2003年至2010年36例ADEM住院患者的一般临床资料、临床表现、辅助检查及治疗与预后转归情况.结果 本文病例多见于儿童和青壮年,急性起病,3例复发.其常见诱因为急性上呼吸道感染、疫苗接种、麻疹、风疹、水痘、流行性腮腺炎、猩红热等共计29例,原因不明7例.实验室检查中脑脊液可出现免疫球蛋白增高,磁共振成像检查提示受累部位包括脊髓、小脑、大脑白质及脑干等,其它辅助检查如电生理和免疫学检查等可协助诊断,应用糖皮质激素治疗效果确切.结论 结合临床特点、神经电生理、脑脊液免疫学及影像学检查等,临床可以作出准确诊断,及时恰当的治疗对预后极为重要.%Objective To further clarify the clinical features, diagnosis and treatment of the acute disseminated encephalomyelitis ( ADEM). Methods This study were to perform a prospective clinical (2003-2010) on ADEM in patients consecutively referred to Xuanwu Hospital in Beijing, China, and undertake a systematic review of general clinical data, clinical manifestations, laboratory examinations and treatment and prognosis of outcome of 36 patients with ADEM. Results The 36 patients had the following characteristics: children and young adults were predomidantly developed with ADEM with an acute onsets, and 3 cases relapse in this group of patients.The common causes included acute upper respiratory tract infection, vaccination, measles, rubella, chickenpox, mumps, scarlet fever, etc. The immunoglobin in cerebrospinal fluid (CSF) increased. Imaging examinations, especially magnetic resonance imaging ( MRI) examinations showed spinal cord, cerebellum, cerebral medullary substance and brain stem were often affected. Other laboratory examinations such as electrophysiological, immunological tests were helpful for diagnosis. The

  16. Reliability of information on varicella history in preschool children Confiabilidade da informação sobre antecedente de varicela em crianças pré-escolares

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    Lúcia Ferro Bricks


    Full Text Available OBJECTIVE: To verify how reliable is the information provided by parents about the history of varicella in their children. METHODS: 204 parents of previously healthy children attending two municipal day-care centers of São Paulo city were interviewed between August 2003 and September 2005. A standardized form was filled out with information regarding age, sex, history of varicella and other diseases, drug use and antecedent of immunization, After medical history, physical examination and checking of immunization records, 5 ml of blood were collected for ELISA (in house varicella test. Exclusion criteria were: age less than 1 year or more than 60 months, previous immunization against chickenpox, presence of co-morbidities or recent use of immunosuppressive drugs. Data were filed in a data bank using the Excel 2003 Microsoft Office Program and stored in a PC computer. The exact Fisher test was employed to calculate sensibility, specificity, positive and negative predictive values of history of varicella informed by children's parents. RESULTS: The age of the children varied from 12 to 54 months (median, 26 months; 49 (24% children had positive history of varicella, 155 (76% a negative or doubtful history. The predictive positive and negative values of the information were 90% and 93%, respectively (p = 0.0001. CONCLUSIONS: The degree of reliability of information about history of varicella informed by parents of children attending day care centers was high and useful to establish recommendations on varicella blocking immunization in day-care centers.OBJETIVOS: Verificar o grau de confiabilidade da informação fornecida pelos pais de crianças atendidas em creches sobre o antecedente de varicela. MÉTODOS: Os pais de 204 crianças previamente saudáveis matriculadas em duas creches da cidade de São Paulo foram entrevistados entre Agosto de 2003 e Setembro de 2005 para preenchimento de um questionário padronizado com informações sobre idade

  17. Brote de varicela en el Servicio de Oncología de hombres del Hospital San Juan de Dios, febrero-abril de 2004, San José, Costa Rica Chicken pox outbreak in the male Oncology Ward at he Hospital San Juan de Dios Hospital, febrero-abril de 2004

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    Sócrates Vargas-Naranjo


    illness. Service quarantine as recommended. Results: The first case of chickenpox happened in February,at the third day of hospitalization. Later on 5 more cases were identified.When the variables were analyzed the epidemic curve and the period of incubation, contact among the patients was the most important to maintain outbreak existence (p < 0,005; R = 25; IC95%2,3 - 275.7. Conclusion: Person to person transmission of varicella was confirmed to be the main source of infection in the hospital. Although quarantine stopped the outbreak, more practical and less expensive mesures should be taken to prevent the appearance of future outbreak.

  18. 南通市通州区春季呼吸道传染病流行特点和防控策略探讨%To Investigate the Epidemiological Characteristics of Respiratory Diseases in Spring and the Control Strategy about Tongzhou District City of Nantong

    Institute of Scientific and Technical Information of China (English)



    Objective Analysis of the epidemiological characteristics of respiratory diseases in spring of Tongzhou District of Nan-tong City, and provide scientific basis for formulating prevention and control strategies. Methods The application of the method of descriptive epidemiology,On the occurrence of respiratory infectious disease report China disease prevention and control informa-tion system of infectious disease information management system in Nantong city of Tongzhou District in 2013 and 2014 from February to April were retrospectively investigated. Results In 2013 and 2014 of February to April, Nantong City, Tongzhou Dis-trict reported a total of 7 kinds of respiratory infectious diseases occurred, a total of 494 cases of pulmonary tuberculosis, mumps and chickenpox secondary;gender distribution shows that the incidence of men than women, there are significant statistical signifi-cance (χ2= 80.94, P<0.01); age distribution the elderly and minors; occupational distribution to most farmers, accounting for 52.02%, followed by students and kindergartens, nursery children, each accounted for 25.91% and 6.28%, including tuberculosis to farmers, varicella, mumps, scarlet fever in students and kindergartens, children are the main clinical manifestations included fever;cough, rash, swelling of the parotid gland and shortness of breath. Conclusion According to the epidemiological characteris-tics of respiratory infectious diseases in the spring, the school should take nurseries for key units, to the elderly and minors as fo-cus groups, especially farmers, to strengthen the monitoring of symptoms, clean and ventilated, daily disinfection, health education, isolation treatment, comprehensive prevention and control measures such as vaccination.%目的:分析南通市通州区春季呼吸道传染病的流行特点,为制订防控策略提供科学依据。方法利用描述流行病学方法,对中国疾病预防控制信息系统传染病报告信

  19. Situación de las Enfermedades de Declaración Obligatoria (EDO en Navarra: 2002 Diseases of Compulsory Notification (DCN in Navarra: 2002

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    M. Urtiaga


    microbiologically and all appeared in a sporadic way. With respect to the causative serogroup, on 12 occasions Neisseria meningitidis serogroup B was isolated and in the 4 remaining cases serogroup C was isolated. One case was notified in infants of less than 2 years of age (Rate: 10.52 cases per 100,000, another case in children between 2 and 5 years (5.52 cases per 100,000, 5 cases in the age group of 6 to 19 years (Rate: 5.86 cases per 100,000 and the remaining nine cases in the age group of persons aged 20 years or over (2.2 per 100,000. 70 cases of Legionellosis were declared in 2002 (EI: 4.67, all but one under the clinical form of pneumonia. Twenty-two of the cases were presented in the context of two outbreaks with a community origin, which affected 17 and 5 persons respectively. Similarly, there was a notable increase in the declaration of cases of bacillary dysentery, with 6 cases (EI: 2.00, brucellosis, with 10 cases (EI: 1.67 and chickenpox, with 4,346 notified cases (EI: 1.61.

  20. The 12th Edition of the Scientific Days of the National Institute for Infectious Diseases “Prof. Dr. Matei Bals” and the 12th National Infectious Diseases Conference

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    Cristian-Mihail Niculae


    asymptomatic HIV-infected patients Ilinca Nicolae, Corina Daniela Ene, Mădălina Irina Mitran, Vasile Benea, Mircea Tampa, Simona Roxana Georgescu A63 Subclinical inflammation in HIV-infected patients undergoing antiretroviral therapy – a cross sectional study Iulia Cristina Bodoșca, Cristina Murariu, Cătălin Tilișcan, Victoria Aramă, Cristina Popescu, Daniela Munteanu, Mihaela Rădulescu, Violeta Molagic, Raluca Năstase, Alina Orfanu, Anca Leuștean, Remulus Catană, Anca Negru, Adrian Streinu-Cercel, Sorin Aramă A64 Severe Guillain-Barré syndrome occurring after chickenpox with favorable evolution Iuliana CAramăngiu, Ovidiu Rosca, Monica Cialma, Radu Opreanu, Laurențiu Vochita, Iosif Marincu A65 Echovirus 30 infection with pulmonary and cardiac complications – case report Vlad Murărescu, Marilena Palaghiță, Alina Cristina Neguț, Cornel Camburu, Adrian Streinu-Cercel A66 Herpetic encephalitis with favorable evolution in an adult immunocompetent patient Irina Duşan, Patricia Poptelecan, Bogdan Trincă, Sorina Mitrescu, Livius Tirnea, Iosif Marincu A67 Clinical-evolutional aspects in present-day measles Narcisa Nicolescu, Alexandru Crișan, Voichița Lăzureanu, Ruxandra Laza, Virgil Musta, Adelina-Raluca Marinescu, Andreea Bîrlad A68 Pneumococcal superinfection in children with influenza Victor Daniel Miron, Anca Cristina Drăgănescu, Constanța-Angelica Vișan, Anuța Bilașco, Daniela Pițigoi, Oana Săndulescu, Monica Luminița Luminos A69 Varicella complicated with transverse myelitis - case presentation Monica Luminos, Endis Osman, Magdalena Vasile, Anca Cristina Drăgănescu, Constanța-Angelica Vișan, Anuța Bilașco, Camelia Kouris, Sabina Șchiopu, Mădălina Merișescu A70 Clinical forms of enterovirus infections during the summer season of 2016 Monica Luminos, Anca Cristina Drăgănescu, Constanța-Angelica Vișan, Anuța Bilașco, Camelia Kouris, Endis Osman, Sabina Vintilă, Magda Vasile, Mădălina Merișescu A71 Face off – HIV and