Contagiousness of Varicella in Vaccinated Cases

Seward, Jane F.; Zhang, Junyi; Maupin, Teresa J.; Mascola, Laurene; Jumaan, Aisha O.

doi:10.1001/jama.292.6.704

Cited by 184 publications

(156 citation statements)

References 22 publications

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“…All comparisons remained qualitatively valid. The SAR calculated with a 10-month period of exposure was similar to that reported in unvaccinated children (71 % [27]); the smaller AR in children aged <6 months was consistent with immune protection by maternal antibodies [28,29].…”

Section: Discussionsupporting

confidence: 80%

Micro and macro population effects in disease transmission: the case of varicella

et al. 2009

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SUMMARYProfiles of varicella-zoster virus (VZV) seroprevalence have shown large variability in European countries in which vaccination has not been implemented. Differences in micro and macro population structures (e.g. household and municipality, respectively) may explain such variability, which is the focus of a population-based study of varicella in 12 000 children from 7800 French households in Corsica. The cumulative incidence was 89 % at age 11 years, as the median age at infection was 5 years in first-born children, but decreased to 3 . 9 years in younger siblings. Hazard of infection in households increased as the first-born child initially enrolled in primary school. Age at infection was higher in less populated areas. Household attack rates increased with age (55 % in <6 months, >90 % in >3 years) and household secondary attack rate was y70 %. Several levels of population structure independently affect age at varicella infection.

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Section: Discussionsupporting

confidence: 80%

Micro and macro population effects in disease transmission: the case of varicella

et al. 2009

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“…Most of these were based on outbreak investigations [30,32], a cohort study [33] a household contact study [34] or a casecontrol study [35]. The median effectiveness has been estimated at 72 % and 71 % [30,32] for all and 96 .…”

Section: Discussionmentioning

confidence: 99%

“…The similarity of our ecological estimate of varicella vaccine efficacy compared to other approaches can be explained by absence of secular trends and consistent reporting. Lack of large multi-year periodicities is suggested from other epidemiological investigations and modelling approaches [29,[34][35][36]. Furthermore, there was no specific varicella catch-up vaccination programme in Germany.…”

Section: Discussionmentioning

confidence: 99%

Assessment of varicella vaccine effectiveness in Germany: a time-series approach

Höhle

Siedler

Bader³

et al. 2010

Epidemiol. Infect.

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SUMMARYA multivariate time-series regression model was developed in order to describe the 2005-2008 age-specific time-course of varicella sentinel surveillance data following the introduction of a varicella childhood vaccination programme in Germany. This ecological approach allows the assessment of vaccine effectiveness under field conditions by relating vaccine coverage in cohorts of 24-month-old children to the mean number of cases per reporting unit in the sentinel network. For the 1-2 years age group, which is directly affected by the vaccination programme, a one-dose vaccine effectiveness of 83 . 2% (95 % CI 80 . 2-85 . 7) was estimated which corresponds to previous approaches assessing varicella vaccine effectiveness in the field in the USA.

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“…In subjects with BV, the disease is milder, fever free, and with fewer skin lesions, which are generally atypical with papules that tend not to progress to vesicles, and so the subjects are not considered infectious until new lesions appear [30,218] . Transmission affects 12%-37% of susceptible contacts but, if the number of lesions is > 50, the wild virus transmission rate is the same as that of classic varicella in unvaccinated subjects [293,294] . In the case of BV, the risk of fetal varicella is considered to lower than that in unvaccinated subjects, but the only data come from reports of cases without fetal consequences [159,295] .…”

Section: Risk Of Transmissionmentioning

confidence: 99%

Microbiology laboratory and the management of mother-child varicella-zoster virus infection

Paschale

Clerici

2016

WJV

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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. Core tip: Although varicella during pregnancy is infrequent and congenital varicella syndrome (CVS) is rare, every available means should be used to prevent and diagnose them. Microbiology laboratories can be crucial in these situations: Evaluating a mother's immune status with sensitive and specific tests for the detection of antibodies; allowing a rapid diagnosis with molecular biology tests when a clinical manifestation may be due to different etiologies; following pregnant women with varicella for the prenatal diagnosis of CVS with close collaboration between molecular biology investigators and specialists in imaging diagnostics.De Paschale M, Clerici P. Microbiology laboratory and the management of mother-child varicella-zoster virus infection. World

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Contagiousness of Varicella in Vaccinated Cases

Cited by 184 publications

References 22 publications

Micro and macro population effects in disease transmission: the case of varicella

Micro and macro population effects in disease transmission: the case of varicella

Assessment of varicella vaccine effectiveness in Germany: a time-series approach

Microbiology laboratory and the management of mother-child varicella-zoster virus infection

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