Fatal varicella in an immunocompromised adult associated with a European genotype E2 variant of varicella zoster virus

Springfeld, Christoph; Sauerbrei, Andreas; Filusch, Arthur; Konstandin, Mathias; Hartschuh, Wolfgang; Sauer, Peter; Encke, Jens; Stremmel, Wolfgang; Schnitzler, Paul

doi:10.1016/j.jcv.2008.10.004

Cited by 24 publications

(18 citation statements)

References 22 publications

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“…Recently, a fatal case due to E2 VZV infection in an immunocompromised adult was reported (22). This particular isolate exhibited distinctive SNPs in ORF21, ORF51, and ORF54; however, not enough information is currently available regarding these nucleotide substitutions to associate them with an increased virulence.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, molecular surveillance is necessary to understand the implications of vaccination on the dynamics of VZV, as well as to better monitor the emergence of recom-binant strains in the population. Furthermore, no information regarding the circulation of E genotypes in Mexico has been documented thus far, and their association with severity is not clear (9,22).…”

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confidence: 99%

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Simultaneous Cocirculation of Both European Varicella-Zoster Virus Genotypes (E1 and E2) in Mexico City

et al. 2010

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Full-length genome analysis of varicella-zoster virus (VZV) has shown that viral strains can be classified into seven different genotypes: European (E), Mosaic (M), and Japanese (J), and the E and M genotypes can be further subclassified into E1, E2, and M1 through 4, respectively. The distribution of the main VZV genotypes in Mexico was described earlier, demonstrating the predominance of E genotype, although other genotypes (M1 and M4) were also identified. However, no information regarding the circulation of either E genotype in the country is available. In the present study, we confirm the presence of both E1 and E2 genotypes in the country and explore the possibility of coinfection as the triggering factor for increased virulence among severe cases. A total of 61 different European VZV isolates collected in the Mexico City metropolitan area from 2005 to 2006 were typed by using a PCR method based on genotype-specific primer amplification. Fifty isolates belonged to the E1 genotype, and the eleven remaining samples were classified as E2 genotypes. No coinfection with both E genotypes was identified among these specimens. We provide here new information on the distribution of VZV genotypes circulating in Mexico City.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Simultaneous Cocirculation of Both European Varicella-Zoster Virus Genotypes (E1 and E2) in Mexico City

et al. 2010

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“…Patients who have been immunosuppressed due to corticosteroid therapy (including short therapeutic courses), cytostatic or other immunosuppressive drugs are at increased risk during VZV infection. [9][10][11] Disseminated varicella is more common in children with malignancies, particularly those in whom therapy is initiated during the varicella incubation period. 12,13 Here we describe a case of an acute hepatic failure and death associated with primary infection caused by a wild-type clade 4 VZV strain in an adult patient treated with corticosteroids for suspected multiple sclerosis (MS).…”

Section: Why This Case Is Importantmentioning

confidence: 99%

“…22 In all these cases, however, no attempt was made to genotype the VZV strain involved. The report by Springfeld et al 11 is the only report of a fatal VZV associated hepatitis, where an extensive genotyping of the virus was performed leading to a determination of the VZV strain.…”

Section: Other Similar and Contrasting Cases In The Literaturementioning

confidence: 99%

Fulminant hepatitis and death associated with disseminated varicella in an immunocompromised adult from the Czech Republic caused by a wild-type clade 4 varicella-zoster virus strain

Plíšek

Plíšková

Boštíková

et al. 2011

Journal of Clinical Virology

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“…Numerous cases of severe (even fatal) acute primary varicella infection have been reported in patients receiving azathioprine [35] as well as TNF-␣ inhibitor therapy [36][37][38] . The majority of adults had clinical chickenpox in childhood and are thus protected against primary varicella.…”

Section: Varicella/zoster Vaccinesmentioning

confidence: 99%

Vaccines and Inflammatory Bowel Disease

Kotton

2010

Dig Dis

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Patients with inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, are at increased risk for infection due to both their underlying disease and the immunosuppressive therapy used to treat the disease. Numerous groups and papers support the routine vaccination of IBD patients, yet many opportunities to vaccinate this vulnerable population are missed. While immunogenicity may be somewhat attenuated, some protection is likely to be provided, especially when vaccination is performed during periods of reduced immunosuppression. Live viral vaccines should be avoided during periods of more intense immunosuppression; further specific guidance on this as well as information on individual vaccines is provided.

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Fatal varicella in an immunocompromised adult associated with a European genotype E2 variant of varicella zoster virus

Cited by 24 publications

References 22 publications

Simultaneous Cocirculation of Both European Varicella-Zoster Virus Genotypes (E1 and E2) in Mexico City

Simultaneous Cocirculation of Both European Varicella-Zoster Virus Genotypes (E1 and E2) in Mexico City

Fulminant hepatitis and death associated with disseminated varicella in an immunocompromised adult from the Czech Republic caused by a wild-type clade 4 varicella-zoster virus strain

Vaccines and Inflammatory Bowel Disease

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