Maternal varicella infection during pregnancy in a vaccinated patient

Picone, Olivier; Vauloup‐Fellous, Christelle; Sénat, Marie-Victoire; Frydman, René; Grangeot-Keros, L.

doi:10.1002/pd.2083

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…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] . In any case, the prophylactic and therapeutic measures are the same as those for unvaccinated women [159,165] .…”

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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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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Fetal varicella – diagnosis, management, and outcome

Mandelbrot

2012

Prenatal Diagnosis

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Fetal varicella syndrome (FVS) is due to transplacental infection by the Varicella zoster virus following maternal infection. The risks for the fetus and neonate depend on the timing. When varicella occurs around delivery, it often leads to disseminated neonatal varicella. When varicella occurs during pregnancy, transmission can occur, but is usually asymptomatic; some infants develop zoster postnatally and a few have FVS. Before 20 weeks' gestation, FVS can occur, with an incidence of about 1%. The lesions can affect the skin, limbs, central and autonomous nervous systems, eyes, cause calcifications, and growth retardation; mortality is high. Lesions typically follow one or several nerve territories, suggesting that damage results from in utero zoster following primary fetal infection. There has been little study of prenatal diagnosis of FVS. Serial ultrasound examination can detect various anomalies, magnetic resonance imaging can be of use to investigate for microphthamia and cerebral lesions, and amniocentesis can diagnose viral transmission. Prevention strategies include vaccination and post-exposure prophylaxis with immune globulin and/or antivirals. Perspectives for treating infected fetuses in utero require further research.

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Maternal varicella infection during pregnancy in a vaccinated patient

Cited by 2 publications

References 8 publications

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

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

Fetal varicella – diagnosis, management, and outcome

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