Second Varicella Infections: Are They More Common Than Previously Thought?

Hall, Susan A.; Maupin, Teresa J.; Seward, Jane F.; Jumaan, Aisha O.; Peterson, Carol L.; Goldman, Gary S.; Mascola, Laurene; Wharton, Melinda

doi:10.1542/peds.109.6.1068

Cited by 82 publications

(42 citation statements)

References 22 publications

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“…VOka establishes latency and can reactivate to cause zoster, and superinfection with wild-type VZV strains has been documented frequently among vaccinated individuals (3, 13-15, 30, 37). In addition, a recent population-based study indicated that second cases of wild-type varicella occur more frequently among naturally infected persons than previously appreciated (19). These findings suggest that recombination between wildtype VZV strains and V-Oka strains is possible in both vaccine recipients and, more rarely, between wild-type viruses in persons dually infected with wild-type strains.…”

Section: Discussionmentioning

confidence: 80%

Complete-Genome Phylogenetic Approach to Varicella-Zoster Virus Evolution: Genetic Divergence and Evidence for Recombination

Norberg

Liljeqvist

Bergström

et al. 2006

J Virol

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Recent studies of varicella-zoster virus (VZV) DNA sequence variation, involving large numbers of globally distributed clinical isolates, suggest that this virus has diverged into at least three distinct genotypes designated European (E), Japanese (J), and mosaic (M). In the present study, we determined and analyzed the complete genomic sequences of two M VZV strains and compared them to the sequences of three E strains and two J strains retrieved from GenBank (including the Oka vaccine preparation, V-Oka). Except for a few polymorphic tandem repeat regions, the whole genome, representing approximately 125,000 nucleotides, is highly conserved, presenting a genetic similarity between the E and J genotypes of approximately 99.85%. These analyses revealed that VZV strains distinctly segregate into at least four genotypes (E, J, M1, and M2) in phylogenetic trees supported by high bootstrap values. Separate analyses of informative sites revealed that the tree topology was dependent on the region of the VZV genome used to determine the phylogeny; collectively, these results indicate the observed strain variation is likely to have resulted, at least in part, from interstrain recombination. Recombination analyses suggest that strains belonging to the M1 and M2 genotypes are mosaic recombinant strains that originated from ancestral isolates belonging to the E and J genotypes through recombination on multiple occasions. Furthermore, evidence of more recent recombination events between M1 and M2 strains is present in six segments of the VZV genome. As such, interstrain recombination in dually infected cells seems to figure prominently in the evolutionary history of VZV, a feature it has in common with other herpesviruses. In addition, we report here six novel genomic targets located in open reading frames 51 to 58 suitable for genotyping of clinical VZV isolates.In temperate climates, varicella-zoster virus (VZV) is a ubiquitous human pathogen with tropism to skin and sensory ganglia. VZV establishes latent infections, most prominently in the dorsal root and trigeminal ganglia, resulting in a permanent association with the host that may reactivate many decades after primary infection to cause herpes zoster. Primary VZV infection is nearly always symptomatic (varicella), a normally benign childhood disease; occasionally first exposure results in more serious illness or, in rare instances, death (40). Several neurological manifestations have been described in relation to VZV reactivation, such as facial palsy, encephalitis, meningitis, and cerebral vasculitis, conditions that may occur without any dermal lesions (4, 12, 16). The combined disease burden of primary and reactivated VZV infections has motivated widespread vaccination using a live, attenuated VZV strain (V-Oka). More recently, it has been demonstrated that a high-dose formulation of V-Oka can prevent or substantially ameliorate both herpes zoster and postherpetic neuralgia in persons 60 years of age and older (33).The genetic diversity of various human herpesviru...

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Section: Discussionmentioning

confidence: 80%

Complete-Genome Phylogenetic Approach to Varicella-Zoster Virus Evolution: Genetic Divergence and Evidence for Recombination

Norberg

Liljeqvist

Bergström

et al. 2006

J Virol

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“…The viral reactivation of VZV occurs years later, following factors favoring the decrease of the specificanti-cellular immunity anti-VZV. A reactivation as fast in our case is very particular little described in the literature [1,4]. In our patient, the diagnosis of generalized herpes zoster was excluded because there was no history of varicellla before, and because the generalized eruption preceded the zoniform eruption on the Path of the sciatic nerve.…”

Section: Discussionmentioning

confidence: 59%

“…In our patient, the diagnosis of generalized herpes zoster was excluded because there was no history of varicellla before, and because the generalized eruption preceded the zoniform eruption on the Path of the sciatic nerve. The rapid reactivation concomitant with primofection with VZV could be explained by the state of HIV immunodeficiency [4,5]. Indeed, the occurrence of VZV infection in an HIV-positive subject would be statistically associated with a risk of progression of the disease [6].…”

Section: Discussionmentioning

confidence: 99%

Varicella and Herpes Zoster in an HIV-Positive Adult

Elloudi¹,

Rabhi²

2017

IJHR

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“…67 Although national surveillance for varicella cases remains incomplete, active surveillance in limited geographic areas and national mortality data revealed marked decreases in varicella incidence, varicella-related hospitalizations, and deaths in all age groups. 64,[68][69][70] Varicella cases decreased 71% to 84% and mortality decreased by 66%. 70 Cases among vaccinated individuals are now increasing, which is believed to be happening because of waning immunity.…”

Section: Epidemiologymentioning

confidence: 99%

New, and Some Not-so-New, Vaccines for Adolescents and Diseases They Prevent

et al. 2008

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Adolescents in the United States now have the opportunity to receive new vaccines that prevent invasive meningococcal infections, pertussis (whooping cough), and cervical cancer. Except for their potential to cause serious illness, these infections could not be more different. Their incidence ranges from extremely low to quite high. Early clinical manifestations of infection range from none to life-threatening illness. Two of the vaccines are similar to those already in use, whereas 1 is completely new. In conjunction with the 4 vaccines previously recommended for adolescents (the tetanus and diphtheria booster, hepatitis B, measles-mumps-rubella, and varicella), the 3 new vaccines (meningococcal, human papillomavirus, and the tetanus-diphtheria-pertussis booster [which replaced the tetanus-diphtheria booster]) bring the number recommended for adolescents to 6. In this article, we describe key characteristics of the 3 new vaccines and infections they were designed to prevent. We also briefly discuss other vaccines recommended for all adolescents who have not already received them and new vaccines that are still under development. B EFORE 2005, THE only vaccine routinely recommended for healthy adolescents who had received all recommended childhood vaccinations was the tetanus and diphtheria toxoids (Td) booster. 1 Three other vaccines (measles-mumps-rubella [MMR], hepatitis B, and varicella) were used as "catch-up vaccinations" for adolescents who did not receive these vaccines as children (and, in the case of varicella, had not had chickenpox). The second dose of MMR vaccine was first recommended for adolescents by the American Academy of Pediatrics (AAP) in 1989, 2 whereas hepatitis B and varicella vaccines were first recommended for this age group in 1995 and 1996, respectively. 3,4 These recommendations were consolidated in 1996, when the Advisory Committee on Immunization Practices (ACIP), AAP, American Academy of Family Physicians, and American Medical Association harmonized their recommendations. These organizations suggested that the recommended immunizations and other preventive services be delivered at a routine preventive visit at 11 to 12 years of age. 1 Three new vaccines intended primarily for adolescents are now available. The first of these, a new vaccine effective for the prevention of disease caused by Neisseria meningitidis, was licensed in the United States in 2005 and officially recommended for use when the ACIP recommendations were published in May of that year. 5,6 Two vaccines for adolescents, both of which prevent infections with Bordetella pertussis, tetanus, and diphtheria, were licensed in May and June of 2005, respectively, and recommendations were published in early 2006. 7 A vaccine that prevents human papillomavirus (HPV), the cause of cervical cancer, was licensed in May 2006, and recommendations for its use were published in March 2007. 8 All the diseases against which these new vaccines offer protection are potentially serious, but the clinical course for each could...

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Second Varicella Infections: Are They More Common Than Previously Thought?

Abstract: Clinical varicella reinfections may occur more commonly than previously thought. Additional studies of the predictive value of a positive varicella history and laboratory studies of reported reinfections are indicated to guide varicella vaccination policy.

Cited by 82 publications

References 22 publications

Complete-Genome Phylogenetic Approach to Varicella-Zoster Virus Evolution: Genetic Divergence and Evidence for Recombination

Complete-Genome Phylogenetic Approach to Varicella-Zoster Virus Evolution: Genetic Divergence and Evidence for Recombination

Varicella and Herpes Zoster in an HIV-Positive Adult

New, and Some Not-so-New, Vaccines for Adolescents and Diseases They Prevent

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