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PubMed1983

A randomised controlled study of intravenous acyclovir (Zovirax) against placebo in adults with chickenpox.

In a double-blind, randomised, placebo-controlled trial of intravenous acyclovir (ACV) in normal adults with chickenpox, the drug was shown to have a significant effect on the duration of vesicles, on virus counts after one day's treatment and in lowering the body temperature on the third, fourth and sixth days of treatment. There were no significant effects on the duration of symptoms or on the evolution of the rash. No adverse effects of acyclovir were seen.

Acyclovir↗
PubMed1988

Antiviral treatment in chickenpox and herpes zoster.

Intravenous acyclovir is effective for varicella in adults and immunocompromised children, causing more rapid resolution of the illness and fewer complications. Intravenous acyclovir in immunocompromised patients with herpes zoster decreases new lesion formation, decreases acute pain, halts dissemination of the virus, and lessens visceral complications. Intravenous acyclovir may also be effective in zoster encephalitis. Intravenous vidarabine also has a favorable affect on chickenpox and herpes zoster. Topical acyclovir may benefit herpes zoster in immunosuppressed patients by accelerating cutaneous healing. Oral acyclovir appears to be effective in varicella and zoster in immunocompromised patients. It is also effective in otherwise normal patients, but its effect seems less dramatic and the drug must be given early. Neither acyclovir nor vidarabine has been proven clearly to prevent postherpetic neuralgia. Because varicella zoster virus is less sensitive to acyclovir than is herpes simplex, intravenous doses of 500 mg/m2 or 10 mg/kg every 8 hours or oral doses of 800 mg five times a day are recommended. At these doses adequate hydration and urine flow must be maintained, the mental status of the patient must be monitored, and impaired renal function requires regulation of dosage downward.

Acyclovir↗
PubMed1998

[Chickenpox in pregnancy].

Chickenpox is rare during pregnancy (1 to 7 per 10,000). The infection can be severe for the mother and indirectly may affect the fetus. Before 20 weeks of amenorrhea, the varicella-zoster virus may be responsible for a rare embryofetopathy (incidence rate: 0.4 to 2%). After the 20th week of amenorrhea, fetal infection is not symptomatic, but it may lead to neonatal or infantile herpes zoster infection. During the perinatal period, a primary maternal infection may be responsible for severe neonatal varicella if delivery occurs prior to maternal antibody production. Practical guidelines are proposed according to the date of infection during pregnancy and prenatal diagnosis using amniocentesis and/or cordocentesis is discussed.

Chickenpox↗
PubMed2002

Focal cerebral vasculitis and stroke after chickenpox.

Cerebral infarcts are rather rare in children and can be caused by a number of diverse conditions. We report a case of cerebral infarct associated with a recent varicella infection. A 5-year old girl presented with an acute central facial palsy 1 month after a chickenpox infection. The infarction was revealed by magnetic resonance imaging and laboratory studies ruled out all known causes of stroke. Cerebral angiogram demonstrated segmental narrowing and irregularity of the wall of the right internal carotid artery, compatible with focal vasculitis. With the presumed diagnosis of varicella-associated focal angiitis, the patient was treated with high-dose methylprednisolone, acyclovir and aspirin. Magnetic resonance angiogram performed 6 weeks after the stroke demonstrated the resolution of the vasculitis. Varicella infection should be considered one of the possible causes of acute ischaemic strokes in children.

Acyclovir↗
PubMed2003

How reliable is the history of chickenpox? Varicella serology among children up to 14 years of age.

OBJECTIVES: The aim of this study was to assess the seroprevalence of antibodies to varicella-zoster virus (VZV) in children of northern Greece and to estimate the reliability of varicella history. METHODS: A serosurvey of 632 children, aged 13 months to 14 years (median 5.2 years), was conducted between April 1999 and July 2001. Serum samples were tested by enzyme-linked immunosorbent assay (ELISA) for IgG antibodies to VZV (IgG Genzyme Virotech GmbH). A history of varicella in these children was obtained from the parents of all these patients. Also, a check of state health cards of the patients was done. RESULTS: Two hundred and forty-eight (39%) of the children were seropositive for VZV. Two hundred and thirty (36%) of the 632 children claimed to have had previous varicella infection; 87.8% were seropositive, and 12.2% lacked antibodies to VZV. One hundred and seven of the 230 children with a history of varicella had the information about the disease confirmed, as it was reported on their state health card by a pediatrician; 10.2% were seronegative for VZV. Absence of history of varicella was reported in 402 (63.6%) of the 632 children; 88.6% of those were seronegative, and 11.4% were seropositive. The percentage of incorrect negative history ranged from 6% (13-60 months of age) to 48% (120-168 months of age). CONCLUSIONS: A large proportion of the study group (61%), mainly below 7 years of age, is susceptible to varicella. The positive predictive value of a history of varicella is 87.8%, whereas the negative predictive value of a negative history is 11.4%, which means that there is an 88.6% probability of a negative history being correct. Varicella serology may be reasonable prior to vaccination in children >10 years old with a negative chickenpox history. However, if one excludes cost considerations, it is also reasonable to vaccinate all children, irrespective of serostatus.

Adolescent↗
PubMed1994

A case report of facial nerve palsy associated with chickenpox.

We examined a very unusual patient who developed peripheral facial palsy with chickenpox. A survey of the English literature revealed that eight such patients had been reported, but the period between the appearance of the vesicles of varicella and the facial nerve palsy ranged from five days before to 16 days after the eruption development. We presume that the route of infection was neurogenous in patients who had palsy after the appearance of the eruptions, but haematogenous in patients who had palsy before the appearance of vesicles. The two patients whose infection route was presumed to be haematogenous, had a poor prognosis.

Chickenpox↗
PubMed2000

Variation in risk for nosocomial chickenpox after inadvertent exposure.

Inadvertent exposure to chickenpox in the healthcare setting results in time-consuming and expensive infection control management strategies. In households, secondary cases occur in up to 96% of susceptibles, but transmission risk after exposure in an occupational setting is less well defined. In this prospective cohort study of inadvertent exposures in a 180-bed paediatric hospital, the secondary transmission rate was 4.5% (4/89; 95% confidence interval 1.2, 11.1%). Fourteen index cases exposed 158 patients and 93 healthcare workers over a 36-month study period. Exposures occurred in inpatient and ambulatory settings, with patients, staff and siblings serving as index cases. Transmission only occurred when the index case and contacts were in the same room and not in a multi-room setting (12% v. 0%, Fisher exact test, P = 0.02). Occupational exposures present a lesser transmission risk than those in households. Definition of those exposure variables that increase risk of transmission in the occupational setting should be explored in future studies.

Adult↗
PubMed1988

Laparoscopic findings in two adults with chickenpox.

We report the laparoscopic findings in two previously healthy adults with chickenpox and hepatic involvement. Both patients were admitted to hospital with severe upper right quadrant abdominal pain coinciding with the skin rash. Liver function tests were abnormal. In case 1, round lesions with a necrotic center, 2 mm in diameter, in both hepatic lobes were observed. Morphologically they resembled the rash on the skin. Numerous granular lesions were also demonstrated. In case 2, laparoscopic examination was performed recently when the cutaneous rash had faded. Granular images were scarce; there was enlargement of the liver capsule with small depressed areas of pink color. These lesions were considered similar to those found in case 1, although in a more advanced stage of scarring and resolution. Both patients made a good recovery.

Adult↗
PubMed1993

[Diaplacental transmission of varicella zoster virus antibodies after chickenpox at the time of birth].

A pregnant woman with post-term birth developed a varicella rash on the day, when birth was to be initiated. The date was then postponed, until varicella zoster virus (VZV) IgG-antibodies could be proved in the mother, so as to allow the child to achieve an adequate diaplacental passive immunisation. Cesarean section was performed on the 7th day after the rash, but a comparison of the child's blood (from the umbilical cord) with the mother's blood showed, that the VZV antibodies developed by the mother during this time were only present in a tenfold reduced amount in the child. Antibodies to herpes simplex virus, already present in the mother's blood before the VZV infection, also increased because of the close relationship of the virus to VZV. Similar to the VZV antibodies, these antibodies did not increase in the baby as in the mother. Our results show that maternal antibodies are not transferred rapidly to the baby, and therefore it seems reasonable, that in the case of chickenpox at the time of delivery, the birth should be delayed, not only until seroconversion in the mother's blood, but - if possible - a few days longer.

Adult↗
PubMedDate not supplied

[Chickenpox prevention in patients at risk with a special immunoglobulin].

Chickenpox, which normally is an innocuous disease in children, may cause serious sequelae in immunocompromised hosts. An open prospective study is presented, that comprised 96 of such patients. They were treated with 0,2 ml/kg Varicella-Zoster-Immunoglobulin (VZIG) prophylactically or after exposure. The immunoglobulin was given in between 72 hours after known contact, newborns received the injection at the day of delivery. After that the patients were followed for six weeks for documentation and assessment of protection. In 85 (88,5%) cases there was no manifestation of varicella. 10 patients showed mild forms of the disease; 3 of these had got the preparation within the recommended time gap of 72 hours after exposure. One child died from varicella pneumonia and haemorrhage. In this case the preparation had only been given 10 days after contact.

Adolescent↗
PubMed2006

Enhanced chickenpox exanthema in vaccine injection site.

Exacerbation of viral exanthema has been described after different types of aggression. We report a case of enhanced chickenpox exanthema occurring in the vaccination site of an otherwise healthy boy. Specific local inflammatory modifications may explain the increased number of varicella skin lesions on the site of a previous vaccine-induced inflammation.

Chickenpox↗
PubMed1976

Chickenpox--a disease predominantly affecting adults in rural West Bengal, India.

Outbreaks of chickenpox were observed every year from 1970-74 in a small West Bengel village. The cases did not follow any definite pattern and were scattered throughout the village each year, occurring between March and June. Sixty-three per cent of cases occurred in people over 15 years old; the mean age at which infection took place was 23.4 years. The attack rate in susceptible children below the age of eight was very low. The transmission of the disease even in contact families was very low, although most families lived in small one-room houses. Epidemiological interference is suggested as a possible cause of the low infectiousness of this otherwise highly-communicable disease.

Adolescent↗
PubMed1983

Common expression of varicella-zoster viral glycoprotein antigens in vitro and in chickenpox and zoster vesicles.

Human cells infected with varicella-zoster virus (VZV) produce at least three major virus-specific, immunogenic glycoproteins: gp118, gp98, and gp62. Since glycoproteins gp98 and gp62 were found to be prominent constituents of the infected cell membrane, a murine monoclonal antibody (clone 3B3) that reacted avidly with this glycoprotein complex was selected as a probe for detection of VZV replication in laboratory and clinical settings. Cultured cells of human, simian, and caviid origin, when infected with wild-type isolates as well as laboratory and vaccine strains of VZV all expressed these viral glycoproteins. The monoclonal antibody immunostained the basal and malpighian epithelial layers of a zoster vesicle biopsy specimen and also reacted with all specimens of vesicular cells obtained from epidemiologically unrelated patients with chickenpox and zoster. Thus, these studies demonstrate that the VZV-specific glycoprotein complex gp98/gp62 is highly conserved, abundantly expressed, and easily detected with a monoclonal antibody probe.

Animals↗
PubMed2001

Most ten-year-old children with negative or unknown histories of chickenpox are immune.

To evaluate the proportion of children to vaccinate against varicella in a catch-up program targeting 9- to 10-year-old children, a study was conducted among children age 10 years to assess the age-specific incidence of varicella and document the immunity against varicella in those with negative or unknown chickenpox history. Of the latter 62% were seropositive for varicella.

Age Factors↗
PubMed2002

Chickenpox and the geniculate ganglion: facial nerve palsy, Ramsay Hunt syndrome and acyclovir treatment.

Facial nerve palsy has long been considered to have an infectious etiology. Recent diagnostic analyses in children and adults have provided convincing evidence that reactivation of varicella-zoster virus (VZV), sometimes during infectious mononucleosis, can lead to cranial nerve VII palsy. The site of reactivation from latency is the geniculate ganglion. Virus most likely enters the ganglion during chickenpox, via the sensory branches of the facial nerve located on the ear and tongue. Retrospective reviews suggest that patients with VZV-related facial nerve palsy have poorer outcomes than other cases of Bell's palsy. Therefore treatment with acyclovir is suggested when VZV reactivation i slikely.

Adult↗
PubMed1997

Multiple pulmonary nodules after recovery from chickenpox in a patient with chronic lymphocytic leukaemia.

A 61-year-old woman with chronic lymphocytic leukaemia (CLL) was found to have multiple pulmonary nodules on an annual chest radiograph 4 months after recovery from chickenpox. To exclude the metastatic carcinoma, an open lung biopsy was performed. Histological examination disclosed isolated necrotic nodules surrounded by some lymphocytes and a few giant cells. These histological findings were compatible with healed varicella pneumonia and the DNA of varicella-zoster virus (VZV) was detected by polymerase chain reaction (PCR) method. We report a case of asymptomatic pulmonary involvement of VZV infection in a patient with CLL.

Antiviral Agents↗
PubMed1981

Rapid differentiation of rocky mountain spotted fever from chickenpox, measles, and enterovirus infections and bacterial meningitis by frequency-pulsed electron capture gas-liquid chromatographic analysis of sera.

Normal sera and sera from patients with Rocky Mountain spotted fever, chickenpox, enterovirus infections, measles, and Neisseria meningitidis infections were extracted with organic solvents under acidic and basic conditions and then derivatized with trichloroethanol or heptafluorobutyric anhydride-ethanol to form electron-capturing derivatives of organic acids, alcohols, and amines. The derivatives were analyzed by frequency-pulsed electron capture gas-liquid chromatography (FPEC-GLC). There were unique differences in the FPEC-GLC profiles of sera obtained from patients with these respective diseases. With Rocky Mountain spotted fever patients, typical profiles were detected as early as 1 day after onset of disease and before antibody could be detected in the serum. Rapid diagnosis of Rocky Mountain spotted fever by FPEC-GLC could permit early and effective therapy, thus preventing many deaths from this disease.

Adolescent↗