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PubMed2005

Correlation of a reported history of chickenpox with seropositive immunity in pregnant women.

OBJECTIVE: To evaluate to what degree a positive verbal history of prior chickenpox infection correlates with current immunity. STUDY DESIGN: Patients presenting for prenatal registration at Naval Medical Center, San Diego, from January through June 2002 were candidates to participate in the study. Each patient was asked about her personal history of chickenpox. A blood sample was then obtained for an enzyme-linked immunosorbent assay IgG antibody test. RESULTS: Results were obtained on 1,085 patients. Of the 940 evaluable patients who reported a positive history of varicella, 904 (96.2%) were serologically immune; 21 (2.2%) of them had a negative antibody titer, and 15 (1.6%) of them had an equivocal titer. The overall seronegativity rate was 4.14% for all patients enrolled. CONCLUSION: There is a strong correlation between a reported history of chickenpox and serum immunity. Universal screening does not seem necessary, but education of susceptible individuals is warranted.

Adolescent↗
PubMed1993

Fatal haemorrhagic chickenpox complicating nephrotic syndrome.

We report a 14 year old Indian-Muslim girl who developed a fulminant, disseminated and fatal varicella infection while receiving steroids for nephrotic syndrome. The terminal phase of her illness was complicated by a bleeding dyscrasia and circulatory collapse. Varicella infection in healthy children is a benign disease. However in neonates and immunosuppressed patients it may be severe and often fatal. There are many reports of fatalities occurring in cancer patients receiving chemotherapy, patients on immunosuppressives for asthma, haemolytic anaemia, rheumatic fever, and renal and bone marrow transplantation. Patients with nephrotic syndrome receiving cyclophosphamide treatment are at particular risk of developing severe chickenpox infection. To our knowledge, there has been only one report of fatal chickenpox infection in a child who received steroids for nephrotic syndrome. We report here a case of fatal haemorrhagic chickenpox complicating nephrotic syndrome.

Adolescent↗
PubMed2001

Serotesting versus presumptive varicella vaccination of adolescents with a negative or uncertain history of chickenpox.

OBJECTIVE: To review the current practice of adolescent health care providers when an adolescent reports a negative or uncertain history of chickenpox in order to provide information for future practice. METHODS: Retrospective chart review of a sample of patients seen in a hospital-based adolescent primary care clinic between 1996 and 1999. RESULTS: Among adolescents who reported a positive history of chickenpox (190 patients, aged 15 +/- 1 years), varicella occurred before age 5 years in 30%, between 5 and 10 years in 56%, and at older than age 10 years in 14% of the patients. When adolescents reported a negative or uncertain history of varicella (55 patients, aged 15 +/- 1 years), serotesting was ordered for the majority (73%) of cases, while only 16% were presumptively vaccinated with varicella vaccine. In six patients no intervention was noted in the charts, and these patients were contacted. In 80% of the patients who were serotested, varicella IgG titers of > or = 1:32 indicated a previous unnoticed infection and lifelong immunity to varicella. In only 20% of the patients sera were negative for varicella IgG titer, requiring varicella vaccination. There was no statistical difference between the number of siblings of patients with a positive serologic test (3 +/- 1) and the number of siblings of seronegative patients (2 +/- 1, p = 0.41). Seven of the eight seronegative patients consented to varicella vaccination and were vaccinated within 10 months of serotesting. CONCLUSIONS: These data support the practice of serotesting for a previously unnoticed varicella infection rather than presumptive vaccination in the adolescent age group. A follow-up vaccination of seronegative adolescents should be scheduled as close to serotesting as possible.

Adolescent↗
PubMed1999

[Vaccination of chickenpox in children with acute lymphoblastic leukaemia].

Varicella vaccine has shown its efficacy to prevent the disease and complications in healthy and immunodeficient children. In this article the authors evaluate the immunologic status of acute lymphoblastic leukaemia at diagnosis and at follow up and the development of chickenpox and/or herpes zoster. Children with negative serology and continuous complete remission of acute lymphoblastic leukaemia for one year were vaccinated. Of 71 children diagnosed of acute lymphoblastic leukaemia from 1983 to 1996, 25 received the vaccine and seroconversion was obtained in 76% after one dose and 92% after the second dose. Vaccine tolerance was adequate. The incidence of herpes zoster infection was decreased in vaccinated children during chemotherapy compared to the wild-virus infected ones. Nowadays that vaccine for healthy children is recommended, we consider a priority to protect from chickenpox the children affected by leukaemia that are in continuous complete remission of the disease.

Chickenpox↗
PubMed1998

Chickenpox immunisation in New Zealand.

PREVENTION: The appropriate use of varicella vaccine, effective in the prevention of chickenpox, has been considered by a Ministry of Health Working Party in 1996 and 1997, including discussion at a workshop held in Wellington, 26-27 June 1996. The introduction of varicella vaccine into the routine childhood immunisation schedule was not supported at this stage. The use of the only varicella vaccine for which the Minister of Health has given consent for distribution in New Zealand, Varilrix (SmithKline Beecham Limited), in healthy children aged nine months to 13 years inclusive, was supported. Consent has not been given for the use of Varilrix in immunocompromised people or in adults. This report discusses other groups that could be candidates for vaccination, such as children with deteriorating renal function and susceptible health care workers who regularly come into contact with especially vulnerable patients. In these cases, the vaccine would need to be administered on a named patient basis. The use of Varilrix in immunocompromised people was not supported. SURVEILLANCE: Enhanced surveillance of chickenpox and zoster are required in New Zealand. Adverse reactions to Varilrix should be carefully monitored. OUTBREAK CONTROL: There are insufficient data at present to support the use of Varilrix in outbreak control. The frequency, cost and current management of nosocomial outbreaks should be ascertained. This information may also assist in the decision whether to incorporate a varicella vaccine into the routine childhood immunisation schedule in the future.

Adolescent↗
PubMed2000

Estimation of the contact rate in a seasonal SEIR model: application to chickenpox incidence in France.

This work was an attempt at analysing the seasonal pattern of varicella epidemics in France by fitting a susceptibles-exposed-infectives-recovered (SEIR) model with a periodic contact rate function to weekly chickenpox incidence data collected over the period 1991 to 1996. The contact rate was assumed to be either a continuous, or a piecewise constant, periodic function. Both assumptions gave a reasonable fit to the data and yielded estimates of the incubation and infectious periods that were consistent with values derived on clinical or serological grounds. Seasonal fluctuation of the estimated contact rate function was likely to reflect the impact of school holidays on chickenpox diffusion among schoolchildren.

Adolescent↗
PubMed1985

Chickenpox with delayed contralateral hemiparesis caused by cerebral angiitis.

Chickenpox and herpes zoster ophthalmicus are caused by the same virus. Herpes zoster ophthalmicus can be followed by contralateral hemiparesis, which is thought to be caused by spread of varicella-zoster virus to blood vessels contiguous to the trigeminal nerve and its branches. We report what we believe to be the first case of a patient with chickenpox followed by hemiparesis in whom there was angiographic evidence of an associated vasculitis similar to that found with herpes zoster ophthalmicus.

Brain Ischemia↗
PubMed1999

Revisited measles and chickenpox dynamics through orthogonal transformation.

The question addressed is whether or not childhood epidemics such as measles and chickenpox are characterized by low-dimensional chaos. We propose a new method for the detection and extraction of hidden periodic components embedded in an irregular cyclical series, and study the characterization of the epidemiological series in terms of the characteristic features or periodicity attributes of the extracted components. It is shown that the measles series possesses two periodic components each having a period of one year. Both the periodic components have time-varying pattern, and the process is nonlinear and deterministic; there is no evidence of strong chaoticity in the measles dynamics. The chickenpox series has one seasonal component with stable pattern, and the process is deterministic but linear, and hence non-chaotic. We also propose surrogate generators based on null hypotheses relating to the variability of the periodicity attributes to analyse the dynamics in the epidemic series. The process dynamics is also studied using seasonally forced SEIR epidemic model, and the characterization performance of the proposed schemes is assessed.

Chickenpox↗
PubMed2006

Delayed internal ophthalmoplegia and amblyopia following chickenpox.

INTRODUCTION: Chickenpox can be responsible for various ophthalmologic complications [4]. DISCUSSION: An internal ophthalmoplegia could be observed in this context and is responsible for a fixed pupil [2]. This complication is extremely rare and seems to occur mainly in young children during the two weeks following cutaneous eruption. We report an atypical observation of internal ophthalmoplegia due to chickenpox that occurs with a particularly prolonged interval. CONCLUSION: We would like to emphasize the consequences of the paralysis of accommodation associated with this tonic pupil on visual acuity.

Amblyopia↗
PubMed1999

Bilateral sequential facial palsy during chickenpox.

UNLABELLED: Facial palsy is a rare neurological complication of chickenpox. A 5-year-old girl exhibited a right facial palsy followed by the appearance of the characteristic chicken pox exanthem. Subsequently she suffered a left facial palsy. In this patient both pathophysiological mechanisms responsible and their relation to the phase of infection are illustrated. CONCLUSION: Facial palsy as a complication of chickenpox can result from pre-eruptive haematogenous or neurogenous spread of varicella-zoster virus.

Antibodies, Viral↗
PubMed2006

Isolated bilateral anterior optic neuritis following chickenpox in an immunocompetent adult.

Chickenpox may lead to several different neurological complications, but optic neuritis has rarely been described; in particular, only one case of isolated bilateral anterior optic neuritis (AON) in an immune-competent adult has so far been reported. We describe a second case of this type and consider similarities and differences between our patient and all other cases of AON following chickenpox. Then, we discuss the therapeutic role of steroids and advance the hypothesis of different pathogenetic pathways in immune-competent and immune-compromised subjects.

Adult↗
PubMed1994

A measure of family disruption for use in chickenpox and other childhood illnesses.

A search of the literature showed the lack of a suitable measure for assessing the impact of minor illness on children and their families. Such illness can lead to considerable disruption within the family and particularly to the parent primarily responsible for the care of the ill child. Discussion groups were run with parents who had a child who had had chickenpox within the previous 6 months. Analysis of the transcripts from the groups produced items indicating three types of disruption; parents' distress, changes in the behaviour of the ill child and general disruption to family arrangements. Items from the transcripts were formed into a questionnaire which was then used in a study of 61 families in which a child had become ill with chickenpox within the previous 7 days. The principal carer completed the measure every evening for a fortnight. The results of the study showed considerable disruption over the first few days of the child's illness, followed by a steady reduction over the whole 2-week period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2001

Retinal vasculitis associated with chickenpox.

PURPOSE: To report retinal vasculitis in a young, immunocompetent Asian female adult with chickenpox. METHODS: Interventional case report. A 32-year-old woman had chickenpox 2 weeks before blurred vision in the left eye. The visual acuity was 20/20 for the right eye and 30/50 for the left eye. The left eye presented keratic precipitates, moderate (2+) cells in the anterior chamber and numerous cells (3+) in the vitreous. The disk was normal. Perivenous exudation was noted mainly in the inferior retina. The sheathed retinal vessels showed late staining but no remarkable leakage on fluorescein angiography. The right eye was normal. RESULTS: After treatment with acyclovir for 10 days, the visual acuity in the left eye improved to 20/20, and the vasculitis resolved. CONCLUSION: Retinal vasculitis may present as a complication of primary varicella infection in an immunocompetent adult.

Acyclovir↗
PubMed1998

Acute childhood hemiplegia associated with chickenpox.

Although primary varicella-associated central nervous system complications and herpes zoster ophthalmicus with delayed hemiplegia are well known, and chickenpox is a common infection, cerebral vasculopathy associated with chickenpox has only been described recently. We report the case of an 18-month-old girl who developed a right hemiplegia 10 days after the onset of a primary varicella infection. She has the shortest latent interval in the literature. Cranial computed tomography and magnetic resonance imaging suggest an infarction involving the left putamen and internal capsule. Magnetic resonance angiography is normal. Possible causes of acute infantile hemiplegia are excluded. Neurologic signs gradually improve without any specific treatment. A review of the literature is also presented.

Acute Disease↗
PubMedDate not supplied

Scarring resulting from chickenpox.

Nine hundred and eighty-six children (519 boys, 467 girls) who had chickenpox at least 1 year previously were examined for the presence of scars resulting from this disease. Ninety-six (18.5%) boys and 88 (18.8%) girls had chickenpox scars, giving rise to an overall prevalence of 18.7%. The scars were found on the face in 75 (40.8%), neck 2 (1.1%), shoulders 8 (4.3%), upper limbs 15 (8.2%), anterior thorax 50 (27.2%), abdomen 106 (57.6%), back 65 (35.3%), buttocks 9 (4.9%), and lower limbs 12 (6.5%) affected children. The mean number of scars in the 184 children was 2.8 (standard deviation 1.9). The scars were hyperpigmented in 32, hypopigmented in 160, depressed in 38, and hypertrophic in 32 children. Keloids were noted in two children.

Chickenpox↗
PubMed2006

An outbreak of cadaver-acquired chickenpox in a health care setting.

The varicella-zoster virus (the chickenpox virus) is highly infectious and may affect nonimmune health care professionals. We report an outbreak of chickenpox in our hospital in which the source of infection was a cadaver. The spread of infection occurred in the course of an autopsy.

Adult↗
PubMed2005

History of chickenpox and shingles and prevalence of antibodies to varicella-zoster virus and three other herpesviruses among adults with glioma and controls.

Whether viruses or immunologic factors might cause or prevent human brain cancer is of interest. Statistically significant inverse associations of adult glioma with history of chickenpox and immunoglobulin G antibodies to varicella-zoster virus have been reported. The authors evaluate associations of immunoglobulin G antibodies to varicella-zoster virus and three other herpesviruses among 229 adults with glioma and 289 controls in the San Francisco Bay Area Adult Glioma Study (1997-2000). Cases were less likely than controls to report a history of chickenpox (for self-reported cases vs. controls: the age-, gender-, and ethnicity-adjusted odds ratio = 0.59, 95% confidence interval: 0.40, 0.86), and they also had lower levels of immunoglobulin G to varicella-zoster virus (for being in the highest quartile vs. the lowest quartile: the age-, gender-, and ethnicity-adjusted odds ratio = 0.41, 95% confidence interval: 0.24, 0.70). The inverse association with anti-varicella-zoster virus immunoglobulin G was most marked for glioblastoma multiforme cases versus controls and was only somewhat attenuated by excluding subjects taking high-dose steroids and other medications. Cases and controls did not differ notably for positivity to three other herpesviruses, Epstein-Barr virus, cytomegalovirus, and herpes simplex virus. Cohort studies may help to clarify the nature of the association between immunity to and/or clinical manifestations of varicella-zoster virus and glioblastoma.

Age Distribution↗
PubMed1993

Childhood chickenpox: its impact on child and family.

Sixty-nine parents took part in nine discussion groups designed to explore the effect of childhood chickenpox on the behaviour of the affected child, on family routines and on the parents themselves. Although most parents thought of chickenpox as a relatively trivial illness, it was found that there was considerable disruption to family organization and plans and, often, great strain was imposed on a parent, usually the mother. Some families incurred extra financial burdens in terms of time taken from work, the purchase of over the counter preparations, childminders and special treats for the sick child. It was apparent that parents needed more information and reassurance about the nature and course of the illness.

Adolescent↗