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Charlier C, Anselem O, Caseris M, Lachâtre M, Tazi A, Driessen M, Pinquier D, Le Cœur C, Saunier A, Bergamelli M, Vanspranghels RG, Chosidow A, Cazanave C, Alain S, Faure K, Birgy A, Dubos F, Lesprit P, Guinaud J, Cohen R, Decousser JW, Grimprel E, Huissoud C, Blanc J, Kayem G, Vuotto F, Vauloup-Fellous C. [Recommendations for clinical practice: Prevention and management of varicella zoster virus (VZV) infection during pregnancy and the perinatal period (extended version)]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2025; 53:118-129. [PMID: 39805558 DOI: 10.1016/j.gofs.2025.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2024] [Accepted: 01/08/2025] [Indexed: 01/16/2025]
Abstract
The Société de Pathologie Infectieuse de Langue Française released in 2024 a new national recommendation for clinical practice on the prevention and management of varicella zoster virus (VZV) infection during pregnancy and the perinatal period. The previous recommendation was issued in 1998, at a time of anti-VZV immunoglobulins shortage; it has hence become obsolete. This recommendation is a formalized expert consensus focusing on infectious diseases management; it is drawn up by a multidisciplinary working group (infectiologists, obstetricians, pediatricians, microbiologists, midwives, hygienists). It has been endorsed by the Collège National des Gynécologues Obstétriciens Français, the Société Française de Médecine Périnatale, the Société Française de Néonatologie, the Collège des Sage-femmes, and the Groupe Infections et Périnatalité of the Société Française de Microbiologie. The aim of this article is to explain and recontextualize the elements of this recommendation.
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Affiliation(s)
- Caroline Charlier
- Infectious diseases transversal team, AP-HP, FHU Prema, université Paris Cité, Paris Centre University Hospital, Paris, France; Biology of Infection Unit, French National Reference Center and WHO Collaborating Center Listeria, Institut Pasteur, Inserm U1117, Paris, France.
| | - Olivia Anselem
- Maternité Port-Royal AP-HP, FHU Prema, Paris Centre University Hospital, Paris, France
| | - Marion Caseris
- Department of general pediatrics, Pediatric Internal Medicine, Rheumatology and Infectious Diseases, Robert-Debré University Hospital, AP-HP, Paris, France
| | - Marie Lachâtre
- Clinical vaccinology Center, Paris Centre University Hospital, AP-HP, Paris, France
| | - Asmaa Tazi
- Bacteriology Unit, French National Reference Center Streptococci, AP-HP, Paris, France, Institut Cochin, Inserm U1016, CNRS UMR8104, Paris, France
| | - Marine Driessen
- Department of obstetrics and fetal medicine, Necker Enfants University Hospital, AP-HP, Paris, France
| | - Didier Pinquier
- Department of neonatal and pediatric intensive care medicine, Normandie University, UNIROUEN, Inserm U1245, CHU de Rouen, 76000 Rouen, France
| | - Chemsa Le Cœur
- Infectious diseases and tropical medicine unit, Tours University Hospital, Tours, France
| | - Aurélie Saunier
- Infectious diseases unit, Périgueux hospital, Périgueux, France
| | - Mathilde Bergamelli
- Department of Clinical Sciences, Intervention and Technology (CLINTEC) Karolinska Institute, Division of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Anaïs Chosidow
- Department of Pediatrics, CHI Villeneuve Saint-Georges, Villeneuve Saint-Georges, France
| | - Charles Cazanave
- Infectious and tropical diseases department, université de Bordeaux, CHU de Bordeaux, UMR 5234 CNRS, ARMYNE, Bordeaux, France
| | - Sophie Alain
- Microbiology Department, and medical genomic unit CHU Limoges, UMR Inserm 1092, RESINFIT, Limoges University, IFR GEIST, Medical Faculty, National Reference Center for Herpesviruses, Centre de Biologie et de Recherche en Santé (CBRS), Limoges, France
| | - Karine Faure
- Infectious Diseases Unit, Lille university hospital, Lille, France
| | - André Birgy
- Microbiology Unit, AP-HP, IAME, UMR1137, Inserm, Université Paris Cité, Robert-Debré University Hospital, Paris, France
| | - François Dubos
- Pediatric Emergency Unit & Infectious Diseases, ULR2694 : METRICS, université Lille, CHU de Lille, 59000 Lille, France
| | | | - Julie Guinaud
- Neonatology and neonatal intensive care unit, CHU La Réunion site sud, Saint-Pierre, France
| | - Robert Cohen
- Service de néonatologie, unité Court Séjour, Petits Nourrissons, CHI Créteil, université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Jean-Winoc Decousser
- Université Paris Est Créteil, Henri-Mondor university hospital EOH, AP-HP, Créteil, France
| | - Emmanuel Grimprel
- Service de pédiatrie générale et aval des urgences, hôpital Trousseau, AP-HP. Sorbonne université médecine, Paris, France
| | - Cyril Huissoud
- Service de gynécologie obstétrique de l HFME, Hospices Civils de Lyon, université Claude Bernard, Lyon 1, Inserm U1208, Stem-Cell and Brain Research Institute, 59, boulevard Pinel, 69500 Bron, France
| | - Julie Blanc
- Université de Marseille, hôpital Nord University hospital, obstetrics ward, Assistance Publique-hôpitaux Marseille, Marseille, France
| | - Gilles Kayem
- Obstetrics ward, Assistance Publique-hôpitaux Paris, Trousseau University hospital, Sorbonne université, FHU Prema, Paris, France
| | - Fanny Vuotto
- Infectious Diseases Unit, Lille university hospital, Lille, France
| | - Christelle Vauloup-Fellous
- Division of Virology, WHO Rubella National Reference Laboratory, Paris-Saclay University Hospital, AP-HP, Paris, France; Université Paris-Saclay, Inserm U1184, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses, France
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Ion A, Orzan OA, Bălăceanu-Gurău B. Varicella Zoster Virus Infection and Pregnancy: An Optimal Management Approach. Pathogens 2025; 14:151. [PMID: 40005527 PMCID: PMC11857854 DOI: 10.3390/pathogens14020151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2025] [Revised: 01/31/2025] [Accepted: 02/03/2025] [Indexed: 02/27/2025] Open
Abstract
Varicella-zoster virus is an α-herpes virus with a double-stranded DNA genome, which causes two main clinical pictures: varicella or chickenpox and herpes zoster. Chickenpox is the primary infection, predominantly affecting children, and it presents with fever and a cutaneous eruption consisting of a vesicular, pruritic, and painful rash. Herpes zoster is a viral infection that typically develops in adulthood as a result of the reactivation of the varicella-zoster virus. If acquired during pregnancy, chickenpox may be responsible for serious complications for the mother, the fetus, or the newborn. The most frequent complication of primary varicella-zoster virus infection in mothers is varicella pneumonia, while encephalitis and hepatitis are rare. The effects on the fetus due to chickenpox infection depend on the stage of pregnancy when the mother becomes infected. If the infection occurs during the first trimester, it does not increase the risk of miscarriage. However, if the infection occurs during the first or second trimester, it may cause fetal varicella syndrome or congenital varicella syndrome. During pregnancy, if the varicella-zoster virus reactivates, it usually does not cause harm to the fetus or lead to any birth defects. However, it may increase maternal morbidity due to herpes zoster and its complications. In the case of primary varicella-zoster virus infection in pregnant women, about 20% of newborns may get neonatal or infantile herpes zoster without any complications. However, it is recommended to start early treatment of herpes zoster in pregnant women as it is believed to accelerate the healing process of skin lesions and alleviate pain, reducing both its duration and severity. Through this narrative review, we discuss the approach to the optimal management of varicella-zoster virus infection during pregnancy.
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Affiliation(s)
- Ana Ion
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.I.); (B.B.-G.)
- Department of Dermatology, ‘Elias’ University Emergency Hospital, 011461 Bucharest, Romania
| | - Olguța Anca Orzan
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.I.); (B.B.-G.)
- Department of Dermatology, ‘Elias’ University Emergency Hospital, 011461 Bucharest, Romania
| | - Beatrice Bălăceanu-Gurău
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.I.); (B.B.-G.)
- Department of Dermatology, ‘Elias’ University Emergency Hospital, 011461 Bucharest, Romania
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Supplisson O, Visseaux B, Haim-Boukobza S, Boutolleau D, Alizon S, Burrel S, Sofonea MT. Seroprevalence of human herpes viruses in France, 2018-2022: a multilevel regression and poststratification approach. Infect Dis (Lond) 2024; 56:931-945. [PMID: 38946531 DOI: 10.1080/23744235.2024.2365906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 05/31/2024] [Accepted: 06/04/2024] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND Information related to herpes simplex virus 1 and 2 (HSV-1 and 2), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) seroprevalence in France is either lacking, incomplete, or outdated, despite their public health burden. METHOD We used routinely collected serological data between 2018 and 2022 to estimate HSV-1, HSV-2, VZV, EBV, and CMV seroprevalence in France. To account for demographic differences between our analytic samples and the French population and get estimates for sparsely sampled districts and age classes, we used a multilevel regression and poststratification approach combined with Bayesian model averaging via stacking weights. RESULTS The observed seroprevalence (number of positive tests/number of tests) were 64.6% (93,294/144,424), 16.9% (24,316/144,159), 93.0% (141,419/152,084), 83.4% (63,199/75, 781), and 49.0% (23,276/47,525), respectively, for HSV-1, HSV-2, VZV, EBV, and CMV. Between 2018 and 2022, France had a model-based average (equal-tailed interval at 95%) expected seroprevalence equal to 61.1% (60.7,61.5), 14.5% (14.2,14.81), 89.5% (89.3,89.8), 85.6% (85.2,86.0), and 50.5% (49.3,51.7), respectively, for HSV-1, HSV-2, VZV, EBV, and CMV infections. We found an almost certain lower expected seroprevalence in Metropolitan France than in overseas territories for all viruses but VZV, for which it was almost certainly greater. The expected seroprevalences were likely greater among females for all viruses. LIMITATIONS Our results relied on the assumption that individuals were sampled at random conditionally to variables used to build the poststratification table. IMPLICATIONS The analysis highlights spatial and demographic patterns in seroprevalence that should be considered for designing tailored public health policies.
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Affiliation(s)
- Olivier Supplisson
- Center for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, Université PSL, Paris, France
- Sorbonne Université, Paris, France
| | | | | | - David Boutolleau
- AP-HP, Sorbonne Université, Centre National de Référence Herpèsvirus (laboratoire Associé), Service de Virologie, Hôpital Pitié-Salpêtrière, Paris, France
- Sorbonne Université, INSERM UMR-S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Paris, France
| | - Samuel Alizon
- Center for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, Université PSL, Paris, France
| | - Sonia Burrel
- CHU de Bordeaux, Service de virologie, Bordeaux, France
- CNRS UMR 5234, Fundamental Microbiology and Pathogenicity, Université de Bordeaux, Bordeaux, France
| | - Mircea T Sofonea
- Pathogenesis and Control of Chronic and Emerging Infections (PCCEI), Université de Montpellier, Inserm, EFS, Montpellier, France and CHU de Nîmes, Nîmes, France
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Charlier C, Anselem O, Caseris M, Lachâtre M, Tazi A, Driessen M, Pinquier D, Le Cœur C, Saunier A, Bergamelli M, Gibert Vanspranghels R, Chosidow A, Cazanave C, Alain S, Faure K, Birgy A, Dubos F, Lesprit P, Guinaud J, Cohen R, Decousser JW, Grimprel E, Huissoud C, Blanc J, Kayem G, Vuotto F, Vauloup-Fellous C. Prevention and management of VZV infection during pregnancy and the perinatal period. Infect Dis Now 2024; 54:104857. [PMID: 38311003 DOI: 10.1016/j.idnow.2024.104857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/20/2023] [Accepted: 01/29/2024] [Indexed: 02/06/2024]
Affiliation(s)
- Caroline Charlier
- Université Paris Cité, Paris Centre University Hospital, Infectious Diseases Transversal Team, Infectious Diseases Department, AP-HP, FHU Prema, Paris, France; Institut Pasteur, French National Reference Center and WHO Collaborating Center Listeria, Biology of Infection Unit, Inserm U1117, Paris, France.
| | - Olivia Anselem
- Paris Centre University Hospital, Maternité Port-Royal AP-HP, FHU Prema, Paris, France
| | - Marion Caseris
- Robert Debré University Hospital, Department of General Pediatrics, Pediatric Internal Medicine, Rheumatology and Infectious Diseases, AP-HP, Paris, France
| | - Marie Lachâtre
- Paris Centre University Hospital, Clinical Vaccinology Center, AP-HP, Paris, France
| | - Asmaa Tazi
- Université Paris Cité, Paris Centre University Hospital, Bacteriology Unit, French National Reference Center Streptococci, AP-HP, Institut Cochin, Inserm U1016, CNRS UMR8104, Paris, France
| | - Marine Driessen
- Necker Enfants University Hospital, Department of Obstetrics and Fetal Medicine, AP-HP, Paris, France
| | - Didier Pinquier
- CHU Rouen, Department of Neonatal and Pediatric Intensive Care Medicine, Normandie University, UNIROUEN, INSERM U1245, Rouen, France
| | - Chemsa Le Cœur
- Tours University Hospital, Infectious Diseases and Tropical Medicine Unit, Tours, France
| | - Aurélie Saunier
- Périgueux Hospital, Infectious Diseases Unit, Périgueux, France
| | - Mathilde Bergamelli
- Department of Clinical Sciences, Intervention and Technology (CLINTEC) Karolinska Institute, Division of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Anaïs Chosidow
- CHI Villeneuve Saint Georges, Department of Pediatrics, Villeneuve Saint Georges, France
| | - Charles Cazanave
- CHU Bordeaux, Infectious and Tropical Diseases Department, Univ. Bordeaux, UMR 5234 CNRS, ARMYNE, Bordeaux, France
| | - Sophie Alain
- Microbiology Department, and Medical Genomic Unit CHU Limoges, UMR Inserm 1092, RESINFIT, Limoges University, IFR GEIST, Medical Faculty, National Reference Center for Herpesviruses, Centre de Biologie et de Recherche en Santé (CBRS) Limoges, France
| | - Karine Faure
- CHU Lille, Infectious Diseases Unit, Lille, France
| | - André Birgy
- Université Paris Cité, Robert Debré University Hospital, Microbiology Unit, AP-HP, IAME, UMR1137, INSERM, Paris, France
| | - François Dubos
- Université Lille, CHU Lille, Pediatric Emergency Unit & Infectious Diseases, ULR2694: METRICS, F-59000 Lille, France
| | | | - Julie Guinaud
- CHU La Réunion site sud, Neonatology and Neonatal Intensive Care Unit, Saint Pierre, France
| | - Robert Cohen
- Université Paris Est, IMRB-GRC GEMINI, Unité Court Séjour, Petits Nourrissons, Service de Néonatologie, CHI Créteil, Créteil, France
| | - Jean-Winoc Decousser
- Université Paris Est Créteil, Henri Mondor University Hospital EOH, AP-HP, Créteil, France
| | - Emmanuel Grimprel
- Service de pédiatrie générale et aval des urgences, hôpital Trousseau, Paris, APHP, Sorbonne Sorbonne Université Médecine, France
| | - Cyril Huissoud
- Hospices Civils de Lyon, Service de gynécologie obstétrique de l HFME, 59 Bd Pinel, 69500 Bron, Université Claude Bernard, Lyon 1, INSERM U1208, Stem-Cell and Brain Research Institute, France
| | - Julie Blanc
- Université de Marseille, Hôpital Nord University Hospital, Obstetrics Ward, Assistance Publique hôpitaux Marseille, Marseille, France
| | - Gilles Kayem
- Trousseau University Hospital, Obstetrics Ward, Assistance Publique - hôpitaux Paris, Sorbonne Université, FHU Prema, Paris, France
| | - Fanny Vuotto
- CHU Lille, Infectious Diseases Unit, Lille, France
| | - Christelle Vauloup-Fellous
- Division of Virology, WHO Rubella National Reference Laboratory, Groupe de Recherche sur les Infections pendant la grossesse (GRIG), Dept of Biology Genetics and PUI, Paris Saclay University Hospital, APHP, Paris, France; Université Paris-Saclay, INSERM U1184, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses, France
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Varicella-Zoster Virus Prevalence among Pregnant Women: A European Epidemiological Review. Life (Basel) 2023; 13:life13020593. [PMID: 36836948 PMCID: PMC9966538 DOI: 10.3390/life13020593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 02/23/2023] Open
Abstract
Europe has faced a massive spread of the varicella-zoster virus through the years. Since the introduction of an effective vaccine, complications and severe forms of chickenpox have been restricted. Nevertheless, among the population, some categories need specific care, such as pregnant women, who present one of the most fragile conditions facing this infection, both for the mother and the fetus. In this review, we highlight how the varicella-zoster virus can be dangerous during pregnancy, underlining the problem of treatment and vaccination, and collect information about the European epidemiology among this particular category of women.
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Dashraath P, Nielsen-Saines K, Rimoin A, Mattar CNZ, Panchaud A, Baud D. Monkeypox in pregnancy: virology, clinical presentation, and obstetric management. Am J Obstet Gynecol 2022; 227:849-861.e7. [PMID: 35985514 PMCID: PMC9534101 DOI: 10.1016/j.ajog.2022.08.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/11/2022] [Accepted: 08/11/2022] [Indexed: 01/26/2023]
Abstract
The 2022 monkeypox outbreak, caused by the zoonotic monkeypox virus, has spread across 6 World Health Organization regions (the Americas, Africa, Europe, Eastern Mediterranean, Western Pacific, and South-East Asia) and was declared a public health emergency of international concern on July 23, 2022. The global situation is especially concerning given the atypically high rate of person-to-person transmission, which suggests viral evolution to an established human pathogen. Pregnant women are at heightened risk of vertical transmission of the monkeypox virus because of immune vulnerability and natural depletion of population immunity to smallpox among reproductive-age women, and because orthopoxviral cell entry mechanisms can overcome the typically viral-resistant syncytiotrophoblast barrier within the placenta. Data on pregnancy outcomes following monkeypox infection are scarce but include reports of miscarriage, intrauterine demise, preterm birth, and congenital infection. This article forecasts the issues that maternity units might face and proposes guidelines to protect the health of pregnant women and fetuses exposed to the monkeypox virus. We review the pathophysiology and clinical features of monkeypox infection and discuss the obstetrical implications of the unusually high prevalence of anogenital lesions. We describe the use of real-time polymerase chain reaction tests from mucocutaneous and oropharyngeal sites to confirm infection, and share an algorithm for the antenatal management of pregnant women with monkeypox virus exposure. On the basis of the best available knowledge from prenatal orthopoxvirus infections, we discuss the sonographic features of congenital monkeypox and the role of invasive testing in establishing fetal infection. We suggest a protocol for cesarean delivery to avoid the horizontal transmission of the monkeypox virus at birth and address the controversy of mother-infant separation in the postpartum period. Obstetrical concerns related to antiviral therapy with tecovirimat and vaccinia immune globulin are highlighted, including the risks of heart rate-corrected QT-interval prolongation, inaccuracies in blood glucose monitoring, and the predisposition to iatrogenic venous thromboembolism. The possibility of monkeypox vaccine hesitancy during pregnancy is discussed, and strategies are offered to mitigate these risks. Finally, we conclude with a research proposal to address knowledge gaps related to the impact of monkeypox infection on maternal, fetal, and neonatal health.
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Affiliation(s)
- Pradip Dashraath
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, National University Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Karin Nielsen-Saines
- Division of Pediatric Infectious Diseases, Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Anne Rimoin
- Fielding School of Public Health, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; University of California Los Angeles-Democratic Republic of the Congo Health Research and Training Program, Kinshasa, Democratic Republic of the Congo
| | - Citra N Z Mattar
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, National University Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Alice Panchaud
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - David Baud
- Materno-fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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Boccard M, Conrad A, Mouton W, Valour F, Roure-Sobas C, Frobert E, Rohmer B, Alcazer V, Labussière-Wallet H, Ghesquières H, Venet F, Brengel-Pesce K, Trouillet-Assant S, Ader F. A Simple-to-Perform ifn-γ mRNA Gene Expression Assay on Whole Blood Accurately Appraises Varicella Zoster Virus-Specific Cell-Mediated Immunity After Allogeneic Hematopoietic Stem Cell Transplantation. Front Immunol 2022; 13:919806. [PMID: 35967359 PMCID: PMC9363621 DOI: 10.3389/fimmu.2022.919806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/20/2022] [Indexed: 11/22/2022] Open
Abstract
Herpes zoster, which is due to the reactivation of Varicella zoster virus (VZV), is a leading cause of morbidity after allogeneic hematopoietic stem cell transplantation (allo-HSCT). While cell-mediated immunity (CMI) is critical to inhibiting VZV reactivation, CMI is not routinely assessed due to a lack of reliable tests. In this study, we aimed to evaluate VZV-specific CMI among allo-HSCT recipients (n = 60) and healthy individuals (HI, n = 17) through a panel of three immune functional assays after ex vivo stimulation by VZV antigen: quantification of (i) IFN-γ release in the supernatants, (ii) T-cell proliferation after a 7-day stimulation of peripheral blood mononuclear cells (PBMC), and (iii) measurement of the ifn-γ mRNA gene expression level after 24 h of stimulation of a whole-blood sample. VZV responsiveness was defined according to IFN-γ release from VZV-stimulated PBMC. Upon VZV stimulation, we found that allo-HSCT recipients at a median time of 6 [5-8] months post-transplant had lower IFN-γ release (median [IQR], 0.34 [0.12–8.56] vs. 409.5 [143.9–910.2] pg/ml, P <.0001) and fewer proliferating T cells (0.05 [0.01–0.57] % vs. 8.74 [3.12–15.05] %, P <.0001) than HI. A subset of allo-HSCT recipients (VZV-responders, n = 15/57, 26%) distinguished themselves from VZV-non-responders (n = 42/57, 74%; missing data, n = 3) by higher IFN-γ release (80.45 [54.3–312.8] vs. 0.22 [0.12–0.42] pg/ml, P <.0001) and T-cell proliferation (2.22 [1.18–7.56] % vs. 0.002 [0.001–0.11] %, P <.0001), suggesting recovery of VZV-specific CMI. Interestingly, VZV responders had a significant fold increase in ifn-γ gene expression, whereas ifn-γ mRNA was not detected in whole blood of VZV-non-responders (P <.0001). This study is the first to suggest that measurement of ifn-γ gene expression in 24-h-stimulated whole blood could be an accurate test of VZV-specific CMI. The routine use of this immune functional assay to guide antiviral prophylaxis at an individual level remains to be evaluated.
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Affiliation(s)
- Mathilde Boccard
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Anne Conrad
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - William Mouton
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Laboratoire de Recherche Commun (LCR), Hospices Civils de Lyon/BioMérieux, Pierre-Bénite, France
| | - Florent Valour
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Chantal Roure-Sobas
- Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Emilie Frobert
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Barbara Rohmer
- Service d’Hépatologie Gastro-Entérologie et Nutrition Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Vincent Alcazer
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Département d’Hématologie clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Hélène Labussière-Wallet
- Département d’Hématologie clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Hervé Ghesquières
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Département d’Hématologie clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Fabienne Venet
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Laboratoire de Recherche Commun (LCR), Hospices Civils de Lyon/BioMérieux, Pierre-Bénite, France
- Laboratoire d’Immunologie, Hospices Civils de Lyon, Lyon, France
- EA7426 UCBL1-HCL-bioMérieux Pathophysiology of Injury-induced Immunosuppression, Lyon, France
| | - Karen Brengel-Pesce
- Laboratoire de Recherche Commun (LCR), Hospices Civils de Lyon/BioMérieux, Pierre-Bénite, France
| | - Sophie Trouillet-Assant
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Laboratoire de Recherche Commun (LCR), Hospices Civils de Lyon/BioMérieux, Pierre-Bénite, France
| | - Florence Ader
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- *Correspondence: Florence Ader,
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Mirinaviciute G, Barlinn R, Gjeruldsen Dudman S, Flem E. Immunity to varicella zoster virus among pregnant women in the Norwegian Mother and Child Cohort Study. PLoS One 2019; 14:e0221084. [PMID: 31408478 PMCID: PMC6692067 DOI: 10.1371/journal.pone.0221084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/30/2019] [Indexed: 12/11/2022] Open
Abstract
Introduction Infection with varicella zoster virus (VZV) in pregnancy may lead to serious outcomes both for the mother and the newborn. Targeted screening and vaccination of non-immune women during reproductive age could prevent varicella infection in pregnancy. Currently, no universal varicella screening of pregnant women is implemented in Norway, but serological testing in pregnancy is recommended in particular situations. We examined seroprevalence of VZV in a national pregnancy cohort in order to help assess a need for VZV screening of women during reproductive age. Methods We determined the susceptibility to VZV and the reliability of self-reported history of VZV infection in the Norwegian obstetric population by using a random sample of 1,184 pregnant women from the Norwegian Mother and Child Cohort study (MoBa). The MoBa study included approximately 95,200 pregnant women in Norway between 1998 and 2009. Blood samples taken at gestational week 17–18 were analysed using a commercial enzyme immunoassay for specific IgG antibodies to Varicella-Zoster virus. Second sample taken at birth was tested if the first sample result was negative or equivocal. Results Of the 1,184 pregnant women, 98.6% (n = 1,167) were seropositive, 0.83% (n = 10) remained seronegative, and four women (0.34%) seroconverted during their pregnancy. No significant associations were found between serological status and women’s age at birth, gestational age, women’s country of birth and year of child’s birth. One woman reported prior history of varicella, whereas 143 (12.1%) women reported a household exposure to childhood diseases with fever and rash, of which 25 reported exposure to varicella, of which all were seropositive. Conclusions The findings support antenatal screening recommendations in Norway advising testing for VZV in pregnant women with unknown immunity to VZV. Further studies are however needed to better identify target groups for screening and vaccination.
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Affiliation(s)
- Grazina Mirinaviciute
- Department of Infectious Diseases Epidemiology and Modeling, Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
- * E-mail:
| | - Regine Barlinn
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Susanne Gjeruldsen Dudman
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elmira Flem
- Department of Infectious Diseases Epidemiology and Modeling, Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
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Premathilake IP, Aluthbaduge P, Senanayake CP, Jayalatharachchi R, Gamage S, Jayamaha J. Susceptibility for varicella and factors associated with immunity among pregnant women in a tertiary care hospital in Sri Lanka- a cross-sectional study. BMC Infect Dis 2019; 19:356. [PMID: 31035950 PMCID: PMC6489179 DOI: 10.1186/s12879-019-3996-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 04/16/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Varicella during pregnancy can lead to serious maternal and fetal consequences. Although an effective vaccine is available it is not incorporated in to the routine vaccination programs in most of the Asian countries. Objectives of the study were to determine the susceptibility to varicella and factors associated with immunity, among a group of pregnant women attending to a tertiary care hospital in Sri Lanka. METHODS A hospital based descriptive cross sectional study was carried out at De Soyza maternity Hospital, Colombo. A sample of 385 pregnant women was selected. Data were collected through an interviewer administered questionnaire; presence of varicella IgG in blood was assessed by a validated commercial ELISA (Enzyme Linked Immunosorbant Assay. RESULTS The sample had a mean age of 28.5 years and majority was educated beyond General Certificate of Education (GCE) Ordinary Level. We found that 34% of study population was susceptible for the infection. A past history of varicella had a 89.5% positive predictive value and 53.1% negative predictive value for varicella immunity. Varicella sero-positivity was only associated with a lower educational level and number of childhood household members more than four. There was no association of sero-positivity with age. CONCLUSION This study demonstrates that a significant proportion of pregnant women of the study population are varicella-susceptible. Pre-pregnancy screening and preventive strategies including vaccination should be evaluated. History of past varicella infection could be a useful screening tool to exclude patients for vaccination.
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Affiliation(s)
- Ishara P Premathilake
- Department of Microbiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Praveena Aluthbaduge
- Department of Microbiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Channa P Senanayake
- Department of Microbiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Sirithilak Gamage
- Department of Microbiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Jude Jayamaha
- Department of Virology, Medical Research Institute, Colombo, Sri Lanka
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Ibrahim EG, Abdel Wahed WY, Eid HM, Deeb WS. Seroprevalence of varicella-zoster virus among pregnant women in Fayoum Governorate, Egypt. J Egypt Public Health Assoc 2019; 94:2. [PMID: 30686830 PMCID: PMC6325979 DOI: 10.1186/s42506-018-0002-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 11/13/2018] [Indexed: 01/29/2023]
Abstract
Background Chickenpox infection acquired during pregnancy is a serious condition. There may be congenital malformations and neonatal varicella syndrome with significant morbidity and mortality. Egypt has no routine varicella-zoster vaccination program. Objective To assess the immune status against varicella-zoster virus (VZV) antibodies among a group of pregnant women and to study the relationship between VZV seroprevalence and some sociodemographic characteristics. Subjects and methods A descriptive cross-sectional study was conducted on a group of pregnant women (n = 333) attending antenatal care (ANC) clinic at Fayoum University Hospital. Serologic testing for VZV was performed using ELISA through the years 2016-2017. Results VZV seroprevalence was detected in 294 (88.3%) of the 333 recruited pregnant women. Older age > 25 years old was significantly associated with low percent of VZV-negative antibodies (6.7% in versus 17.4% in younger age, OR (95%CI) 0.34 (0.17-0.70)), also having more than one child was significantly associated with a low percent of VZV-negative antibodies (8.2% versus 16.1% among participants with no children or having one child, OR 0.34 (0.17-0.70)). Conclusions Despite the absence of a routine VZV vaccination program in Egypt, VZV immunity was high among pregnant women, but less than that reported in many developed countries. We recommend targeted vaccination for women in the reproductive age especially young and primipara. Trial registration Ethical Committee Registration number R67 session 42: date 12/11/2017(retrospectively registered).
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Affiliation(s)
- Enas G Ibrahim
- 1Microbiology Department, Faculty of Medicine, Fayoum University, Faiyum, Egypt
| | - Wafaa Y Abdel Wahed
- 2Public Health & Community Medicine Department, Faculty of Medicine, Fayoum University, Faiyum, 63514 Egypt
| | - Hanaa M Eid
- 1Microbiology Department, Faculty of Medicine, Fayoum University, Faiyum, Egypt
| | - Wessam S Deeb
- 3Obstetric and Gynecological Department, Faculty of Medicine, Fayoum University, Faiyum, Egypt
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Epidemiology and factors influencing varicella infections in tropical countries including Sri Lanka. Virusdisease 2018; 29:277-284. [PMID: 30159361 DOI: 10.1007/s13337-018-0459-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/29/2018] [Indexed: 02/07/2023] Open
Abstract
Varicella zoster virus (VZV) infections occur worldwide but the epidemiology differs between different geographical regions. Epidemiology of varicella is partly understood in tropical and subtropical regions. Various hypotheses showing differences in exposure rates in different age groups have been proposed. Exposure to VZV during late childhood or adolescent stage causes high morbidity, especially in high school children, university students and young work force in tropical nations. Exposure to VZV infection or sero-prevalence rates through anti-VZV immunoglobulin G appears to be lower in Sri Lanka, similar to other tropical countries prior to the millennium. In contrast, a more recent study in a group of antenatal women showed a relatively higher exposure rate to VZV when compared to the exposure rates prior to 2004 in Sri Lanka. Climatic factors, socioeconomic conditions, mobility and cultural practices appear to play a role in the differences in the exposure rates to VZV infection in the tropics. In most tropical Asian countries including Sri Lanka, routine vaccination against varicella is not carried out. Individuals with negative history for varicella take the vaccine when there is a necessity. Medical and nursing students take the vaccine prior to their clinical training to avoid adulthood varicella.
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Varicella infection in a non-universally vaccinated population: Actual epidemiology in Bulgaria (2013-2015). J Infect Public Health 2017; 11:326-330. [PMID: 29017751 DOI: 10.1016/j.jiph.2017.09.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 08/23/2017] [Accepted: 09/09/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Varicella is a common and usually mild disease but it has great importance in regard to general infectious morbidity. The current study aimed to characterize possible risk factors of varicella epidemiology in Bulgaria, a country where infection follows its natural epidemiological pattern as no mandatory or recommended vaccine is currently applied. METHODS Administrative regions of Bulgaria were used as units of observation and a set of sociodemographic and economic determinants, as well as geographic location (south or north) were tested for associations with the mean 3-year varicella incidence rates (2013-2015). RESULTS The proportion of urban population, proportion of females, number of health care units and proportion of urban population aged <10 years were the four sociodemographic variables most strongly and significantly correlated (p<0.05) with varicella frequency (Spearman's rank correlation coefficients of 0.62, 0.47, 0.43, and 0.38, respectively). After reducing the number of intercorrelated factors to a few principal components and accounting for confounders, the demographic component and geographic location remained most robustly associated with varicella incidence in Bulgaria (adjusted R2 of 0.51, p<0.001). CONCLUSIONS The results obtained identify important determinants in the local epidemiology of varicella and show that community characteristics should be considered, to improve our understanding of varicella distribution.
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Riera-Montes M, Bollaerts K, Heininger U, Hens N, Gabutti G, Gil A, Nozad B, Mirinaviciute G, Flem E, Souverain A, Verstraeten T, Hartwig S. Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization. BMC Infect Dis 2017; 17:353. [PMID: 28521810 PMCID: PMC5437534 DOI: 10.1186/s12879-017-2445-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 05/07/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Varicella is generally considered a mild disease. Disease burden is not well known and country-level estimation is challenging. As varicella disease is not notifiable, notification criteria and rates vary between countries. In general, existing surveillance systems do not capture cases that do not seek medical care, and most are affected by underreporting and underascertainment. We aimed to estimate the overall varicella disease burden in Europe to provide critical information to support decision-making regarding varicella vaccination. METHODS We conducted a systematic literature review to identify all available epidemiological data on varicella IgG antibody seroprevalence, primary care and hospitalisation incidence, and mortality. We then developed methods to estimate age-specific varicella incidence and annual number of cases by different levels of severity (cases in the community, health care seekers in primary care and hospitals, and deaths) for all countries belonging to the European Medicines Agency (EMA) region and Switzerland. RESULTS In the absence of universal varicella immunization, the burden of varicella would be substantial with a total of 5.5 million (95% CI: 4.7-6.4) varicella cases occurring annually across Europe. Variation exists between countries but overall the majority of cases (3 million; 95% CI: 2.7-3.3) would occur in children <5 years. Annually, 3-3.9 million patients would consult a primary care physician, 18,200-23,500 patients would be hospitalised, and 80 varicella-related deaths would occur (95% CI: 19-822). CONCLUSIONS Varicella disease burden is substantial. Most cases occur in children <5 years old but adults require hospitalisation more often and are at higher risk of death. This information should be considered when planning and evaluating varicella control strategies. A better understanding of the driving factors of country-specific differences in varicella transmission and health care utilization is needed. Improving and standardizing varicella surveillance in Europe, as initiated by the European Centre for Disease Prevention and Control (ECDC), is important to improve data quality to facilitate inter-country comparison.
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Affiliation(s)
- Margarita Riera-Montes
- P95 Pharmacovigilance and Epidemiology Services, Koning Leopold III Laan 1, 3001, Leuven, Belgium.
| | - Kaatje Bollaerts
- P95 Pharmacovigilance and Epidemiology Services, Koning Leopold III Laan 1, 3001, Leuven, Belgium
| | - Ulrich Heininger
- Division of Paediatric Infectious Diseases and Vaccinology, University of Basel Children's Hospital, CH-4056, Basel, Switzerland
| | - Niel Hens
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Hasselt University, Antwerp, Belgium.,Centre for Health Economics Research and Modelling Infectious Diseases and Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Giovanni Gabutti
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Angel Gil
- Universidad Rey Juan Carlos, Madrid, Spain
| | - Bayad Nozad
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Grazina Mirinaviciute
- Department of Infectious Disease Epidemiology and Modelling, Norwegian Institute of Public Health, Oslo, Norway
| | - Elmira Flem
- Department of Infectious Disease Epidemiology and Modelling, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Thomas Verstraeten
- P95 Pharmacovigilance and Epidemiology Services, Koning Leopold III Laan 1, 3001, Leuven, Belgium
| | - Susanne Hartwig
- Sanofi Pasteur MSD, 162 avenue Jean Jaurès, 69007, Lyon, France
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Olsson J, Kok E, Adolfsson R, Lövheim H, Elgh F. Herpes virus seroepidemiology in the adult Swedish population. IMMUNITY & AGEING 2017; 14:10. [PMID: 28491117 PMCID: PMC5424393 DOI: 10.1186/s12979-017-0093-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 05/05/2017] [Indexed: 01/01/2023]
Abstract
Background Herpes viruses establish a life-long latency and can cause symptoms during both first-time infection and later reactivation. The aim of the present study was to describe the seroepidemiology of Herpes simplex type 1 (HSV1), Herpes simplex type 2 (HSV2), Cytomegalovirus (CMV), Varicella Zoster virus (VZV) and Human herpes virus type 6 (HHV6) in an adult Swedish population (35–95 years of age). Methods Presence of antibodies against the respective viruses in serum from individuals in the Betula study was determined with an enzyme-linked immunosorbent assay (ELISA). Singular samples from 535 persons (53.9% women, mean age at inclusion 62.7 ± 14.4 years) collected 2003-2005 were analyzed for the five HHVs mentioned above. In addition, samples including follow-up samples collected 1988–2010 from 3,444 persons were analyzed for HSV. Results Prevalence of HSV1 was 79.4%, HSV2 12.9%, CMV 83.2%, VZV 97.9%, and HHV6 97.5%. Herpes virus infections were more common among women (p = 0.010) and a lower age-adjusted HSV seroprevalence was found in later birth cohorts (p < 0.001). The yearly incidence of HSV infection was estimated at 14.0/1000. Conclusion Women are more often seropositive for HHV, especially HSV2. Age-adjusted seroprevalence for HSV was lower in later birth cohorts indicating a decreasing childhood and adolescent risk of infection.
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Affiliation(s)
- Jan Olsson
- Department of Clinical Microbiology, Virology, Umeå University, Umeå, Sweden
| | - Eloise Kok
- Department of Forensic Medicine, University of Tampere, Tampere, 33520 Finland
| | - Rolf Adolfsson
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
| | - Hugo Lövheim
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Fredrik Elgh
- Department of Clinical Microbiology, Virology, Umeå University, Umeå, Sweden
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De Paschale M, Clerici P. Microbiology laboratory and the management of mother-child varicella-zoster virus infection. World J Virol 2016; 5:97-124. [PMID: 27563537 PMCID: PMC4981827 DOI: 10.5501/wjv.v5.i3.97] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 07/08/2016] [Accepted: 07/22/2016] [Indexed: 02/05/2023] Open
Abstract
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.
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Puhakka L, Sarvikivi E, Lappalainen M, Surcel HM, Saxen H. Decrease in seroprevalence for herpesviruses among pregnant women in Finland: cross-sectional study of three time points 1992, 2002 and 2012. Infect Dis (Lond) 2015; 48:406-10. [DOI: 10.3109/23744235.2015.1123290] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Doret M, Marcellin L. Les vaccinations dans le post-partum immédiat : recommandations. ACTA ACUST UNITED AC 2015; 44:1135-40. [DOI: 10.1016/j.jgyn.2015.09.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 09/18/2015] [Indexed: 11/24/2022]
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Helmuth IG, Poulsen A, Suppli CH, Mølbak K. Varicella in Europe-A review of the epidemiology and experience with vaccination. Vaccine 2015; 33:2406-13. [PMID: 25839105 DOI: 10.1016/j.vaccine.2015.03.055] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 03/18/2015] [Accepted: 03/19/2015] [Indexed: 10/23/2022]
Abstract
There is no consensus as regards the European varicella immunisation policy; some countries have introduced varicella vaccination in their routine childhood immunisation programs whereas others have decided against or are debating. With the aim of providing an overview of the epidemiology of varicella in Europe and addressing the different strategies and the experiences so far, we performed a review of epidemiological studies done in Europe from 2004 to 2014. Varicella is mainly a disease of childhood, but sero-epidemiological studies show regional differences in the proportion of susceptible adults. Hospitalisation due to varicella is not common, but complications and hospitalisation mainly affect previously healthy children, which underlines the importance of not dismissing varicella as a disease of little importance. The experience with universal vaccination in Europe shows that vaccination leads to a rapid reduction of disease incidence. Vaccine effectiveness is high and a protective herd effect is obtained. Experience with vaccination in Europe has not been long enough, though, to draw conclusions on benefits and drawbacks with vaccination as well as the capacity for national programs in Europe to maintain a sufficiently high coverage to prevent a change in age group distribution to older children and young adults or on the impact that varicella immunisation may have on the epidemiology of shingles.
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Affiliation(s)
- Ida Glode Helmuth
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; Department of Infectious Disease Epidemiology, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark.
| | - Anja Poulsen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
| | - Camilla Hiul Suppli
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark.
| | - Kåre Mølbak
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark.
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Tafuri S, Gallone MS, Cappelli MG, Gallone MF, Larocca AMV, Germinario C. A seroprevalence survey on varicella among adults in the vaccination era in Apulia (Italy). Vaccine 2014; 32:6544-7. [PMID: 25236583 DOI: 10.1016/j.vaccine.2014.08.088] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 08/20/2014] [Accepted: 08/21/2014] [Indexed: 01/11/2023]
Abstract
In 2006, the Apulia Region (Italy) introduced universal routine vaccination (URV) against varicella disease. The coverage for one dose of varicella vaccine at 24 month of age reached 91.1% in 2010 birth-cohort. Vaccination coverage for the second dose at 5-6 years was 64.8% for the cohort 2005, and 28.8% for adolescents born in 1997. The aim of the present study is to evaluate the pattern of immunity/susceptibility to varicella in Apulian adults by a seroprevalence survey carried out 6 years after the introduction of URV. The study was carried out from May 2011 to June 2012 among blood donors of the Department of Transfusion Medicine of Policlinico General Hospital in Bari. Subjects were enrolled by a convenience sample. For each enrolled patient we collected a sample of serum of 5 ml. Anti-VZV IgG in collected sera were analyzed by chemiluminescence (CLIA). We enrolled 1769 subject; 1365 (77.2%) were male with a mean age of 38.4 ± 11.7 years. 93% (95% CI=91.7-94.1) of enrolled subject presented a titre of anti-VZV IgG >164 mIU/mL. GMT of anti-VZV IgG titre was 1063.4 mIU/ml and no difference was observed between different age group. According to our data, URV did not seem to have any impact on susceptibility among adults and in particular we did not note any cluster of susceptible subjects among young adults. Also in the vaccination era, we did not note that the average age of infection shifts among adults and then we could exclude an increase of case of complicated varicella related to the URV.
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Affiliation(s)
- S Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy.
| | - M S Gallone
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - M G Cappelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - M F Gallone
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - A M V Larocca
- Hygiene Department, Policlinico General Hospital, Bari, Italy
| | - C Germinario
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
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Baratin D, Del Signore C, Thierry J, Caulin E, Jacquard AC, Vanhems P. Pertussis vaccination coverage among adults in the Lyon area. Med Mal Infect 2014; 44:366-73. [DOI: 10.1016/j.medmal.2014.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 04/24/2014] [Accepted: 07/02/2014] [Indexed: 11/27/2022]
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Charlier C, Le Mercier D, Salomon LJ, Ville Y, Kermorvant-Duchemin E, Frange P, Postaire M, Lortholary O, Lecuit M, Leruez-Ville M. Varicelle, zona et grossesse. Presse Med 2014; 43:665-75. [DOI: 10.1016/j.lpm.2014.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 04/01/2014] [Accepted: 04/01/2014] [Indexed: 02/02/2023] Open
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Influence of frequent infectious exposures on general and varicella-zoster virus-specific immune responses in pediatricians. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2014; 21:417-26. [PMID: 24429070 DOI: 10.1128/cvi.00818-13] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Reexposure to viruses is assumed to strengthen humoral and cellular immunity via the secondary immune response. We studied the effects of frequent exposure to viral infectious challenges on immunity. Furthermore, we assessed whether repetitive exposures to varicella-zoster virus (VZV) elicited persistently high immune responses. Blood samples from 11 pediatricians and matched controls were assessed at 3 time points and 1 time point, respectively. Besides the assessment of general immunity by means of measuring T-cell subset percentages, antibody titers and gamma interferon (IFN-γ)/interleukin 2 (IL-2)-producing T-cell percentages against adenovirus type 5 (AdV-5), cytomegalovirus (CMV), tetanus toxin (TT), and VZV were determined. Pediatricians had lower levels of circulating CD4(+)-naive T cells and showed boosting of CD8(+) effector memory T cells. Although no effect on humoral immunity was seen, repetitive exposures to VZV induced persistently higher percentages of IFN-γ-positive T cells against all VZV antigens tested (VZV glycoprotein E [gE], VZV intermediate-early protein 62 [IE62], and VZV IE63) than in controls. T cells directed against latency-associated VZV IE63 benefitted the most from natural exogenous boosting. Although no differences in cellular or humoral immunity were found between the pediatricians and controls for AdV-5 or TT, we did find larger immune responses against CMV antigens in pediatricians. Despite the high infectious burden, we detected a robust and diverse immune system in pediatricians. Repetitive exposures to VZV have been shown to induce a stable increased level of VZV-specific cellular but not humoral immunity. Based on our observations, VZV IE63 can be considered a candidate for a zoster vaccine.
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Ogunjimi B, Van Damme P, Beutels P. Herpes Zoster Risk Reduction through Exposure to Chickenpox Patients: A Systematic Multidisciplinary Review. PLoS One 2013; 8:e66485. [PMID: 23805224 PMCID: PMC3689818 DOI: 10.1371/journal.pone.0066485] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 05/07/2013] [Indexed: 11/19/2022] Open
Abstract
Varicella-zoster virus (VZV) causes chickenpox and may subsequently reactivate to cause herpes zoster later in life. The exogenous boosting hypothesis states that re-exposure to circulating VZV can inhibit VZV reactivation and consequently also herpes zoster in VZV-immune individuals. Using this hypothesis, mathematical models predicted widespread chickenpox vaccination to increase herpes zoster incidence over more than 30 years. Some countries have postponed universal chickenpox vaccination, at least partially based on this prediction. After a systematic search and selection procedure, we analyzed different types of exogenous boosting studies. We graded 13 observational studies on herpes zoster incidence after widespread chickenpox vaccination, 4 longitudinal studies on VZV immunity after re-exposure, 9 epidemiological risk factor studies, 7 mathematical modeling studies as well as 7 other studies. We conclude that exogenous boosting exists, although not for all persons, nor in all situations. Its magnitude is yet to be determined adequately in any study field.
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Affiliation(s)
- Benson Ogunjimi
- Centre for Health Economics Research and Modeling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Hasselt, Belgium
- * E-mail:
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Philippe Beutels
- Centre for Health Economics Research and Modeling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
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Baratin D, Del Signore C, Thierry J, Caulin E, Vanhems P. Evaluation of adult dTPaP vaccination coverage in France: experience in Lyon city, 2010-2011. BMC Public Health 2012; 12:940. [PMID: 23114050 PMCID: PMC3526515 DOI: 10.1186/1471-2458-12-940] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 10/22/2012] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Compliance with official recommendations can be assessed by evaluating vaccination coverage (VC) in populations. The main objective of our study was to assess VC of adults against diphtheria, tetanus, poliomyelitis and pertussis (dTPaP) according to age. The second objective was to explore if vaccination status could be confirmed by documentation. METHODS A cross-sectional study was conducted in 680 adults consulting for biological examination in private laboratories in Lyon (France) to evaluate VC for diphtheria, tetanus, poliomyelitis and pertussis (dTPaP) and enabled reported vaccinations to be compared with documented, confirmed vaccinations. RESULTS Verification of documented, confirmed vaccinations disclosed VC of 78.7% for tetanus, 63.6% for poliomyelitis, 57.8% for diphtheria and 10.7% for pertussis. Comparison of confirmed and self-reported vaccinations revealed that a large percentage of people who thought that they were vaccinated were not. VC significantly decreased with age for diphtheria and poliomyelitis and did not vary by gender. The VC rate for pertussis has increased since the 2008 recommendations were made. CONCLUSIONS The main thrust of this study was to compare reported and confirmed data. A significant percentage of people wrongly believed that they were up to date with their vaccination.
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Affiliation(s)
- Dominique Baratin
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d’Hygiène, Epidémiologie et Prévention, Lyon, France
| | - Corinne Del Signore
- Institut d’Epidémiologie, Laboratoire de Biométrie et Biologie Evolutive, UMR CNRS 5558, Claude Bernard Lyon 1 University, Lyon, France
| | - Jacques Thierry
- Groupement de laboratoires de biologie médicale libéraux DYOMEDEA, Lyon, France
| | | | - Philippe Vanhems
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d’Hygiène, Epidémiologie et Prévention, Lyon, France
- Institut d’Epidémiologie, Laboratoire de Biométrie et Biologie Evolutive, UMR CNRS 5558, Claude Bernard Lyon 1 University, Lyon, France
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25
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Alain S, Dommergues MA, Jacquard AC, Caulin E, Launay O. State of the art: Could nursing mothers be vaccinated with attenuated live virus vaccine? Vaccine 2012; 30:4921-6. [DOI: 10.1016/j.vaccine.2012.05.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Revised: 05/10/2012] [Accepted: 05/19/2012] [Indexed: 11/25/2022]
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26
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Immunity to varicella-zoster virus in Croatian women of reproductive age targeted for serology testing. Arch Gynecol Obstet 2012; 286:901-4. [PMID: 22678561 DOI: 10.1007/s00404-012-2398-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 05/24/2012] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of this study was to determine the immunity to varicella-zoster virus (VZV) in Croatian pregnant and non-pregnant women of reproductive age. METHODS During 2007-2011, a total of 638 women aged 16-45 years were tested for the presence of VZV IgM and IgG antibodies using commercial enzyme-linked immunosorbent assay. Samples positive for IgG antibodies with positive or equivocal IgM antibodies were tested for IgG avidity. RESULTS The overall IgG seroprevalence was 84.3 %. There was a significant increase in IgG seropositivity with age (OR = 1.04 for 1-year increase in age; 95 % CI 1.01-1.08). The lowest seroprevalence rate was reported in the 16-20 age groups (78.6 %), and the highest was in the 41-45 age groups (94.3 %). There was no significant difference in seroprevalence among women residing in urban and rural areas (83.6 vs. 87.0 %, OR 0.76, 95 % CI 0.43-1.34). CONCLUSIONS The results of this study have shown that a high proportion of Croatian childbearing-aged women (15.7 %) who were referred to the laboratory for VZV serology testing are susceptible to VZV and, thus, at risk for contracting varicella during pregnancy. Serology testing of adolescent girls and adult women who do not have a documented history of varicella is encouraged with the aim of vaccinating seronegative girls and women against VZV before pregnancy. In addition, testing of pregnant women is advised to identify susceptible women and vaccinate them after delivery.
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27
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Guido M, Tinelli A, De Donno A, Quattrocchi M, Malvasi A, Campilongo F, Zizza A. Susceptibility to varicella-zoster among pregnant women in the province of Lecce, Italy. J Clin Virol 2011; 53:72-6. [PMID: 22074933 DOI: 10.1016/j.jcv.2011.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 09/21/2011] [Accepted: 10/14/2011] [Indexed: 01/30/2023]
Abstract
BACKGROUND Varicella is predominantly a childhood disease, considered a mild self-limiting disease that can have serious complications for a pregnant woman and her developing fetus. OBJECTIVES We investigated the susceptibility to varicella-zoster Virus (VZV) among pregnant women in the province of Lecce. STUDY DESIGN A cross-sectional study was carried out in Departments of Gynecology and Obstetrics of the Province of Lecce, where 539 pregnant women were recruited, and face-to-face interviews were conducted. Varicella IgG tests were performed. RESULTS The prevalence of varicella susceptibility among pregnant mothers was 10.6%. The prevalence of IgG antibodies increases significantly with increasing age, from 62.5% in the age group 15-19 years to 94.4% in the age group 40-49 years. DISCUSSION In the Italian National Vaccination Plan 2005-2007, varicella vaccine is only recommended for childbearing women. A safe and effective vaccine is available and no abnormalities have been observed among infants born to susceptible women who received varicella vaccines during pregnancy. Such a high number of susceptible women indicates that preventive and informative programs should be introduced, even among those who do not plan to become pregnant. Routine counselling, varicella IgG antibody screening and varicella vaccination should be considered if they have no history of the infection, to reduce the risk of fetal complications and the cost of healthcare associated with the infection.
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Affiliation(s)
- M Guido
- Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, Faculty of Sciences, University of Salento, Lecce, Italy
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Hannachi N, Marzouk M, Harrabi I, Ferjani A, Ksouri Z, Ghannem H, Khairi H, Hidar S, Boukadida J. Séroépidémiologie de la rubéole, de la varicelle et des infections par le cytomégalovirus et le parvovirus B19 chez les femmes enceintes dans la région de Sousse, Tunisie. ACTA ACUST UNITED AC 2011; 104:62-7. [DOI: 10.1007/s13149-010-0119-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Accepted: 10/12/2010] [Indexed: 11/28/2022]
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Gétaz L, Siegrist CA, Stoll B, Humair JP, Scherrer Y, Franziskakis C, Sudre P, Gaspoz JM, Wolff H. Chickenpox in a Swiss prison: susceptibility, post-exposure vaccination and control measures. ACTA ACUST UNITED AC 2010; 42:936-40. [PMID: 20854218 DOI: 10.3109/00365548.2010.511259] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
After the occurrence of a case of chickenpox in Switzerland's largest pre-trial prison, protective measures including post-exposure vaccination were implemented, as chickenpox can cause severe complications in adults. Serology for chickenpox was carried out for all contacts of the index case and rapid post-exposure vaccination proposed to all prisoners with a negative history for chickenpox. Susceptibility was found in 14 out of 110 prisoners (12.7%; 95% confidence interval 6.5-18.9). The positive predictive value of a history of chickenpox was 90%. In this predominantly migrant population, susceptibility to chickenpox was approximately 6 times higher than in the general Swiss adult population. Since the attack rate among susceptible household contacts is usually high, preventive measures such as vaccination and quarantine probably allowed containment of the spread of infection.
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Affiliation(s)
- Laurent Gétaz
- Department of Community Medicine and Primary Care, Geneva University Hospitals, Geneva, Switzerland.
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Kurukulasooriya G, Thevanesam V, Agampodi S, Abeykoon A, Amarasiri S, Goonasekera K. Susceptibility of New Entrant University Students in Sri Lanka to Varicella Zoster Infection. Asia Pac J Public Health 2009; 22:219-24. [DOI: 10.1177/1010539509334625] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To investigate the susceptibility of Sri Lankan new entry university students to varicella zoster virus (VZV) infection, a cross-sectional descriptive study was carried out among new entrant medical and engineering students of the University of Peradeniya, Sri Lanka. Self-reported history of chicken pox was studied first, followed by serological evaluation for VZV IgG antibodies. A total of 451 students participated in the study out of which 189 (41.9%) reported a history of chicken pox. Median age of reported age of acquiring the disease was 14 years with an interquartile range of 10 to 17 years. Only 25% of the population reported history of infection prior to age of 10 years. The seropositive rate of VZV IgG antibodies among undergraduates with a negative history of chicken pox was 10.1% ( 25/247). The present study indicates that nearly half (222/436) of the study population (50.9%, 95% CI 46.2-55.6) was susceptible to VZV infection.
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Affiliation(s)
| | - V. Thevanesam
- Departments of Microbiology, University of Peradeniya, Peradeniya, Sri Lanka
| | - S.B. Agampodi
- Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka,
| | - A.M.S.B. Abeykoon
- From the Departments of Microbiology, University of Peradeniya, Peradeniya, Sri Lanka
| | - S.P. Amarasiri
- Faculty of Medicine, and the Health Centre, University of Peradeniya, Peradeniya, Sri Lanka
| | - K.P.C. Goonasekera
- Faculty of Medicine, and the Health Centre (SPA, KPCG) University of Peradeniya, Peradeniya, Sri Lanka
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Prevalence of anti-varicella-zoster virus antibodies in French infants under 15 months of age. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2009; 16:484-7. [PMID: 19176690 DOI: 10.1128/cvi.00397-08] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Varicella is a widespread disease of childhood resulting from primary infection with varicella-zoster virus (VZV). The objective of this study was to determine the kinetics of the decline of maternal anti-VZV antibodies in French infants between birth and the age of 15 months in order to estimate the duration of passively acquired maternal anti-VZV immunoglobulin G (IgG). This prospective multicenter study was conducted between October 2005 and January 2007 in the pediatric wards and/or pediatric emergency units of seven French hospitals scattered throughout the country. The level of anti-VZV IgG antibodies in serum was measured by a time-resolved fluorescence immunoassay (TRFIA) (the threshold considered positive is 150 mIU/ml). A total of 345 infants were included. Seventy-seven percent of mothers reported a history of varicella. A rapid decline in the prevalence of anti-VZV antibodies was observed during the first few months of life, with the mean antibody titer decreasing from 536 mIU/ml at birth and through 1 month to below the 150-mIU/ml threshold at 3 to 4 months. The half-life of passively acquired maternal immunoglobulins was around 6 weeks. Based on a large number of subjects, this study clearly demonstrated, for the first time in France, high levels of passively acquired maternal antibodies during the neonatal period, and it allowed us to estimate the duration of passively acquired maternal anti-VZV IgG in French infants. After 4 to 5 months, infants had very low levels of maternal anti-VZV IgG, below the 150-mIU/ml cutoff of the VZV IgG TRFIA.
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32
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Hofman A. Recent trends in publications in the European Journal of Epidemiology. Eur J Epidemiol 2008; 23:757-60. [PMID: 19039670 DOI: 10.1007/s10654-008-9305-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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