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@#Objective To prepare high titer specific immune serum of varicella-herpes zoster virus(VZV)for the quality control of live attenuated varicella vaccine and live attenuated herpes zoster vaccine.MethodsMale rabbits were immunized with high purity recombinant gE glycoprotein combined with Freund's adjuvant,aluminum hydroxide adjuvant or MF59 adjuvant,2 rabbits in each group. On the 56th day after immunization,the maximum blood samples(heart or carotid artery)were collected from each rabbit to prepare serum,which was mixed with VZV for neutralization reaction,and then inoculated into a 6-well plate full of monolayer of MRC-5 human diploid cells. After incubation for 7 d,the number of plaques was counted and the neutralizing titer and virus neutralizing ability of immune serumwere determined. The serum with high neutralizing titer and virus neutralizing ability was selected for the identification test of live attenuated varicella vaccine and live attenuated herpes zoster vaccine VZV(Oka strain)working seed lot and the detection of exogenous virus factors.ResultsThe immune sera prepared by immunizing rabbits with various combinations of recombinant gE glycoprotein all showed neutralizing activity,among which the serum prepared by the combination of recombinant gE glycoprotein and Freund's adjuvant had the highest neutralizing titer of 1∶512 and the virus neutralizing ability of 240 000 PFU/mL;The prepared immune serum was usedfor the identification test of VZV(Oka strain)working seed lot and the detection of exogenous virus factors,of which all the results were in line with the requirements. Conclusion The recombinantgE glycoprotein could be used for the preparation of high titer neutralizing antibody against VZV,and the prepared high titer neutralizing antibody is suitable for thequality control of live attenuated varicella vaccine and live attenuated herpes zoster vaccine.
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Resumen Presentamos el caso de un hombre campesino de 33 años de edad, inmunocompetente, quien presentó cuadro clínico agudo con máculas, pápulas y vesículas simultáneas, generalizadas, de 10 dias de evolución, con fiebre y conjuntivitis. Se sospechó varicela, la cual se confirmó con frotis directo y biopsia de piel con inmunohistoquímica. El paciente mejoró y curó sin complicaciones y sin tratamiento antiviral. Es un caso interesante al tratarse de un hombre adulto, sin inmuno supresión ni enfermedad de base predisponente, con manifestaciones floridas e importante compromiso cutáneo, con evolución satisfactoria. Revisamos aspectos generales de la varicela, de su incidencia en Colombia y de los programas de vacunación.
Abstract We describe a case of varicella in one immunocompetent man of 33 years, who consulted by cutaneous lesions consistent in maculopapular and vesicles generali zed after 10 days of evolution, accompanied by fever and conjunctivitis. Diagnosis of varicella was confirmed by direct stain and biopsy with immunohistochemistry analysis. The patient improved without antiviral treatment and no complications. We consider this caes of interest because its inusual presentation in one man without immunodeficiency nor subjacent disease. We reviewed the situation of varicella in Colombia and of the vaccination programs.
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@#Abstract: Objective This paper aims to explore the effect of live attenuated varicella vaccine on the sensitivity of tuberculin skin test(TST), and to provide reference for tuberculin skin test in the future. Methods TST and emergency varicella vaccine were administered to students in grade one of a high school in Wuxi, Jiangsu province, who had both TB and varicella cases. Independent-samples t test was used to analyze the mean diameter of induration of TST in day 0, day 83 and day 195. The retrospective cohort study was used to analyze the effect of live attenuated varicella vaccine on TST. Results The mean induration diameter of 45 students who participated in three TST tests on day 0, day 83 and day 195 were analyzed by independent sample t test. On day 0, there was a difference in the mean diameter of TST induration between the unvaccinated and vaccinated groups(1.630±2.837 vs 5.818±4.530) (t=-3.692, P=0.001). On day 83, there was no difference in the mean diameter of TST induration between the two groups(0.001±0.001 vs 0.114±0.533) (t=-1.000, P=0.329). On day 195, there was a difference in the mean diameter of TST induration between the two groups(1.913±3.774 vs 5.023±5.126) (t=-2.309, P=0.026). Moreover, the retrospective cohort study showed that the mean diameter of TST induration changed more significantly after inoculation with varicella vaccine, RR=6.071, 95%CI (1.667-22.116), P<0.05; After inoculation with varicella vaccine, the mean diameter of TST test did not change significantly from day 0 to day 195 with no statistical significance RR=3.474, 95%CI (0.333-36.240), P>0.05. Conclusions Live attenuated varicella vaccine may temporarily affect the sensitivity of tuberculin skin test.
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Objective:To investigate the protective effect of two doses of varicella vaccine in a population at high risk for varicella.Methods:The case group involved all varicella cases in classes with no less than three patients during varicella outbreaks in Tianjin schools from 2017 to 2019. A case-control study was carried out in a 1∶3 ratio. According to the seat position of each case, three nearby students who did not suffer from varicella were selected as controls. The protective effect of two doses of varicella vaccine was evaluated.Results:The total protective effect of varicella vaccine was 46.0% (95% CI: 42.7%-49.0%). The protective effect was 44.7% (95% CI: 41.2%-48.0%) for one-dose varicella vaccine and 80.0% (95% CI: 63.1%-89.2%) for two-dose varicella vaccine. For two doses of varicella vaccine, the protective effect was 87.6% (95% CI: 52.0%-96.8%) after 0-2 years and 76.6% (95% CI: 33.6%-91.5%) after 3-5 years.Conclusions:The protective effect of two doses of varicella vaccine is better than that of one dose. However, both one-dose and two-dose vaccines show decreased protective effect over time. A booster immunization could be considered in high-risk population with longer intervals since the last vaccination.
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A 95-year-old woman was admitted to our hospital for rehabilitation after a subarachnoid hemorrhage, but her physical function deteriorated due to repeated aspiration pneumonia. On the first day of the illness, a painless erythema appeared on the right elbow fossa, and expanded soon afterwards. She developed a fever of unknown origin, which led us to the diagnosis of generalized herpes zoster by using a rapid diagnostic kit. The patient was placed in a private room to prevent nosocomial infection, and we took contact infection prevention measures, such as, restricting the number of staff in the room. Antiviral drugs were administered to the patient, quickly relieving her fever. The erythema became encrusted in about 2 weeks, and private room management was terminated.Recently, due the start of periodic vaccination, the incidence of varicella has decreased；however, the increasing incidence of herpes zoster infections among the elderly remains a concern, since the onset of herpes zoster infections is inhibited by the booster effect of contact with varicella patients. Many patients are at a high risk for herpes zoster in convalescent rehabilitation wards due to the long-term admission of elderly patients with underlying diseases. Because more patients with severe herpes zoster are expected in convalescent rehabilitation wards in the future, we herein reexamine the management of such patients from the perspective of early diagnosis, nosocomial infection prevention measures, and prevention of herpes zoster onset.
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Objective To evaluate the vaccination of live attenuated varicella vaccine ((VarV) in Jinshan District of Shanghai. Methods Descriptive and analytical epidemiological analysis was carried out using the information of VarV immunization of children born between November 1, 2006 and October 31, 2018 (1-12 years) in the Jinshan District Immunization Program Information System. Results There were 82 584 registered children aged 1-12 years in Jinshan District, and the vaccination rate of VarV at the first dose (VarV1) was 90.95%. The vaccination rate of children in this city was higher than that of migrant children, and the annual vaccination rate of children born in different years was between 59.81% and 99.93%. The vaccination rates in northern, central and southern Jinshan District were 89.25%, 93.27% and 91.39%, respectively. Among the 82 584 registered children, the second dose of VarV (VarV2) vaccination rate was 49.01%. The vaccination rate of children in this city was higher than that of migrant children, and the annual vaccination rate of children born in different years was between 25.94% and 77.14%. The vaccination rates in northern, central and southern Jinshan District were 28.72%, 45.88% and 66.30%, respectively. Conclusion The VarV1 vaccination rate of children aged 1-12 in Jinshan District was higher, but the VarV2 vaccination rate was relatively low. It is necessary to further strengthen publicity in key areas to improve the level of VarV2 vaccination.
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Varicella(chickenpox)is an acute infectious disease with high incidence in children. It is mainly transmitted through the airborne route and vaccination is the best measure for the prevention and control. Data from post-marketing studies show the effectiveness of varicella vaccines is 80%-85%, and two-dose regimen is significantly more effective than one-dose. After inclusion of varicella vaccines into the national immunization programme, there has been a clear decrease in varicella morbidity. Despite the lack of direct evidence, there remains the risk that varicella-zoster virus might latent in the dorsal route ganglia after vaccination. Therefore, more safe and effective novel varicella vaccines are under development. This paper reviewed the progress in varicella vaccine development and their long-term efficacy and safety.
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Varicella( chickenpox) is an acute infectious disease with high incidence in children. It is mainly transmitted through the airborne route and vaccination is the best measure for the prevention and control. Data from post-marketing studies show the effectiveness of varicella vaccines is 80％-85％, and two-dose regimen is significantly more effective than one-dose. After inclusion of varicella vaccines into the na-tional immunization programme, there has been a clear decrease in varicella morbidity. Despite the lack of direct evidence, there remains the risk that varicella-zoster virus might latent in the dorsal route ganglia after vaccination. Therefore, more safe and effective novel varicella vaccines are under development. This paper reviewed the progress in varicella vaccine development and their long-term efficacy and safety.
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Objective To explore the epidemic factors of varicella transmission under high varicella vacince coverage, assess the vaccine effectineness of one dose of varicella vaccine, so as to provide scientific basis for controlling the varicella outbreak and optimizing the varicella immunization strategy. Methods A 1 ∶〗2 paired case-control study of a varicella outbreak was conducted in a primary school in central region of Jiangsu Province in 2018. Analysis of varicella epidemic factors was performed using conditional logistic stepwise regression. Results This outbreak lasted for 14 days. A total of 45 students were infected with varicella, of which 71.1% were breakthrough cases. The fever, rash degree and disease course of breakthrough cases were all relatively mild compared with those without immune history (all P5 years and the initial immunization age <15 months were potential risk factors for breakthrough cases. The overall vaccine effectiveness of one dose of varicella vaccine was 77.9%(95% CI: 53.3%-92.1%). The fever, severity of the rash and the course of the disease were all milder than those without the history of immunization (all P<0.05). Conclusions The clinical symptoms of the breakthrough cases are relatively mild, and one dose of varicella vaccine is insufficient to control the outbreak of varicella with limited vaccine effectiveness. Two doses of varicella immunization strategy is recommended.
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The number of reported varicella cases is continuously increasing in Korea; however, associated medical utilization is declining. The ratio between varicella insurance claims and reports of passive infectious disease surveillance has gradually increased to > 80% since the second half of 2017. The recent increase in reported varicella cases is influenced by improved reporting. We calculated the varicella incidence and cumulative incidence in each birth cohort according to age. The cumulative incidence rate among children aged < 6 years in the birth cohort born after the National Immunization Program introduced the varicella vaccine was about 60% lower than among children born before
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Child , Humans , Chickenpox Vaccine , Chickenpox , Cohort Studies , Communicable Diseases , Immunization Programs , Immunization , Incidence , Insurance , Korea , ParturitionABSTRACT
Objective To investigate the effect of live attenuated encephalitis vaccine immunization , the effectiveness and safety of live attenuated vaccine against varicella joint vaccination.Methods From January 2015 to December 2016,400 children with vaccination in Yuncheng Municipal Center for Disease Control and Prevention were selected in this research.They were randomly divided into two groups according to the digital table ,with 200 cases in each group.The control group received live attenuated encephalitis vaccine strengthening immunization ,the observa-tion group received live attenuated encephalitis vaccine immunization and live attenuated vaccine against varicella joint vaccination.The positive rate of neutralizing antibody and the incidence of adverse reactions were compared between the two groups.Results The positive rate of encephalitis neutralizing antibody in the observation group was 94.50%,which was significantly higher than 86.00% of the control group (χ2＝8.211,P＜0.05).The incidence rates of adverse reactions in the observation group and the control group were 6.00%,4.50%, respectively, the difference was not statistically significant (χ2＝0.452,P＞0.05).Conclusion The use of live attenuated encephalitis vaccine to enhance immunity and live attenuated varicella vaccine combined inoculation of vaccine can effectively improve the immunity of children to encephalitis virus ,and it is safe and reliable.
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Objective To evaluate the vaccine effectiveness ( VE) in children who received one dose of live attenuated varicella vaccine. Methods A questionnaire-based 1 ∶ 2 matching case-control study was conducted during May, 2015 to April, 2016 to evaluate the VE based upon the demographic data, vacci-nation status and clinical symptoms of 127 children with varicella and 254 healthy subjects under 12 years old. Results Compared with the healthy subjects, 83. 46% of the patients with varicella were immunized with one dose of varicella vaccine, which was lower than that of the control group (90. 55%) (χ2=4. 08, P<0. 05). The overall protective rate of one dose of varicella vaccine reached 64. 29% (95% CI:42. 00%-78. 00%). Of the 127 cases of varicella, 83. 46% were breakthrough cases immunized with one dose of var-icella vaccine. Primary cases presented more severe clinical symptoms than breakthrough cases. The longer the interval between vaccination and varicella-zoster virus infection was, the more severe the breakthrough cases would be. Conclusion Varicella vaccine is effective for preventing varicella, but the VE of one dose of varicella vaccine is limited. A two-dose varicella vaccination strategy should be proposed in our country as soon as possible.
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To observe the incidence of varicella vaccine after breaking through the case of varicella vaccine , immunization strategy ,popularized in the city.Inoculation Population living in the Binhai New Area of full age to 12 years old children in December,has been vaccinated or who have had chickenpox varicella vaccine except .Controls were four districts around the city girls without varicella in children.Methods: Implementation of vaccination for the target population.All vaccinees was observed from 42 days to 2 and a half years later ,the incidence of varicella break cases.In the observation group and the control group was observed in two groups of varicella vaccine protection rate calculation.Results: The gelatin free attenuated varicella vaccine breakthrough in 134 cases,the incidence rate was 0.35%;no gelatin attenuated varicella vaccine protection rate of 80.92%, with domestic and foreign reports consistent.Conclusion:After vaccination from 42 to 2 and a half years ,varicella vaccine can effectively protect children from the onset, while reducing the prevalence of children 's pain and the economic burden of the family.Varicella vaccine is still a breakthrough occurred ,therefore to consider two inoculations ,with further observation of two times after inoculation the body to produce antibody level and epidemiological protection effect.
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PURPOSE: This study (NCT00751348) evaluated the immunogenicity and safety of a combined measles-mumps-rubella-varicella (MMRV) vaccine compared to co-administration of measles-mumps-rubella and varicella (MMR+V) vaccines in Korean children during their second year of life. MATERIALS AND METHODS: Healthy children aged 11-24 months received one dose of MMRV or MMR+V. Antibody titers against measles, mumps and rubella were measured using enzyme-linked immunosorbent assay and against varicella using an immunofluorescence assay. Parents/guardians recorded adverse events in diary cards for up to 43 days post-vaccination. The primary objective was to demonstrate non-inferiority of MMRV to MMR+V for all antigens in terms of seroconversion rates (SCRs), defined as a group difference with a lower limit of the 95% confidence interval (CI)>-10%. RESULTS: Of 474 subjects enrolled, 458 (MMRV, 301; MMR+V, 157) were included in the according-to-protocol cohort. For measles (98.0% vs. 99.4%), rubella (99.7% vs. 100%) and varicella (98.9% vs. 100%) SCRs, the lower limits of the 95% CIs for group differences were greater than -10%; however, for mumps SCRs (88.8% vs. 94.2%), it was -10.40%. The primary objective of non-inferiority in mumps SCRs was therefore not met, although the observed group difference in a post-hoc analysis of anti-mumps antibodies using a plaque reduction neutralization assay was 0.39% with a 95% CI lower limit of -4.03%. Adverse events occurred at comparable frequencies for both groups, except for more frequent fever in MMRV recipients. CONCLUSION: Based on the pre-specified non-inferiority criterion, SCRs of the MMRV vaccine were non-inferior to that elicited by MMR+V vaccines for all antigens except mumps.
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Child , Humans , Antibodies , Chickenpox , Cohort Studies , Enzyme-Linked Immunosorbent Assay , Fever , Fluorescent Antibody Technique , Korea , Measles , Mumps , Rubella , VaccinesABSTRACT
Introduction: Efficacy and effectiveness of varicella vaccine (VV) as post exposure prophylaxis (PEP) strategy have shown discordant results for disease risk reduction, and more consistent results in their ability to attenuate the disease. Aim: To assess the effectiveness of VV as PEP among household contacts. Material and Methods: We followed up 33 children after household exposure to a varicella case, of which 15 received VV as PEP and 18 did not received VV. The presence and severity of the disease were clinically determined. Results: Secondary attack rate was 53% among vaccinated and 89% among non-vaccinated children. Overall effectiveness of VV as PEP was 40% (CI95% 1%-64%). The effectiveness for preventing moderate or severe disease was 63% (CI95% 8%-85%) in the entire group and 77% (CI95% 14%-94%) among children vaccinated during the first 3 days post exposure. Vaccine tolerance was acceptable, with a low number of adverse reactions, all of them mild. Conclusion: The results suggest that VV as PEP is effective among household contacts, especially for reducing the severity of the disease.
Introducción: Los estudios de eficacia y efectividad de la vacuna antivaricela (V AV) como profilaxis post exposición (PPE) han mostrado resultados disímiles en cuanto a la reducción del riesgo de enfermar, y algo más consistentes en su capacidad de atenuar la enfermedad. Objetivo: Evaluar la efectividad de la VAV como PPE utilizada en contactos domiciliarios. Material y Métodos: Se realizó el seguimiento post exposición de 33 contactos domiciliarios de casos de varicela, de los cuales 15 recibieron VAV como PPE y 18 no la recibieron. Se determinó clínicamente el desarrollo de enfermedad y la intensidad de la misma. Resultados: La tasa de ataque secundario fue 53% en vacunados y 89% en no-vacunados, siendo la efectividad global de la VAV como PEP 40% (IC95% 1%-64%). La efectividad para prevenir enfermedad moderada o intensa fue 63% (IC95% 8-85%) en el grupo completo y 77% (IC95% 14-94%) en los niños vacunados durante los primeros tres días post exposición. La tolerancia a la vacuna fue aceptable, con un bajo número de reacciones adversas, todas leves. Conclusión: Los resultados sugieren que la VAV es efectiva como PPE en contactos domiciliarios, especialmente para reducir la intensidad de la enfermedad.
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Child , Child, Preschool , Humans , Infant , Chickenpox Vaccine/administration & dosage , Chickenpox/prevention & control , /immunology , Post-Exposure Prophylaxis/methods , Chile , Chickenpox Vaccine/immunology , Chickenpox/transmission , Family CharacteristicsABSTRACT
Objective To study the genetic characteristrics of vaccine and varicella-zoster virus(VZV)strains isolated from patients with chickenpox or zoster by molecular analysis.Methods SNP based VZV genetic characteristrics were analyzed in 19 VZV isolates using the restriction fragment length polymorphisms analysis of DNA fragments of the open reading frames 6,38,62 and sequence alignment of the open reading frames 1,31,51,62.Results All vaccine strains were revealed Alu Ⅰ~-Pst Ⅰ~-Sma Ⅰ~+ BssH Ⅱ~+ Nae Ⅰ~+,96% clinical isolates were revealed Alu Ⅰ~+ Pst Ⅰ ~+Sma Ⅰ BssHⅡ Nae Ⅰ~-,2% clinical isolates were revealed Alu Ⅰ~-Pst Ⅰ~-Sma Ⅰ~+ BssH Ⅱ~+,2%clinical isolates were revealed Alu Ⅰ~+ Pst Ⅰ~-Sma Ⅰ~-BssHⅡ Nae Ⅰ~-by restriction fragment length polymorphisms analysis and sequence alignment revealed the mutations also presented in this four vaccine strains.Conclusion Use the restriction fragment length polymorphisms analysis of DNA fragments of the open reading,frames 6 and 62 could be distinguished VZV wild-type strains and vaccine strain in clinical isolates in China.In order to find the adverse effect caused by vaccine from certain company's,analysis on the SNPs in ORFs 1,31,51 and 62 is needed.
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Varicella zoster virus (VZV) causes two diseases: Varicella, a generalized, primary infection, and herpes zoster (zoster), a secondary infection caused by latent VZV reactivation. Zoster can also be caused by latent VZV reactivation after a varicella vaccination. The complications associated with varicella include cutaneous infections, which are the most common, as well as pulmonary and neurological involvement. However, a deep venous thrombosis (DVT) has been rarely described as a varicella-associated complication. Here, we describe the case of a child with varicella zoster who developed a DVT that completely resolved after intravenous acyclovir and subcutaneous low-molecular-weight heparin treatment.
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Child , Humans , Acyclovir , Chickenpox , Chickenpox Vaccine , Coinfection , Heparin, Low-Molecular-Weight , Herpes Zoster , Herpesvirus 3, Human , Vaccination , Venous ThrombosisABSTRACT
Varicella zoster virus (VZV) causes two diseases: Varicella, a generalized, primary infection, and herpes zoster (zoster), a secondary infection caused by latent VZV reactivation. Zoster can also be caused by latent VZV reactivation after a varicella vaccination. The complications associated with varicella include cutaneous infections, which are the most common, as well as pulmonary and neurological involvement. However, a deep venous thrombosis (DVT) has been rarely described as a varicella-associated complication. Here, we describe the case of a child with varicella zoster who developed a DVT that completely resolved after intravenous acyclovir and subcutaneous low-molecular-weight heparin treatment.
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Child , Humans , Acyclovir , Chickenpox , Chickenpox Vaccine , Coinfection , Heparin, Low-Molecular-Weight , Herpes Zoster , Herpesvirus 3, Human , Vaccination , Venous ThrombosisABSTRACT
Objective To evaluate the effectiveness of post-exposure varicella vaccination in elementary schools in Beijing and to explore its influencing factors. Methods From May to July 2007, variceila cases from 49 elementary schools in 4 districts in Beijing were observed prospectively. The study included 7882 children who were from the same classrooms, same floor or same bungalow areas with the varicella cases. Vaccination status, history on varicella and onset of rashes were collected to calculate the secondary attack rate among those children under observation and then the effectiveness of vaccine was calculated. Results The protection rate on post-exposure vaccination among children under observation was 85.26%. The rates were higher when the 1st case had received varicella vaccine before the onset, vaccines were administered soon after the exposure or there were less varicella cases occurred in the schools. For children in the same class, same floor or bungalow with varicella cases before post-exposure vaccination, the average rates of protection by vaccination were 84.26% and 87.06%, respectively. When the 1st case had received varicella vaccine prior to the onset, the post-exposure protection rates reached 92.09% and 93.06%, respectively, higher than that of the case when the 1st case had received no vaccination. When the administration of vaccine right after the occurrence of first varicella case, the rates of the effectiveness of vaccine were 83.09% and 93.02%, both of which were higher than that of vaccine administered after the occurrence of 2 or 3 cases. When the vaccine administration of vaccination combined with the isolation of the already infected cases or within 5 days after the onset of the 1st case, the vaccine effectiveness could reach 86.60% and 92.73%, both were higher than otherwise. However, in those schools that bungalows were used as classrooms but without bus, canteen from school or student lodgings, it seemed that post exposure vaccination was more effective in preventing varicella from occurring. Conclusion Varicella vaccination after exposure in elementary schools in Beijing was effective in prevention and control of the disease. Immediate administration together with the isolation of cases could maximize the effectiveness of the vacine.
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Recent issues in varicella vaccination Varicella is a highly infectious disease caused by the varicella zoster virus. The varicella vaccine was developed by Michiaki Takahashi in Japan in 1974. Despite the worldwide distribution of efficient vaccines, varicella vaccination policy is extremely variable from country to country. Although varicella vaccine is not currently recommended as an universal vaccination in Japan, Europe, and developing countries, it had been introduced into Korea in 1988 and 20 years have passed since its first use in Korea. Currently, the varicella vaccine has been used most extensively in the United States where routine a 2-dose vaccination program has been recently implemented for children. Recent the 2-dose schedule in the United States and the availability of combination measles-rubella-varicella vaccines may lead to future varicella vaccination policy changes in many countries. With this background, this article summarizes the current status of varicella vaccination policies worldwide and presents provisional updated recommendation of varicella vaccination in Korea.