Neonatal Varicella Despite Maternal Immunity – A Case Report and What Can Be Learnt

@#A 20-day-old previously well neonate presented with a 3-day vesiculopapular rash and was admitted to the paediatrics ward. He received extensive workup and treatment with IV acyclovir. The disease ran a mild, uncomplicated course, and recovery. His mother was found to be immune to varicella, having had the disease as a child. However, her immunity had not transferred to the neonate, which was unexpected. A literature review revealed that maternal varicella antibodies do not necessarily prevent infection but may help the infant avoid severe or complicated disease. A review of the management of neonatal varicella in both the immune and the non-immune mother which put the child at risk is also done. Vaccination of all susceptible young females prior to pregnancy will help to reduce the incidence of neonatal varicella in infants and is strongly encouraged. Vaccination of household contacts especially siblings, is also encouraged. Family Physicians should remain open to the diagnosis of neonatal varicella, even when the mother has a history having chickenpox as a child.

Association of the time that elapsed from last vaccination with protective effectiveness against foot-and-mouth disease in small ruminants

Routine and emergency vaccination of small ruminants against foot-and-mouth disease (FMD) is mandatory in many endemic countries, yet data on the field effectiveness of the vaccines used is scarce. We conducted an investigation of a serotype O FMD outbreak that took place in a sheep and goat pen, and estimated the effectiveness of various routine vaccination statuses. We also evaluated the protection provided by colostrum administration and emergency vaccination. Animals which were routinely vaccinated twice were not clinically affected while disease incidence was observed among animals routinely vaccinated only once (p = 0.004 according to a two-sided Fisher's exact test). In groups vaccinated only once, there was a significant association between the average time that elapsed since last vaccination and the disease incidence (n = 5; Spearman correlation coefficient: r(s) = 1.0, p < 0.01). In addition, non-vaccinated lambs fed colostrum from dams vaccinated more than 2 months before parturition had a mortality rate of 33%. Administration of emergency vaccination 2 days after the occurrence of the index case was the probable reason for the rapid blocking of the FMD spread within 6 days from its onset in the pen.