Primary infection is followed by latency in ganglionic neurons. During this period, no virus particles are produced and no obvious neuronal damage occurs. Reactivation of the virus leads to virus replication, which causes zoster shingles in tissues innervated by the involved neurons, inflammation and cell death - a process that can lead to persistent radicular pain postherpetic neuralgia.
The pathogenesis of postherpetic neuralgia is unknown and it is difficult to treat. Gershon AA, et al. Latency of varicella zoster virus in dorsal root, cranial, and enteric ganglia in vaccinated children.
Trans Am Clin Climatol Assoc. Mahalingam R, et al. Simian varicella virus infects ganglia before rash in experimentally infected monkeys. Infected peripheral blood mononuclear cells transmit latent varicella zoster virus infection to the guinea pig enteric nervous system. J Neurovirol. Varicella-zoster virus DNA in cells isolated from human trigeminal ganglia. Epigenetic regulation of varicella-zoster virus open reading frames 62 and 63 in latently infected human trigeminal ganglia.
Ambagala AP, et al. Varicella-zoster virus immediate-early 63 protein interacts with human antisilencing function 1 protein and alters its ability to bind histones h3. Attempts to recover varicella virus from ganglia. Ann Neurol. Ouwendijk WJD, et al. Restricted varicella-zoster virus transcription in human trigeminal ganglia obtained soon after death. Varicella zoster virus VZV infects and establishes latency in enteric neurons.
This study demonstrates the latency of VZV in the enteric nervous system. A model of lytic, latent, and reactivating varicella-zoster virus infections in isolated enteric neurons. Latent and lytic infection of isolated guinea pig enteric ganglia by varicella zoster virus.
J Med Virol. The pathology of herpes zoster and its bearing on sensory localisation. Rev Med Virol. Presence, distribution and spread of productive varicella zoster virus infection in nervous tissues.
Steain M, et al. Analysis of T cell responses during active varicella-zoster virus reactivation in human ganglia. Gowrishankar K, et al. Characterization of the host immune response in human ganglia after herpes zoster. This paper describes the immunological events in latently infected dorsal root ganglia. Translation of varicella-zoster virus genes during human ganglionic latency. Virus Genes. Aberrant intracellular localization of varicella-zoster virus regulatory proteins during latency.
Varicella-zoster virus gene 66 transcription and translation in latently infected human ganglia. A study of the VZV gene expression in the latent infection of neurons. Molecular characterization of varicella zoster virus in latently infected human ganglia: physical state and abundance of VZV DNA, quantitation of viral transcripts and detection of VZV-specific proteins.
Nuclear import of the varicella-zoster virus latency-associated protein ORF63 in primary neurons requires expression of the lytic protein ORF61 and occurs in a proteasome-dependent manner. Zerboni L, et al. Expression of varicella-zoster virus immediate-early regulatory protein IE63 in neurons of latently infected human sensory ganglia. Apparent expression of varicella-zoster virus proteins in latency resulting from reactivity of murine and rabbit antibodies with human blood group a determinants in sensory neurons.
Diaphragmatic paralysis following cervical herpes zoster. Med J Aust. Herpes zoster with dysfunction of bladder and anus. Neurological picture. Findings of segmental zoster paresis on MRI. J Neurol Neurosurg Psychiatry.
Brachial plexopathy following herpes zoster infection: two cases with MRI findings. J Neurol Sci. Segmental zoster paresis — a disease profile. Smith FP. Pathological studies of spinal nerve ganglia in relation to intractable intercostal pain. Surg Neurol. The prognosis with postherpetic neuralgia. Voltage-gated sodium channels and hyperalgesia.
Annu Rev Pharmacol Toxicol. Kennedy PGE, et al. Varicella-zoster viruses associated with post-herpetic neuralgia induce sodium current density increases in the ND Nav Persistence of varicella-zoster virus DNA in elderly patients with postherpetic neuralgia. Chronic varicella-zoster virus ganglionitis — a possible cause of postherpetic neuralgia. Valaciclovir compared with acyclovir for improved therapy for herpes zoster in immunocompetent adults. Antimicrob Agents Chemother. Degreef H. Famciclovir, a new oral antiherpes drug: results of the first controlled clinical study demonstrating its efficacy and safety in the treatment of uncomplicated herpes zoster in immunocompetent patients.
Int J Antimicrob Agents. Acyclovir for treatment of postherpetic neuralgia: efficacy and pharmacokinetics. Improvement of postherpetic neuralgia after treatment with intravenous acyclovir followed by oral valacyclovir. Arch Neurol. Chen N, et al. Antiviral treatment for preventing postherpetic neuralgia. Cochrane Database Syst Rev. Postherpetic neuralgia.
Varicella-zoster virus meningoencephalitis in an immunocompetent patient without a rash. Scand J Infect Dis. A woman with acute headache and sacral dermatomal numbness. Varicella zoster virus cerebellitis in a year-old patient without herpes zoster.
Ciccone S, et al. Stroke after varicella-zoster infection: report of a case and review of the literature. Increased risk of stroke after a herpes zoster attack: a population-based follow-up study. Nagel MA, et al. The varicella zoster virus vasculopathies: clinical, CSF, imaging, and virologic features. This paper demonstrates that VZV vasculopathies in cerebral arteries lead to strokes. Herpes zoster ophthalmicus and the risk of stroke: a population-based follow-up study.
Herpes zoster ophthalmicus and delayed contralateral hemiparesis caused by cerebral angiitis: diagnosis and management approaches.
Herpes zoster ophthalmicus and delayed ipsilateral cerebral infarction. This paper shows the link between VZV infection and stroke. Varicella zoster virus vasculopathy: analysis of virus-infected arteries. Varicella zoster virus vasculopathies: diverse clinical manifestations, laboratory features, pathogenesis, and treatment. Lancet Neurol. Grose C. Stroke after varicella and zoster ophthalmicus: another indication for treatment and immunization.
Gilden D, et al. Prevalence and distribution of VZV in temporal arteries of patients with giant cell arteritis. Franco-Paredes C, et al. Aseptic meningitis and optic neuritis preceding varicella-zoster progressive outer retinal necrosis in a patient with AIDS. Furuta Y, et al.
Varicella-zoster virus reactivation is an important cause of acute peripheral facial paralysis in children. Varicella zoster disease of the central nervous system: epidemiological, clinical, and laboratory features 10 years after the introduction of the varicella vaccine.
This paper describes meningitis and encephalitis caused by VZV, often without rash. Varicella-zoster virus reactivation without rash. Gilden DH, et al. Varicella zoster virus, a cause of waxing and waning vasculitis: the New England Journal of Medicine case 5— revisited.
Varicella-zoster virus infections of the nervous system: clinical and pathologic correlates. Arch Pathol Lab Med. McKelvie PA, et al. Meningoencephalomyelitis with vasculitis due to varicella zoster virus: a case report and review of the literature. Risk of stroke following herpes zoster: a self-controlled case-series study. This paper provides further recognition of the relationship between VZV and stroke. Varicella-zoster virus myelitis: an expanding spectrum.
Chen JJ, et al. Latent, lytic and reactivating varicella zoster virus in the ENS of humans and guinea pigs: could intestinal shingles be a hidden cause of gastrointestinal disease? Neuroastroenterol Motil. Edelman DA, et al.
Ogilvie syndrome and herpes zoster: case report and review of the literature. J Emerg Med. Acta Haematol. Use of saliva to identify varicella-zoster virus VZV infection of the gut. This paper identifies VZV infection of the gastrointestinal tract in the absence of rash. Leung J, et al. Evaluation of laboratory methods for diagnosis of varicella. Harbecke R, et al. A real-time PCR assay to identify and discriminate among wild-type and vaccine strains of varicella-zoster virus and herpes simplex virus in clinical specimens, and comparison with the clinical diagnoses.
Mehta SK, et al. Rapid and sensitive detection of varicella zoster virus in saliva of patients with herpes zoster. J Virol Methods. Varicella-zoster virus in the saliva of patients with herpes zoster. Quantitation of varicella-zoster virus DNA in patients with Ramsay Hunt syndrome and zoster sine herpete. J Clin Microbiol. Detection of varicella-zoster virus DNA by polymerase chain reaction in the cerebrospinal fluid of patients suffering from neurological complications associated with chicken pox or herpes zoster.
The effectiveness of the varicella vaccine in clinical practice. Resistance testing of clinical varicella-zoster virus strains. Antiviral Res. Novel genetic variation identified at fixed loci in ORF62 of the Oka varicella vaccine and in a case of vaccine-associated herpes zoster. This article describes the molecular differentiation between wild-type and vaccine-types of VZV using viral DNA from patients. LaRussa P, et al. Restriction fragment length polymorphism of polymerase chain reaction products from vaccine and wild-type varicella-zoster virus isolates.
Ibraheem M, et al. Fatal wild-type varicella-zoster virus encephalitis without a rash in a vaccinated child. National Health Service. Varicella Zoster Virus Reference Lab. Stress-induced subclinical reactivation of varicella zoster virus in astronauts.
Papaevangelou V, et al. Subclinical VZV reactivation in immunocompetent children hospitalized in the ICU associated with prolonged fever duration. Clin Microbiol Infect. Birlea M, et al. Search for varicella zoster virus DNA in saliva of healthy individuals aged 20—59 years. Live vaccine used to prevent the spread of varicella in children in hospital. This study describes the successful attenuation of VZV and the use of this live attenuated virus to prevent varicella, thereby demonstrating the first successful vaccine against varicella.
Gomi Y, et al. Comparison of the complete DNA sequences of the Oka varicella vaccine and its parental virus. Oxman MN. Zoster vaccine: current status and future prospects. Yamanishi K. Molecular analysis of the Oka vaccine strain of varicella-zoster virus. This study identifies the molecular features of the attenuated vaccine strain of VZV compared with the wild-type strain.
Peters GA, et al. The attenuated genotype of varicella-zoster virus includes an ORF0 transitional stop codon mutation. Protection against varicella in family contacts by immediate inoculation with live varicella vaccine. This is the first demonstration of the clinical effectiveness of the Oka strain in preventing varicella, together with immunological data.
Asano Y, Takahashi M. Clinical and serologic testing of a live varicella vaccine and two-year follow-up for immunity of the vaccinated children.
Live attenuated varicella vaccine. Efficacy for children with leukemia in remission. This paper provides the first proof that the varicella vaccine is safe and effective in preventing varicella in children with underlying leukaemia. White CJ. Clinical trials of varicella vaccine in healthy children. Infect Dis Clin North Am. White CJ, et al. Weibel RE, et al.
Live attenuated varicella virus vaccine. Efficacy trial in healthy children. This study demonstrates that varicella vaccination protects healthy children from chickenpox. Shapiro ED, et al. Effectiveness of 2 doses of varicella vaccine in children. Oral acyclovir prophylaxis of varicella after intimate contact.
Acyclovir prophylaxis of varicella after household exposure. A randomized, double-blind, placebo-controlled trial of valacyclovir prophylaxis to prevent zoster recurrence from months 4 to 24 after BMT.
Bone Marrow Transplant. Ljungman P, et al. Long-term acyclovir prophylaxis in bone marrow transplant recipients and lymphocyte proliferation responses to herpes virus antigens in vitro. Emergence of acyclovir-resistant varicella zoster virus in an AIDS patient on prolonged acyclovir therapy. Levin MJ, et al.
Development of resistance to acyclovir during chronic infection with the Oka vaccine strain of varicella-zoster virus, in an immunosuppressed child.
This paper demonstrates that VZV can reactivate in immunocompromised children and that the vaccine virus can become resistant to acyclovir. Bhalla P, et al. Disseminated, persistent, and fatal infection due to the vaccine strain of varicella-zoster virus in an adult following stem cell transplantation.
Baxter R, et al. Long-term effectiveness of varicella vaccine: a year, prospective cohort study. Effectiveness over time of varicella vaccine. This study shows that immunity to varicella after vaccination does not wane substantially with time. Seward JF, et al. Varicella disease after introduction of varicella vaccine in the United States, — This study demonstrates personal and herd immunity as a result of vaccination in healthy children.
The protective effect of immunologic boosting against zoster: an analysis in leukemic children who were vaccinated against chickenpox. Varicella vaccination: impact of vaccine efficacy on the epidemiology of VZV. Exposure to varicella boosts immunity to herpes-zoster: implications for mass vaccination against chickenpox.
The impact of the varicella vaccination program on herpes zoster epidemiology in the United States: a review. Gaillat J, et al. This paper shows that immunity to VZV does not require continued exogenous exposure to VZV and that asymptomatic episodes of reactivation of VZV are likely to have a role in maintaining long-term immunity to the virus.
Contagiousness of varicella in vaccinated cases: a household contact study. Weinmann S, et al. Incidence and clinical characteristics of herpes zoster among children in the varicella vaccine era, — Galea SA, et al.
The safety profile of varicella vaccine: a year review. Immunization to reduce the frequency and severity of herpes zoster and its complications. Elsevier; Vaccination against herpes zoster and postherpetic neuralgia. Schmader KE, et al. Effect of a zoster vaccine on herpes zoster-related interference with functional status and health-related quality-of-life measures in older adults.
J Am Geriatr Soc. Simberkoff MS, et al. Safety of herpes zoster vaccine in the shingles prevention study: a randomized trial. Tseng HF, et al. Herpes zoster vaccine in older adults and the risk of subsequent herpes zoster disease. Herpes zoster vaccine effectiveness against incident herpes zoster and post-herpetic neuralgia in an older US population: a cohort study. PLoS Med. Efficacy, safety, and tolerability of herpes zoster vaccine in persons aged 50—59 years.
Persistence of the efficacy of zoster vaccine in the shingles prevention study and the short-term persistence substudy. Morrison VA, et al. Long-term persistence of zoster vaccine efficacy. Berkowitz EM, et al. Chlibek R, et al. Lal H, et al. Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. This is the first demonstration of an adjuvanted subunit vaccine that is not infectious can prevent zoster in the elderly.
Cohen JIA. A new vaccine to prevent herpes zoster. Acyclovir for treating varicella in otherwise healthy children and adolescents. Belay ED, et al. Severe necrotizing soft-tissue infections and nonsteroidal anti-inflammatory drugs. Clin Exp Dermatol. The use of oral acyclovir in otherwise healthy children with varicella. Feldman S, Lott L. Varicella in children with cancer: impact of antiviral therapy and prophylaxis. Etzioni A, et al. Fatal varicella associated with selective natural killer cell deficiency.
This study shows the importance of innate immunity in host defences against VZV. Acyclovir therapy of chickenpox in immunosuppressed children — a collaborative study. This is the first demonstration of successful antiviral therapy to protect immunocompromised children from varicella. Treatment of adult varicella with oral acyclovir. A randomized, placebo-controlled trial. Balfour HH, et al. Controlled trial of acyclovir for chickenpox evaluating time of initiation and duration of therapy and viral resistance.
Sauerbrei A, Wutzler P. Herpes simplex and varicella-zoster virus infections during pregnancy: current concepts of prevention, diagnosis and therapy. Part 2: Varicella-zoster virus infections. Med Microbiol Immunol. Davies HD, et al. Invasive group A streptococcal infections in Ontario, Canada. Purpura fulminans due to protein S deficiency following chickenpox. Br J Dermatol.
Science M, et al. Central nervous system complications of varicella-zoster virus. Cohen JI. Clinical practice: herpes zoster.
Dworkin RH, et al. Recommendations for the management of herpes zoster. Antivirals for management of herpes zoster including ophthalmicus: a systematic review of high-quality randomized controlled trials. Antivir Ther.
Antiviral therapy for herpes zoster: randomized, controlled clinical trial of valacyclovir and famciclovir therapy in immunocompetent patients 50 years and older. Arch Fam Med. Lin WR, et al. Comparative study of the efficacy and safety of valaciclovir versus acyclovir in the treatment of herpes zoster.
J Microbiol Immunol Infect. Whitley RJ, et al. Acyclovir with and without prednisone for the treatment of herpes zoster. Han Y, et al. Corticosteroids for preventing postherpetic neuralgia. A randomized, placebo-controlled trial of oxycodone and of gabapentin for acute pain in herpes zoster. Herpes zoster ophthalmicus in Olmsted County, Minnesota: have systemic antivirals made a difference?
Arch Ophthalmol. Gilron I, et al. Nortriptyline and gabapentin, alone and in combination for neuropathic pain: a double-blind, randomised controlled crossover trial. Opioids for neuropathic pain. Risk of herpes zoster in children with leukemia: varicella vaccine compared with history of chickenpox.
Civen R, et al. A mild prodrome of fever and malaise may occur 1 to 2 days before rash onset, particularly in adults. In children, the rash is often the first sign of disease.
The rash is generalized and pruritic. It progresses rapidly from macular to papular to vesicular lesions before crusting. Lesions are typically present in all stages of development at the same time. The rash usually appears first on the chest, back, and face, then spreads over the entire body.
The lesions are usually most concentrated on the chest and back. Symptoms typically last 4 to 7 days. Infants, adolescents, adults, pregnant women, and immunocompromised people are at risk for more severe disease and have a higher incidence of complications. Recovery from primary varicella infection usually provides immunity for life.
In otherwise healthy people, a second occurrence of varicella is uncommon. Second occurrence of varicella may be more likely to occur in people who are immunocompromised. As with other viral infections, re-exposure to natural wild-type varicella may lead to re-infection that boosts antibody titers without causing illness or detectable viremia.
Breakthrough varicella is infection with wild-type varicella-zoster virus VZV occurring in a vaccinated person more than 42 days after varicella vaccination. Breakthrough varicella is usually mild.
Patients typically are afebrile or have low fever and develop fewer than 50 skin lesions. They usually have a shorter illness compared to unvaccinated people who get varicella.
The rash is more likely to be predominantly maculopapular rather than vesicular. Since the clinical features of breakthrough varicella are often mild, it can be difficult to make a diagnosis on clinical presentation alone. Laboratory testing is increasingly important for confirming varicella and appropriately managing the patients and their contacts. Breakthrough varicella occurs less frequently among those who have received two doses of vaccine compared with those who have received only one dose; disease may be even milder among two-dose vaccine recipients, although the information about this is limited.
Varicella is highly contagious. The virus can be spread from person to person by direct contact, inhalation of aerosols from vesicular fluid of skin lesions of acute varicella or zoster, and possibly through infected respiratory secretions that also may be aerosolized. A person with varicella is considered contagious beginning one to two days before rash onset until all the chickenpox lesions have crusted. Vaccinated people may develop lesions that do not crust.
These people are considered contagious until no new lesions have appeared for 24 hours. It takes from 10 to 21 days after exposure to the virus for someone to develop varicella. People with breakthrough varicella are also contagious. However, people with breakthrough varicella with 50 or more lesions were just as contagious as unvaccinated people with the disease. Severe complications caused by the virus include cerebellar ataxia, encephalitis, viral pneumonia, and hemorrhagic conditions.
Other severe complications are due to bacterial infections and include:. Immunocompromised people who get varicella are at risk of developing visceral dissemination VZV infection of internal organs leading to pneumonia, hepatitis, encephalitis, and disseminated intravascular coagulopathy.
They can have an atypical varicella rash with more lesions, and they can be sick longer than immunocompetent people who get varicella. New lesions may continue to develop for more than 7 days, may appear on the palms and soles, and may be hemorrhagic.
0コメント