Consequences of varicella and herpes zoster in pregnancy: prospective study of 1739 cases

Enders, Gisela; Bolley, I.; Miller, Elizabeth; Cradock-Watson, J. E.; Ridehalgh, MargaretK.S.

doi:10.1016/s0140-6736(94)92943-2

Cited by 618 publications

(344 citation statements)

References 12 publications

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“…Isso talvez possa ser explicado por comportamentos sociais diferentes, com as mulheres assumindo mais freqüentemente os cuidados de crianças doentes. Se mulheres susceptíveis à varicela são infectadas durante a gestação, a taxa de incidência da varicela congênita pode ser tão alta quanto 1,2% e a de zoster, durante os primeiros anos de vida e fases iniciais da infância, situar-se entre 0,8 e 1,3% 20,29 .…”

Section: Discussionunclassified

Soroepidemiology of Varicella in Brazil - results of a prospective cross-sectional study

Clemens¹,

Azevedo²,

Fonseca³

et al. 1999

J Pediatr (Rio J)

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ResumoObjetivos: A varicela tem conseqüências mais graves em adolescentes e adultos. Recentes relatos da Europa e da Ásia mostram um número crescente de adolescentes e adultos jovens soronegativos. Como são poucos os dados sobre a prevalência de anti-VZV no Brasil e com o objetivo de definir estratégias para a imunização contra a varicela, realizamos um estudo de soroprevalência para o VZV (vírus varicela zoster) em diferentes partes do Brasil.Métodos: Este estudo soroepidemiológico, transversal e populacional foi realizado em quatro diferentes regiões do Brasil. A população estudada foi estratificada por sexo, idade e situação socioeconômica. Anticorpos Ig G, anti-VZV foram analisados pelo método ELISA.Resultados: Foram incluídos no estudo 3.879 indivíduos de 1 a 40 anos. A taxa de soropositividade do anti-VZV em todos os grupos etários e centros no Brasil foi de 85,4 %. Evidenciou-se uma forte correlação com a idade. Especialmente no Sudeste e Sul, a soroprevalência foi menor no grupo etário de 1-5 anos (44,5% e 57,8%, respectivamente). Na região Norte esta taxa foi de 88,9%. No geral, a infecção pelo VZV foi independente do nível socioeconômico, entretanto nos grupos etários jovens (1-10 anos) a soroprevalência foi significativamente menor nas classes alta/média, na maioria das regiões. A história clínica de varicela se correlacionou com a soropositividade anti-VZV, tendo um valor preditivo de 95,1%.Conclusões: Na pré-adolescência, uma proporção substancial da população brasileira é susceptível à varicela e uma parcela considerável de adolescentes e adultos jovens permanecem soronegativos e, conseqüentemente, em risco. AbstractObjectives: Varicella has more serious consequences in adolescents and adults. Recent reports from Europe and Asia show an increasing number of adolescents and young adults being seronegative. As there is only limited data on varicella zoster virus (VZV) seroprevalence in Brazil and to facilitate the strategy for varicella vaccination we conducted a VZV seroprevalence study in Brazil.Methods: This population-based, cross sectional seroepidemiology study was performed in 4 different regions of Brazil. The studied population was stratified according to gender, age and socioeconomic status. VZV IgG antibodies were analyzed by ELISA.Results: 3,879 subjects aged 1-40 years were included into the study. The overall anti-VZV seropositivity rate across all age groups and centers in Brazil was 85.4%. There was a strong age relationship. Especially in the South East and South seroprevalence was low in the age group 1-5 years (44.5% and 57.8%, respectively) while in the North the rate was 88.9%. Overall, Varicella infection was independent of the socioeconomic level, but in the youngest age groups (1-10 years) seroprevalence rates were significantly lower in the high/medium socioeconomic class for most regions. Clinical history of chickenpox correlates well with anti-VZV seropositivity with a predictive value of 95.1%Conclusions: In preadolescence a substantial proportion of the Brazilian populat...

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Section: Discussionunclassified

Soroepidemiology of Varicella in Brazil - results of a prospective cross-sectional study

Clemens¹,

Azevedo²,

Fonseca³

et al. 1999

J Pediatr (Rio J)

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“…Previous large series of up to 1739 cases of varicella and herpes zoster during pregnancy have not documented any clinical disease in the offspring where the mother contracted the infection during the third trimester of pregnancy or in any mothers with reactivated rather than primary VZV infection. 6,7 The chronic progressive small vessel vasculopathy is typical for immunocompromised patients, usually those posttransplantation, but children acquiring the infection in the neonatal period would also fit into this category. 9 Although older children generally have large-vessel disease, features of moyamoya have previously been described in the angiogram of a male aged 3 years 6 months after acute chickenpox.…”

Section: Discussionmentioning

confidence: 99%

“…The case is unique in that it is the first report of congenital VZV infection and its consequences following maternal zoster in the third trimester of pregnancy. 6,7 Informed written consent was obtained from the child's parents for the publication of this case report. Case report sudden onset of a left hemiparesis, heralded by right-sided headaches.…”

mentioning

confidence: 99%

Recurrent hemiplegia associated with cerebral vasculopathy following third trimester maternal herpes zoster infection

West

Newton

Baildam³

et al. 2006

Develop Med Child Neuro

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The chickenpox virus (varicella zoster virus; VZV) is known to cause large and small vessel central nervous system vasculopathies that may be associated with strokes in both adults and children. We present the case of a female aged 2 years 6 months who developed a chronic progressive small‐vessel vasculopathy with radiological features of moyamoya disease as a manifestation of congenital varicella syndrome. Clinically, the condition was characterized by recurrent ischaemic strokes, which were brought under control using intravenous acyclovir. The case is unique in that it is the first report of congenital varicella syndrome to occur after a maternal herpes zoster infection. Furthermore, it is the first case of symptomatic VZV infection in a child to occur after a maternal infection occurring in the third trimester of pregnancy.

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“…On the basis of current knowledge, zoster during pregnancy is not associated with birth defects [15,23]. Although there are some reports of neonates with congenital malformations being born to mothers with history of zoster during early pregnancy, no case showed laboratory evidence of intrauterine infection with VZV.…”

Section: Zoster During Pregnancymentioning

confidence: 94%

“…Congenital anomalies described as congenital varicella syndrome (CVS) can be expected in about 12% of infected fetuses [14]. Prospective studies in Europe and North America revealed that the incidence of congenital anomalies after maternal varicella infection in the first 20 weeks of pregnancy is about 1-2% [15,16]. The first case of CVS was reported by Laforet and Lynch in 1947 [17].…”

Section: Congenital Varicella Syndromementioning

confidence: 99%

Review of varicella-zoster virus infections in pregnant women and neonates

Sauerbrei¹

2010

Health

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Even though varicella is rare in pregnancy, the disease can lead occasionally to disastrous illnesses for both the mother and her neonate. By contrast, normal zoster is not associated with special problems during pregnancy and perinatal period. Pregnant women, who contract varicella, are at risk of varicella pneumonia which must be regarded as medical emergency. At any stage during pregnancy, chickenpox may cause intrauterine infection. The consequences for the fetus depend on the time of maternal disease. During the first two trimesters, maternal varicella may result in congenital varicella syndrome which may occur in nearly 2%. Typical symptoms are skin lesions in dermatomal distribution, neurological defects, eye diseases, and skeletal anomalies. Maternal infection near term is associated with a substantial risk of intrauterine acquired neonatal chickenpox in the neonate. If the mother develops varicella rash between day 4 (5) ante partum and day 2 post partum, generalized neonatal varicella leading to death in about 20% of the cases has to be expected. The present paper reviews the clinical consequences and the currently available concepts of prevention, diagnosis, and therapy of varicella-zoster virus infections during pregnancy.

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Consequences of varicella and herpes zoster in pregnancy: prospective study of 1739 cases

Cited by 618 publications

References 12 publications

Soroepidemiology of Varicella in Brazil - results of a prospective cross-sectional study

Soroepidemiology of Varicella in Brazil - results of a prospective cross-sectional study

Recurrent hemiplegia associated with cerebral vasculopathy following third trimester maternal herpes zoster infection

Review of varicella-zoster virus infections in pregnant women and neonates

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