Herpes Zoster in Healthy Infants and Toddlers After Perinatal Exposure to Varicella-Zoster Virus

Rodríguez-Fanjul, Xavier; Noguera, Antoni; Vicente, A.; González-Enseñat, Maria Antònia; Jiménez, Rafael; Fortuny, Clàudia

doi:10.1097/inf.0b013e3181d76f7f

Cited by 27 publications

(31 citation statements)

References 17 publications

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“…Este facto modifica a história natural da infeção primária e pode condicionar no lactente até aos seis meses de idade uma forma subclínica de varicela, sem as típicas lesões cutâneas (2% dos lactentes). [1][2][3][4] No caso relatado, a lactente manifestou HZ aos três meses, sem clínica prévia de varicela, apesar do contacto às duas semanas de vida com uma irmã com a doença.…”

Section: Discussionunclassified

“…Numa criança previamente saudável não está recomendada a exclusão de imunodeficiência ou patologia oncológica subjacente. [1][2][3][4][5] Pode surgir em crianças imunocompetentes e saudáveis após exposição ao vírus nos períodos intra-uterino e pós-natal. 2,4,6 O HZ é raro na idade pediátrica e cursa habitualmente com menor gravidade que nos adultos.…”

Section: Introductionunclassified

“…1,4,6 A incidência aumenta com a idade e em estados de imunossupressão. 2,3,7 A incidência ajustada à idade, até aos 14 anos, é de 0,45/1.000 indivíduos por ano, sendo cerca de dez vezes superior acima dos 75 anos (4,2-4,5/1.000 indivíduos por ano). Na idade pediátrica a incidência é menor até aos cinco anos (0,2/1.000 indivíduos por ano) comparativamente à adolescência (0,63/1.000 indivíduos por ano).…”

Section: Introductionunclassified

“…Apesar de menos frequente em crianças, pode acompanhar-se de dor, prurido ou sensação de queimadura. 1,3,4,6,7 O aciclovir, quando iniciado precocemente, pode contribuir para a mais rápida resolução das lesões cutâneas e melhoria das queixas álgicas.…”

Section: Introductionunclassified

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Herpes Zoster in a 4-Month Old Infant

Jain

Singal

2012

IJD

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Case Report: We describe the case of an healthy infant, three months old, without previous clinical symptoms of chickenpox, in spite of having contacted with the disease at two weeks of life. She was hospitalized for vesicular-papular rash involving unilaterally dermatomes L4 and L5 and was treated with acyclovir with good clinical outcome.Conclusion: The immaturity of the immune system and the interference of maternal antibodies contribute to the manifestation of HZ in the first year of life. In a previously healthy child it is not recommended the exclusion of underlying immunodeficiency or malignant disease.Keywords: Herpes zoster, varicella-zoster virus, infant RESUMO Introdução: O Herpes Zoster (HZ) é raro na idade pediátrica e resulta da reativação do vírus varicella-zoster, latente na raiz dorsal dos gânglios sensoriais ou dos nervos cranianos, após infeção primária (varicela).Caso Clínico: Descreve-se o caso de uma lactente de três meses de idade, previamente saudável, sem manifestações clí-nicas anteriores de varicela, apesar de contacto com a doença às duas semanas de vida. Internada por exantema papulo-vesicular envolvendo de forma unilateral os dermátomos L4 e L5 e medicada com aciclovir com boa evolução clínica.Conclusão: A imaturidade do sistema imunitário e a interferência dos anticorpos maternos contribuem para a manifestação do HZ no primeiro ano de vida. Numa criança previamente saudável não está recomendada a exclusão de imunodeficiência ou patologia oncológica subjacente.Palavras-chave: Herpes zoster, vírus varicella-zoster, lactente Nascer e Crescer 2015; 24(4): 179-82

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Section: Discussionunclassified

Section: Introductionunclassified

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Herpes Zoster in a 4-Month Old Infant

Jain

Singal

2012

IJD

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“…Maternal varicella occurring after the twenty-fourth week of gestation leads to asymptomatic fetal seroconversion and the birth of an asymptomatic newborn; however, herpes zoster may develop in the first years of life (especially in the first or second year) because of viral reactivation [202] . The short latency period is due to the infant's immature cell-mediated response [203] .…”

Section: Herpes Zoster In the First Years Of Lifementioning

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Microbiology laboratory and the management of mother-child varicella-zoster virus infection

Paschale

Clerici

2016

WJV

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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. Core tip: Although varicella during pregnancy is infrequent and congenital varicella syndrome (CVS) is rare, every available means should be used to prevent and diagnose them. Microbiology laboratories can be crucial in these situations: Evaluating a mother's immune status with sensitive and specific tests for the detection of antibodies; allowing a rapid diagnosis with molecular biology tests when a clinical manifestation may be due to different etiologies; following pregnant women with varicella for the prenatal diagnosis of CVS with close collaboration between molecular biology investigators and specialists in imaging diagnostics.De Paschale M, Clerici P. Microbiology laboratory and the management of mother-child varicella-zoster virus infection. World

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Serious neurological adverse events in immunocompetent children and adolescents caused by viral reactivation in the years following varicella vaccination

Ramachandran,

Grose

2024

Reviews in Medical Virology

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Serious adverse events following vaccination include medical complications that require hospitalisation. The live varicella vaccine that was approved by the Food and Drug Administration in the United States in 1995 has an excellent safety record. Since the vaccine is a live virus, adverse events are more common in immunocompromised children who are vaccinated inadvertently. This review includes only serious adverse events in children considered to be immunocompetent. The serious adverse event called varicella vaccine meningitis was first reported in a hospitalised immunocompetent child in 2008. When we carried out a literature search, we found 15 cases of immunocompetent children and adolescents with varicella vaccine meningitis; the median age was 11 years. Eight of the children had received two varicella vaccinations. Most of the children also had a concomitant herpes zoster rash, although three did not. The children lived in the United States, Greece, Germany, Switzerland, and Japan. During our literature search, we found five additional cases of serious neurological events in immunocompetent children; these included 4 cases of progressive herpes zoster and one case of acute retinitis. Pulses of enteral corticosteroids as well as a lack of herpes simplex virus antibody may be risk factors for reactivation in immunocompetent children. All 20 children with adverse events were treated with acyclovir and recovered; 19 were hospitalised and one child was managed as an outpatient. Even though the number of neurological adverse events remains exceedingly low following varicella vaccination, we recommend documentation of those caused by the vaccine virus.

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Herpes Zoster in Healthy Infants and Toddlers After Perinatal Exposure to Varicella-Zoster Virus

Cited by 27 publications

References 17 publications

Herpes Zoster in a 4-Month Old Infant

Herpes Zoster in a 4-Month Old Infant

Microbiology laboratory and the management of mother-child varicella-zoster virus infection

Serious neurological adverse events in immunocompetent children and adolescents caused by viral reactivation in the years following varicella vaccination

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