Preventing congenital varicella syndrome with immunization

Sauerbrei, Andreas

doi:10.1503/cmaj.110055

Cited by 15 publications

(4 citation statements)

References 11 publications

(14 reference statements)

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“…Varicella vaccine is an attenuated live virus, which is safe and highly efficacious, preventing 90% of cases. 88,89 In the United States and some other countries (including Germany and Australia), a two-dose varicella vaccination is recommended for all infants, 85,88 resulting in a sharp reduction in the incidence of congenital and neonatal varicella. 90 France and several countries in Europe have selective varicella vaccination programs, which include adolescents with no recollection of having had the disease.…”

Section: Primary Preventionimmunizationmentioning

confidence: 99%

“…Varicella vaccine is an attenuated live virus, which is safe and highly efficacious, preventing 90% of cases . In the United States and some other countries (including Germany and Australia), a two‐dose varicella vaccination is recommended for all infants, resulting in a sharp reduction in the incidence of congenital and neonatal varicella .…”

Section: Prevention Issuesmentioning

confidence: 99%

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Fetal varicella – diagnosis, management, and outcome

Mandelbrot

2012

Prenatal Diagnosis

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Fetal varicella syndrome (FVS) is due to transplacental infection by the Varicella zoster virus following maternal infection. The risks for the fetus and neonate depend on the timing. When varicella occurs around delivery, it often leads to disseminated neonatal varicella. When varicella occurs during pregnancy, transmission can occur, but is usually asymptomatic; some infants develop zoster postnatally and a few have FVS. Before 20 weeks' gestation, FVS can occur, with an incidence of about 1%. The lesions can affect the skin, limbs, central and autonomous nervous systems, eyes, cause calcifications, and growth retardation; mortality is high. Lesions typically follow one or several nerve territories, suggesting that damage results from in utero zoster following primary fetal infection. There has been little study of prenatal diagnosis of FVS. Serial ultrasound examination can detect various anomalies, magnetic resonance imaging can be of use to investigate for microphthamia and cerebral lesions, and amniocentesis can diagnose viral transmission. Prevention strategies include vaccination and post-exposure prophylaxis with immune globulin and/or antivirals. Perspectives for treating infected fetuses in utero require further research.

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Section: Primary Preventionimmunizationmentioning

confidence: 99%

Section: Prevention Issuesmentioning

confidence: 99%

Fetal varicella – diagnosis, management, and outcome

Mandelbrot

2012

Prenatal Diagnosis

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“…Als Folge einer VZVInfektion kann es bis zur 21. Schwangerschaftswoche (SSW) zum kongenitalen Varizellensyndrom kom men [11]. Erkrankt die Schwangere 5 Ta ge vor bis 2 Tage nach der Geburt an VZV kann dies zu lebensbedrohlichen dissemi nierten neonatalen Varizellen führen.…”

Section: Varizellenunclassified

Seroprävalenz von Antikörpern gegen schwangerschaftsrelevante virale Infektionserreger bei Mitarbeiterinnen im Gesundheitswesen

Wicker

Friedrichs

Rabenau

2012

Bundesgesundheitsbl.

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Healthcare workers (HCWs) are exposed to infectious diseases throughout the course of their work. The concerns of pregnant HCWs are considerable because certain otherwise mild infections may affect fetal development. We studied 424 pregnant HCWs at the University Hospital Frankfurt between March 2007 and July 2011. Serological tests were carried out for varicella zoster virus (VZV), measles, mumps, rubella (MMR), cytomegalovirus (CMV) and parvovirus B19. Our overall seroprevalence data with regard to VZV, MMR, CMV and parvovirus B 19 corresponded to the general population. However, physicians demonstrated lower seroprevalence towards the two non-vaccine-preventable diseases (CMV: 37.5% [KI 27.4-48.5]; parvovirus B19: 69.3% [KI 58.6-78.7]) compared with nurses (CMV: 53.4% [KI 46.1-60.6], parvovirus B19: 75.1% [68.4-81.1]). It was striking that, only one in five of the study population showed IgG antibodies against all of the six pregnant-relevant viral diseases tested, of the physicians as few as one in six. A routine exclusion from the workplace due to non-immunity would mean that it would not be possible to employ the majority of pregnant staff in healthcare and childcare.

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“…Administering varicella-zoster virus immunoglobulin to susceptible mothers, within 48 to 96 hours of contact with an infected person and early acyclovir to the infected pregnant mother may prevent or decrease the severity of FVS. [ 5 ]…”

mentioning

confidence: 99%