Varicella and herpes zoster in pregnancy and the newborn

Enders, Gisela; Miller, Elizabeth

doi:10.1017/cbo9780511601194.018

Cited by 61 publications

(84 citation statements)

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“…Chickenpox occurring in the first 12 days of life is described as intrauterine acquired neonatal varicella. Clinical observations suggest that the incubation period of intrauterine transmitted varicella from the beginning of maternal varicella rash to the onset of rash in the neonate is about 12 days, but it can be reduced to few days [4]. On the basis of these data, neonatal chickenpox occurring after the 12 th day of the neonatal period is most likely not transmitted by intrauterine infection, but it is acquired by postnatal VZV infection.…”

Section: Neonatal Varicellamentioning

confidence: 93%

“…According to a seroepidemiological study in Germany, the prevalence of VZV-specific IgG class antibodies in women of reproductive age is 96-97% and only 3-4% of women were found to be susceptible to varicella [1]. The average incidence of varicella in pregnant women has been calculated as 0.7-3 per 1,000 pregnancies [2][3][4]. Information on a positive history of varicella correlates well with serological findings.…”

Section: Maternal Varicella-zoster Virus Infections and Their Consequmentioning

confidence: 99%

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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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Section: Neonatal Varicellamentioning

confidence: 93%

Section: Maternal Varicella-zoster Virus Infections and Their Consequmentioning

confidence: 99%

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

Sauerbrei¹

2010

Health

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“…Varicella is a ubiquitous disease: In countries with a temperate climate such as North America, European countries, more than 90% of the population contract the infection before the age of 15 years [54,[88][89][90][91][92][93] . It mainly affects children with especially winter/spring seasonality: It is estimated that 52%-78% of all reported cases of varicella occur in children aged < 6 years, and 89%-96% of cases in children aged < 14 years; only 5%-7% of cases occur in adults [5,94,95] .…”

Section: Epidemiologymentioning

confidence: 99%

“…Fortunately, as most adults in temperate countries are already protected, the possibility of contracting varicella during pregnancy among susceptible women is much lower, and the estimated incidence of varicella is 0.1-3 per 1000 pregnancies [8,26,90,117,[144][145][146][147][148][149][150] . Contracting varicella during pregnancy can be very serious for a mother, especially if it is contracted in the third trimester [10,151] .…”

Section: Consequences Of An Infection Contracted During Pregnancymentioning

confidence: 99%

“…During pregnancy, the infection can also be transmitted to the fetus and, depending on the time of transmission, may cause congenital varicella syndrome (CVS), neonatal varicella, or childhood herpes zoster. It has been estimated that transmission from mother to fetus occurs in 8%-24% of cases [56,90,145,164] . Early studies using IgM in the newborn as a sign of infection (now considered a very insensitive marker) indicated transmission rates of 5% in the first trimester, 10% in the second, and 25% in the third [145] .…”

Section: Consequences Of An Infection Contracted During Pregnancymentioning

confidence: 99%

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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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Viral Infections of the Fetus and Neonate, other than Rubella

Enders¹

2010

Topley &Amp; Wilson's Microbiology and Microbial Infections

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Varicella and herpes zoster in pregnancy and the newborn

Cited by 61 publications

References 0 publications

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

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

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

Viral Infections of the Fetus and Neonate, other than Rubella

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