Varicella in the neonatal ICU due to the Varicella vaccine Oka strain

Abstract

BACKGROUND: Varicella vaccination of non-immune post-partum women is recommended to reduce the risk of chickenpox in mothers and their infants. Though rare, transmission of the varicella vaccine strain vOka can occur from recent vaccinees to non-immune contacts who usually develop mild chickenpox. METHODS/RESULTS: Here we describe an infant hospitalized in the neonatal ICU with vaccine-strain varicella due to transmission from their mother who received the varicella vaccine post-partum. We describe the infection prevention and control strategies implemented to prevent further transmission. CONCLUSION: Vaccine-strain varicella transmission from mother to infant is a rare event and its occurrence in the neonatal ICU setting can be challenging. Anticipatory guidance for mothers vaccinated in the postpartum period and support of parents of an infected infant are recommended.

Remote Disseminated Vaccine-Strain Varicella-Zoster Virus in an Adolescent with Secondary Immunodeficiency: A Case Report and Literature Review

“…Several cases described this phenomenon in pediatric subjects. [10][11][12][13][14][15][16][17][18][19][20] These cases described the following: Breakthrough varicella in previously undiagnosed primary immunode ciency (NK T cell de ciency, SCID), occurring 2-5 weeks post-vaccination. [10][11][12][13][14] Breakthrough varicella in neonates postpartum due to unclear / vertical transmission from a vaccinated mother.…”

“…[10][11][12][13][14] Breakthrough varicella in neonates postpartum due to unclear / vertical transmission from a vaccinated mother. [15][16] VZV infection without dissemination but with severe complications (chronic verrucous, acyclovir resistance, meningoencephalitis) in patients with secondary immunode ciency (neuroblastoma, hematopoietic stem cell transplant, acute lymphoblastic leukemia [ALL]) shortly after vaccination. [17][18] Disseminated herpes zoster across 2 dermatomes in previously undiagnosed secondary immunode ciency (HIV), occurring 8 weeks post-vaccination.…”