Chickenpox at Ninety Four: A Case for Extending the Use of Varicella Vaccine in the UK

Justin Bendig,Fiona Sindall

doi:10.1155/2010/561707

Justin Bendig, Fiona Sindall

Open Access

https://doi.org/10.1155/2010/561707

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Abstract

A case of chickenpox in a 94-year-old female is described. Serological tests for Varicella zoster virus (VZV) performed on early and late serum samples confirmed primary VZV infection. The patient recovered but seventeen days after presentation she developed a stroke from which she subsequently died. Chickenpox in older people is relatively rare—this case may be the oldest case of laboratory-proven chickenpox described—but it is a life-threatening illness. The varicella vaccine is licensed for use in immunocompetent persons of 12 months of age or older but in the UK is only offered to susceptible healthcare workers and close contacts of immunocompromised patients. In the US, the vaccine is recommended for all susceptible adolescents and adults. The same recommendation should be made in the UK.

Highlights

Chickenpox is considered a universal childhood infection in temperate parts of the world with >90% seropositivity by adolescence
The following day the rash was very typical of chickenpox with some crusting of older lesions. She felt weak but remained apyrexial and had no chest symptoms or signs. Serum collected on this second day of clinical review was positive for Varicella zoster virus (VZV) IgM antibody by enzyme immunoassay (EIA) (Trinity biotech) and negative for VZV IgG (EIA) consistent with early chickenpox infection
The absence of VZV-specific IgG antibody early in a chickenpox-like illness can be taken as evidence of primary VZV infection once subsequent seroconversion to IgG positive is demonstrated

Summary

Introduction

Chickenpox is considered a universal childhood infection in temperate parts of the world with >90% seropositivity by adolescence. Chickenpox in older people is uncommon but life-threatening and could be prevented by wider use of varicella vaccine than is currently recommended in the UK.

Results

Conclusion