Reinfection of Varicella zoster in a vaccinated adult

Abstract

Chickenpox is an acute, highly infectious disease caused by Varicella-zoster virus. Approximately 90% of cases occur in children and lesser in adults. As per literature 55 percent of Varicella-associated deaths occur among adults.1 One attack gives durable immunity and second attacks are rare.1 People who already had chickenpox and get it again – is known as “reinfection”.2 If this happens, a milder form of the illness usually occurs, with fewer symptoms. Diagnosis is usually made on clinical grounds, based on rash characteristics and on epidemiologic features, such as contact with other Varicella cases.2 Laboratory tests are available to confirm diagnosis of Varicella, assess immune status, and genotype of VZV strains. Varicella vaccine (OKA strain) is available in India. However, reports of Varicella outbreaks in highly immunized groups in Japan and USA have made effectiveness of Varicella vaccine questionable. We present a case of Varicella in a young adult patient who gave history of chickenpox in childhood and was previously immunized with Varicella vaccine, yet manifested a full blown disease.