Recent Varicella Zoster Virus Infection Research Articles

Varicella zoster virus infections increase the risk of disease flares in patients with SLE: a matched cohort study

ObjectiveTo explore whether varicella zoster virus (VZV) infection could increase the risk of disease flares in patients with SLE.MethodsPatients who had VZV reactivations between January 2013 and April 2018 were...

Interferon-γ release assay: A simple method for detection of varicella-zoster virus-specific cell-mediated immunity

Herpes zoster is closely related to decreased varicella-zoster virus (VZV)-specific cell-mediated immunity. We validated a new assay for measuring VZV-specific immunity. We cultured the whole blood of healthy subjects with live attenuated VZV vaccine. Cultured supernatants were harvested at 24-h intervals and assayed for interferon-gamma (IFN-γ) by an enzyme-linked immunosorbent assay (ELISA). The 48-h culture was suitable for estimating IFN-γ release. IFN-γ production was stable after standing for at least 4 h at room temperature. IFN-γ production was observed in whole blood from subjects with recent VZV infection, but not in blood from subjects naïve to the virus. Thus, the IFN-γ release assay may be useful as a new surrogate assay for measuring VZV-specific immunity.

Clinical and radiological features of childhood cerebral infarction following varicella zoster virus infection

The aim of the study was to describe the clinical and radiological features of childhood post-varicella cerebral infarction (PVCI). A retrospective review was undertaken of children with arterial ischaemic stroke (AIS) who had experienced varicella zoster virus (VZV) infection within the preceding year. Twenty-four children (15 males, nine females; age range at time of VZV infection 2mo-6y) were identified, with a median of 4 months between VZV and AIS (range 1wk-12mo). All had infarction in the middle cerebral artery (MCA) territory and abnormalities of the M1 segment; arteriopathy affected other arteries in 10 children. After a median of 27 months, six patients had recurrent transient ischaemic attacks (TIA), with new infarcts in two of 22 children on re-imaging. Arterial disease improved in 11 children, was stable in four, and progressed in seven (of whom four had recurrent TIA and two had re-infarction). PVCI affects young, previously healthy children within a few months of VZV infection and is characterized by MCA territory infarction and proximal MCA disease. One quarter of patients have recurrence, usually, but not inevitably, associated with progressive arteriopathy. Treatable co-existing AIS risk factors should always be excluded. A more comprehensive diagnostic evaluation should be considered in children with AIS who do not fit the clinical and radiological profile outlined, even where there is a history of recent VZV infection.

Biobrane ® in bairns with burns and bugs?

1. Summary The physiological and immunological impact of burns in children is well described. Biobrane 1 is a commonly used product in the treatment of superficial burns in children and has many attractive properties, warranting its use. Unfortunately, bacterial super-infections and serious sepsis due to Staphylococcus aureus and group A beta haemolytic are ever increasing complications in the patients under the age of five who have been exposed to Varicella Zoster Viruses. Biobrane 1 , despite its healing properties, is a foreign substance and we ask the question whether recent or current chickenpox is a relative contraindication to its use. Burns, due to their very nature, pose a challenging problem with regard to bacterial super-infection, especially in very young children. In recent years, the acute management of scalds and superficial burns in young patients (bairns: Scottish term for children) has changed. Current practice involves thorough cleansing of the wound, usually under general anaesthesia, and application of Biobrane 1 (Bertek Pharmaceuticals Inc., Morgantown, West Virginia, USA). It is marketed on the premise that the highly purified peptides from porcine dermal collagen, bonded to a nylon and silicone semipermeable membrane, minimises bacterial proliferation by minimising dead space. Previously, partial thickness burns in children involved painful daily bathing, washing and cleansing of the burn wound followed by topical application of antimicrobial creams [1]. Biobrane 1 diminishes the need for daily wound dressing which increases exposure of the wound, has an analgesic effect and, therefore, minimises the use of painkillers while providing a suitable environment for re-epithelialisation. One randomised trial showed that there were also fewer infections when compared with 1% silver sulphadiazine [1]. Since changing our protocol for the management of paediatric burns, two cases have come to light which we feel warrant further investigation concerning its use in children with burns who also have a current or recent Varicella Zoster Virus infection or who may have been exposed to it. Bacterial super-infections are one of the most common complications following Varicella Zoster Virus infection. Although other complications such as Reyes syndrome, encephalitis, pneumonia, hepatitis, glomerulonephritis, cerebellar ataxia, arthritis and purpura fulminans are also recognised, skin and soft tissue infection are still the most frequent manifestations of the virus within healthy children [2,3]. These complicated infections are more common in children below the age of five and are largely due to S. aureus (SA) and group A beta haemolytic streptococcus

A case of cytomegalovirus mononucleosis associated with pleural effusion

A 5 year old boy had a spiky fever accompanied by a mild pharyngitis, cervical lymphadenopathy and hepatosplenomegaly. Laboratory findings revealed leukocytosis with 26% atypical lymphocytes, and liver dysfunction. A chest X-ray showed pneumonia and a considerable amount of pleural effusion. Serum antibody titers for cytomegalovirus (CMV) were elevated significantly and CMV-DNA (polymerase chain reaction) was detected in the pleural effusion. Only 13 cases of pleural effusion associated with infectious mononucleosis have been reported previously in the literature, but there was no documentation that proved CMV infection. The case reported here suggests that the pleural effusion was caused by the infiltration of mononuclear cells to the pleura as a result of systemic inflammation, and the possible alternative of host immune response against CMV was related to recent Varicella zoster virus infection.

Single high ELISA values suggest recent varicella-zoster virus infection

Sera from 383 healthy adults were examined by an ELISA procedure for varicellazoster virus (VZV) antibody and only one specimen was found with a value greater than 0.84. Clinical information from the next 51 individuals whose serum ELISA values exceeded 0.84 was evaluated. Sufficient clinical data was obtained for 42 of the cases. At least 39 of the 42 cases had laboratory evidence or clinical suspicion of recent VZV infection. Single ELISA values greater than 0.84, when they occur, suggest recent VZV infection.

A Practical Method for Preparation of Varicella-Zoster Immune Globulin

Outdated blood from blood banks in Massachusetts was screened for complement-fixing antibody to varicella-zoster virus (VZV). Approximately 15% of the plasma units had a titer greater than or equal to 16, and one-half of these had a titer of greater than or equal to 32. Plasma units with titers of CF antibody to VZV of greater than or equal to 16 were pooled. This pool had a CF antibody titer of 32 and a titer of fluorescent antibody of 64. Varicella-zoster immune globulin was prepared from the selected plasma pool by alcohol fractionation and analyzed for VZV-specific antibody. Varicella-zoster immune globulin had a fluorescent antibody titer of 2,048 and a neutralizing antibody titer of 1,024. This antibody concentration is equivalent to that in preparations of zoster immune globulin made from plasma of donors recovering from recent VZV infection.